Shah Ashok K, Yadav Birendra K, Shah Amrendra K, Suri Arpita, Deo Saurabh K
Department of Biochemistry, Faculty of Medicine and Health Sciences, Adesh Medical College and Hospital, Shahbad, Haryana, India.
Department of Biochemistry, Faculty of Medicine and Health Sciences, Banas Medical College and Research Institute, Palanpur, Gujrat, India.
J Lab Physicians. 2022 Jul 26;15(1):31-37. doi: 10.1055/s-0042-1750066. eCollection 2023 Mar.
Accumulating evidence suggests increased cardiovascular risk in women with polycystic ovarian syndrome (PCOS) due to a cluster of factors, such as obesity, lipid abnormalities, impaired glucose tolerance (IGT), and hypertension. Markers such as high-sensitivity C-reactive protein (hs-CRP) and plasminogen activator inhibitor-1 (PAI-1) can provide an adjunctive method for the assessment of cardiovascular risk and can indicate future coronary heart diseases in women with lean PCOS. In this prospective case-control study, women clinically diagnosed with PCOS ( = 25) with normal body mass index (BMI) and age and BMI-matched healthy controls ( = 75) were enrolled. The quantitative data were expressed as mean ± standard deviation (SD). Unpaired Student's -test was used to compare the values (PCOS vs. controls) and Pearson's correlation coefficient was used to elucidate the relationship between the variables. The mean level of fasting blood sugar, serum total cholesterol, low-density lipoprotein (LDL), thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), hs-CRP, and PAI-1 were significantly increased in PCOS patients ( < 0.000) compared with the control patients. Of the reported cases, 54.16% had hs-CRP levels greater than 3 mg/L. When the cases were further divided into normal ( = 20) and IGT ( = 5), hs-CRP values were significantly higher in IGT group as compared with normal glucose tolerance (NGT) group. On bivariate correlation analysis, hs-CRP had significant correlations with PAI-1 ( = 0.41, < 0.000), waist-to-hip ratio (WHR; = 0.23, = 0.02), fasting blood sugar (FBS; = 0.26, = 0.009), LDL ( = 0.20, = 0.03), TSH ( = 0.42, < 0.000), and LH-to-FSH ratio ( = 0.24, = 0.01). Women with lean phenotype of PCOS suffer from many metabolic abnormalities such as abdominal obesity, dyslipidemia, hyperandrogenemia, and insulin resistance. The findings of the study suggest that environment of ongoing low-grade inflammation due to infiltration further exacerbates the metabolic derangements and cardiovascular risk. The investigations as hs-CRP and PAI-1 will help in early identification, diagnosis, and management of cardiovascular diseases associated with lean type of PCOS. These markers can prove to be beneficial in monitoring any unfavorable changes in cardiometabolic profile of such patients.
越来越多的证据表明，多囊卵巢综合征（PCOS）女性由于肥胖、脂质异常、糖耐量受损（IGT）和高血压等一系列因素，心血管风险增加。高敏C反应蛋白（hs-CRP）和纤溶酶原激活物抑制剂-1（PAI-1）等标志物可为评估心血管风险提供辅助方法，并可提示瘦型PCOS女性未来患冠心病的风险。
在这项前瞻性病例对照研究中，纳入了临床诊断为PCOS（n = 25）且体重指数（BMI）和年龄正常、BMI匹配的健康对照者（n = 75）。定量数据以平均值±标准差（SD）表示。采用非配对学生t检验比较数值（PCOS组与对照组），并使用Pearson相关系数阐明变量之间的关系。
与对照患者相比，PCOS患者的空腹血糖、血清总胆固醇、低密度脂蛋白（LDL）、促甲状腺激素（TSH）、促卵泡激素（FSH）、促黄体生成素（LH）、催乳素（PRL）、hs-CRP和PAI-1的平均水平显著升高（P < 0.000）。在报告的病例中，54.16%的hs-CRP水平大于3 mg/L。当病例进一步分为正常（n = 20）和IGT（n = 5）两组时，IGT组的hs-CRP值显著高于正常糖耐量（NGT）组。在双变量相关分析中，hs-CRP与PAI-1（r = 0.41，P < 0.000）、腰臀比（WHR；r = 0.23，P = 0.02）、空腹血糖（FBS；r = 0.26，P = 0.009）、LDL（r = 0.20，P = 0.03）、TSH（r = 0.42，P < 0.000）和LH与FSH比值（r = 0.24，P = 0.01）显著相关。
瘦型PCOS女性存在许多代谢异常，如腹部肥胖、血脂异常、高雄激素血症和胰岛素抵抗。研究结果表明，由于浸润导致的持续低度炎症环境进一步加剧了代谢紊乱和心血管风险。hs-CRP和PAI-1等检测有助于早期识别、诊断和管理与瘦型PCOS相关的心血管疾病。这些标志物在监测此类患者心脏代谢状况的任何不利变化方面可能是有益的。
