多囊卵巢综合征(PCOS)炎症标志物的系统评价及病例对照研究中白细胞介素-6(IL-6)的荟萃分析。

A Systematic Review of Inflammatory Markers in Polycystic Ovary Syndrome (PCOS) and Meta-Analysis of Interleukin-6 (IL-6) in Case-Control Studies.

作者信息

Bansal Bhavit, Thazhuthadath Kishore Avelyn, Kathiresan Sasikala, Farook Ghachi Arzina, Pradhan Swetapadma, Paul Sheuli, Chaturvedi Khyati, Singh Mukul, Patil Sauvit, Johnson Lalitha Soumya, V P Akshay, Ns Delna, Pillai Ajita

机构信息

Research, Central Council for Research in Yoga and Naturopathy, Delhi, India.

Plastic and Reconstructive Surgery, Jubilee Mission Medical College and Research Institute, Thrissur, IND.

出版信息

Cureus. 2025 Apr 16;17(4):e82350. doi: 10.7759/cureus.82350. eCollection 2025 Apr.

Abstract

Chronic low-grade inflammation plays a crucial role in the pathophysiology of polycystic ovary syndrome (PCOS). This systematic review aims to synthesize the recent evidence on key inflammatory markers in PCOS and the role of IL-6. A comprehensive literature search was conducted using the PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Studies published between 2014 and 2024 were screened based on predefined eligibility criteria. Both observational and interventional studies that reported levels of inflammatory markers in patients with polycystic ovary syndrome (PCOS) were included. Data were systematically extracted, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS) for observational studies, the Cochrane Risk of Bias tool for randomized controlled trials (RCTs), and the ROBINS-1 tool for non-randomized controlled trials. A statistical synthesis of IL-6 levels was performed for the meta-analysis using a random-effects model in R. A total of 44 studies met the inclusion criteria for qualitative analysis and identified 94 biomarkers. The most commonly used biomarkers across the majority of studies, listed in descending order, are as follows: high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), CRP, adiponectin, IL-18, vascular endothelial growth factor (VEGF), IL-8, IL-1β, sex hormone binding globulin (SHBG), leptin, and vascular cell adhesion protein 1 (VCAM-1). Additionally, four case-control studies conducted in four countries (Taiwan, Russia, Spain, and Turkey) were included in the quantitative analysis, which involved 689 participants (PCOS group: n = 365; Control group: n = 324). The pooled mean difference (MD), calculated using the random-effects model, was 0.72 (0.47; 0.98) (p < 0.0001), indicating a significant increase in IL-6 levels among PCOS patients compared to the control group. The funnel plot exhibited slight asymmetry, suggesting publication bias, where smaller studies with negative or neutral results may be absent. The adjusted effect size after trim and fill analysis remained significant, indicating that publication bias is unlikely to affect the conclusions substantially. Chronic low-grade inflammation plays a crucial role in PCOS, and IL-6 levels in women with PCOS were elevated. Potential markers that can be investigated to assess inflammatory status in PCOS include hs-CRP, TNFα, CRP, adiponectin, IL-18, VEGF, IL-8, iIL-1β, SHBG, leptin, and VCAM-1.

摘要

慢性低度炎症在多囊卵巢综合征(PCOS)的病理生理学中起着至关重要的作用。本系统评价旨在综合近期关于PCOS关键炎症标志物及白细胞介素-6(IL-6)作用的证据。使用PubMed、科学网、考克兰图书馆和谷歌学术数据库进行了全面的文献检索。根据预先确定的纳入标准,筛选了2014年至2024年发表的研究。纳入了报告多囊卵巢综合征(PCOS)患者炎症标志物水平的观察性和干预性研究。系统地提取数据,并使用纽卡斯尔-渥太华量表(NOS)评估观察性研究的质量,使用考克兰偏倚风险工具评估随机对照试验(RCT)的质量,使用ROBINS-1工具评估非随机对照试验的质量。在R中使用随机效应模型对IL-6水平进行统计综合以进行荟萃分析。共有44项研究符合定性分析的纳入标准,并确定了94种生物标志物。大多数研究中最常用的生物标志物,按降序排列如下:高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、CRP、脂联素、IL-18、血管内皮生长因子(VEGF)、IL-8、IL-1β、性激素结合球蛋白(SHBG)、瘦素和血管细胞黏附蛋白1(VCAM-1)。此外,在四个国家(台湾、俄罗斯、西班牙和土耳其)进行的四项病例对照研究纳入了定量分析,涉及689名参与者(PCOS组:n = 365;对照组:n = 324)。使用随机效应模型计算的合并平均差(MD)为0.72(0.47;0.98)(p < 0.0001),表明与对照组相比,PCOS患者的IL-6水平显著升高。漏斗图显示出轻微不对称,提示存在发表偏倚,可能缺少结果为阴性或中性的小型研究。修剪和填充分析后的调整效应大小仍然显著,表明发表偏倚不太可能对结论产生实质性影响。慢性低度炎症在PCOS中起关键作用,PCOS女性的IL-6水平升高。可用于评估PCOS炎症状态的潜在标志物包括hs-CRP、TNFα、CRP、脂联素、IL-18 VEGF、IL-8、IL-1β、SHBG、瘦素和VCAM-1。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11e6/12082375/1c5e1a027f49/cureus-0017-00000082350-i01.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索