Shrivastava Chandrashekhar, Sagiraju Praharshitha, Rajbhar Sarita, Bansal Ruchi, Kodumuri Loukya
Obstetrics and Gynaecology, All India Institute of Medical Sciences, Raipur, IND.
Cureus. 2024 Dec 6;16(12):e75224. doi: 10.7759/cureus.75224. eCollection 2024 Dec.
Polycystic ovarian syndrome (PCOS) is a heterogeneous endocrinal physiological disorder characterized by chronic oligo-ovulation or an-ovulation, hyperandrogenism, and polycystic morphology in ovaries on transvaginal or abdominal ultrasound. Hyperandrogenism and insulin resistance are already well-documented pathophysiological mechanisms in PCOS. Besides this, autoimmunity has been hypothesized in its pathogenesis. Studies regarding the association between PCOS and autoimmunity have yielded contradictory results. There is scarce data regarding the prevalence of autoimmune markers among PCOS women from India. Therefore, this study was done to find the relationship between antinuclear antibody (ANA) positivity and PCOS.
To determine the prevalence of ANA positivity in women with PCOS and to see the association of Serum antinuclear antibodies ANA with clinical, hormonal, and biochemical parameters of PCOS.
This cross-sectional study was done in the Obstetrics and Gynaecology department, All India Institute of Medical Sciences (AIIMS), Raipur, for a period of 18 months. The study population consisted of a total of 140 women aged 18-35 years and were equally divided into the 'PCOS 'and 'Control' groups. The 'PCOS' group consisted of 70 women with a diagnosis of PCOS as per revised 2003 Rotterdam criteria. The 'Control' group consisted of 70 healthy women with no PCOS. History-taking and clinical examinations were done on all women. History taking included medical, surgical, menstrual, and any other relevant history. Clinical examinations included general physical examination and anthropometry like height, weight, build, body mass index (BMI), waist-to-hip ratio (WHI), etc. We did Hirsutism scoring with a modified Ferriman-Gallaway scoring system. Blood samples were taken for ANA estimation and biochemical and hormonal essay.
The prevalence of ANA positivity in PCOS and the control group was 10% and 4.3%, respectively (not statistically significant). There was no significant association found between ANA positivity and PCOS (p-value=-0.326). There was no significant association found between ANA positivity and modified Ferriman-Gallwey scores, serum testosterone levels and HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) levels.
There was no statistically significant association between ANA positivity and PCOS, but we found an increased prevalence of ANA in the PCOS group as compared to the non-PCOS group.Though our study did not find a significant association between ANA positivity and modified Ferriman Gallwey score, serum testosterone levels, and HOMA-IR levels, we found a significant increase in anti-TPO levels in ANA-positive PCOS women. We conclude that the increased prevalence of ANA positivity in PCOS could be an indicator of autoimmunity.
多囊卵巢综合征（PCOS）是一种异质性内分泌生理紊乱疾病，其特征为慢性少排卵或无排卵、高雄激素血症，以及经阴道或腹部超声检查显示卵巢呈多囊形态。高雄激素血症和胰岛素抵抗是PCOS中已得到充分记录的病理生理机制。除此之外，其发病机制中还存在自身免疫的假说。关于PCOS与自身免疫之间关联的研究结果相互矛盾。来自印度的PCOS女性自身免疫标志物患病率的数据很少。因此，本研究旨在探讨抗核抗体（ANA）阳性与PCOS之间的关系。
确定PCOS女性中ANA阳性的患病率，并观察血清抗核抗体ANA与PCOS的临床、激素和生化参数之间的关联。
本横断面研究在赖布尔全印度医学科学研究所（AIIMS）妇产科进行，为期18个月。研究人群共有140名年龄在18 - 35岁之间的女性，她们被平均分为“PCOS组”和“对照组”。“PCOS组”由70名根据2003年修订的鹿特丹标准诊断为PCOS的女性组成。“对照组”由70名无PCOS的健康女性组成。对所有女性进行了病史采集和临床检查。病史采集包括医疗、手术、月经及任何其他相关病史。临床检查包括一般体格检查和人体测量，如身高、体重、体型、体重指数（BMI）、腰臀比（WHR）等。我们使用改良的费里曼 - 加洛威评分系统进行多毛症评分。采集血样进行ANA测定以及生化和激素检测。
PCOS组和对照组中ANA阳性的患病率分别为10%和4.3%（无统计学意义）。未发现ANA阳性与PCOS之间存在显著关联（p值 = -0.326）。未发现ANA阳性与改良费里曼 - 加洛威评分、血清睾酮水平和胰岛素抵抗稳态模型评估（HOMA - IR）水平之间存在显著关联。
ANA阳性与PCOS之间无统计学意义上的显著关联，但我们发现PCOS组中ANA的患病率高于非PCOS组。尽管我们的研究未发现ANA阳性与改良费里曼 - 加洛威评分、血清睾酮水平和HOMA - IR水平之间存在显著关联，但我们发现ANA阳性的PCOS女性抗甲状腺过氧化物酶（anti - TPO）水平显著升高。我们得出结论，PCOS中ANA阳性患病率的增加可能是自身免疫的一个指标。
