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Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis.

Abstract

OBJECTIVE

To perform a review and metaanalysis of the studies evaluating the status of serum inflammatory markers in women with polycystic ovary syndrome (PCOS).

DESIGN

Systematic review and metaanalysis of articles published in English before January 2010 and identified using the PubMed search engine.

SETTING

Academic hospital.

PATIENT(S)

Women with PCOS and appropriate controls.

INTERVENTION(S)

Measurement of serum concentrations of inflammatory markers by high-sensitivity techniques.

MAIN OUTCOME MEASURE(S)

Metaanalyses of the mean difference in serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations among patients with PCOS and appropriate controls, applying random-effects models to limit interstudy variability, and using appropriate estimates of evidence dissemination bias.

RESULT(S)

Metaanalysis of the 31 articles meeting inclusion criteria showed that circulating CRP was 96% higher in women with PCOS compared to controls (95% confidence interval, 71%-122%; z = 7.32) without evidence of dissemination bias (Egger's regression intercept, 0.45; 95% confidence interval, -2.30 to 3.21). These findings persisted after excluding five studies with mismatches in body mass, frequency of obesity, or both, between women with PCOS and controls. Metaanalyses involving 10 studies of IL-6, and nine studies of TNF-α revealed no statistically significant differences between PCOS and controls.

CONCLUSION(S)

Women with PCOS exhibit an elevation in circulating CRP that is independent of obesity. This finding corroborates existing molecular evidence of the chronic low-grade inflammation that may underpin the pathogenesis of this disorder.

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  • Authors+Show Affiliations

    ,

    Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Madrid, Spain. hescobarm.hrc@salud.madrid.org

    ,

    Source

    Fertility and sterility 95:3 2011 Mar 01 pg 1048-58.e1-2

    MeSH

    Biomarkers
    Female
    Glucose Intolerance
    Humans
    Inflammation
    Obesity
    Polycystic Ovary Syndrome

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    21168133

    Citation

    Escobar-Morreale, Héctor F., et al. "Circulating Inflammatory Markers in Polycystic Ovary Syndrome: a Systematic Review and Metaanalysis." Fertility and Sterility, vol. 95, no. 3, 2011, pp. 1048-58.e1-2.
    Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril. 2011;95(3):1048-58.e1-2.
    Escobar-Morreale, H. F., Luque-Ramírez, M., & González, F. (2011). Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertility and Sterility, 95(3), pp. 1048-58.e1-2. doi:10.1016/j.fertnstert.2010.11.036.
    Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating Inflammatory Markers in Polycystic Ovary Syndrome: a Systematic Review and Metaanalysis. Fertil Steril. 2011 Mar 1;95(3):1048-58.e1-2. PubMed PMID: 21168133.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. AU - Escobar-Morreale,Héctor F, AU - Luque-Ramírez,Manuel, AU - González,Frank, Y1 - 2010/12/17/ PY - 2010/08/02/received PY - 2010/10/15/revised PY - 2010/11/15/accepted PY - 2010/12/21/entrez PY - 2010/12/21/pubmed PY - 2011/4/26/medline SP - 1048-58.e1-2 JF - Fertility and sterility JO - Fertil. Steril. VL - 95 IS - 3 N2 - OBJECTIVE: To perform a review and metaanalysis of the studies evaluating the status of serum inflammatory markers in women with polycystic ovary syndrome (PCOS). DESIGN: Systematic review and metaanalysis of articles published in English before January 2010 and identified using the PubMed search engine. SETTING: Academic hospital. PATIENT(S): Women with PCOS and appropriate controls. INTERVENTION(S): Measurement of serum concentrations of inflammatory markers by high-sensitivity techniques. MAIN OUTCOME MEASURE(S): Metaanalyses of the mean difference in serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations among patients with PCOS and appropriate controls, applying random-effects models to limit interstudy variability, and using appropriate estimates of evidence dissemination bias. RESULT(S): Metaanalysis of the 31 articles meeting inclusion criteria showed that circulating CRP was 96% higher in women with PCOS compared to controls (95% confidence interval, 71%-122%; z = 7.32) without evidence of dissemination bias (Egger's regression intercept, 0.45; 95% confidence interval, -2.30 to 3.21). These findings persisted after excluding five studies with mismatches in body mass, frequency of obesity, or both, between women with PCOS and controls. Metaanalyses involving 10 studies of IL-6, and nine studies of TNF-α revealed no statistically significant differences between PCOS and controls. CONCLUSION(S): Women with PCOS exhibit an elevation in circulating CRP that is independent of obesity. This finding corroborates existing molecular evidence of the chronic low-grade inflammation that may underpin the pathogenesis of this disorder. SN - 1556-5653 UR - https://www.unboundmedicine.com/medline/citation/21168133/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0015-0282(10)02838-4 DB - PRIME DP - Unbound Medicine ER -