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The Increase of Leukocytes as a New Putative Marker of Low-Grade Chronic Inflammation and Early Cardiovascular Risk in Polycystic Ovary Syndrome

Summary and Commentary by Jeremy M. Groll, M.D.
Edited by Charles C. Coddington, III, M.D.

Capsule: PCOS patients were studied as to markers for chronic inflammation and found to have increased white blood cell counts (WBC) and C-reactive protein (CRP) concentrations compared to controls.

Background: PCOS is a common disorder that has been associated with long-term health risks such as atherosclerosis and cardiovascular disease. Often, PCOS is accompanied by insulin resistance. Chronic inflammation has been linked to insulin resistance syndrome and it has been reported that PCOS patients have elevated CRP values compared to controls.

Objective: To evaluate PCOS patients to confirm elevation in CRP and demonstrate changes in WBC.

Methods: Subjects included 150 PCOS patients, diagnosed according to NIH criteria, and 150 control women matched for age and body mass index (BMI). Laboratory values and menstrual cycle status were confirmed be diary and hormone levels.

Results: In the PCOS group, hormones (LH, 17-OHP, T, A, E2, DHEAS, SHBG, insulin) and insulin sensitivity, as reflected in the homeostasis model assessment (HOMA index), were significantly different from controls. WBC count was higher in PCOS than in controls (p<0.0001) even though there was no evidence of leukocytosis. PCOS had more lymphocytes and monocytes and higher CRP levels than controls. However, regression analysis indicated these hormone levels were not predictive of leukocycte counts. HOMA was predictive of PCOS.

Comment: PCOS patients appear to have increased markers of inflammation (CRP and WBC) in their serum. This finding might be related to insulin resistance as demonstrated by the HOMA and may lead to more significant cardiovascular risk, than age and BMI-matched controls. Further study is warranted. -- Jeremy M. Groll, M.D.

Reference: Francesco Orio, Jr., Stefano Palomba, Teresa Cascella, Sebastiano Di Biase, Francesco Manguso, Libuse Tauchmanovà, Luciano G. Nardo, Donato Labella, Silvia Savastano, Tiziana Russo, Fulvio Zullo, Annamaria Colao and Gaetano Lombardi. JCEM 90:2-5, 2005.

Source: http://www.asrm.org/Professionals/journal_highlights/Jan2005.html

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