Research On The Association Of APN, IL-6 And CRP In PCOS

Polycystic ovarian syndrome (PCOS) is an endocrine syndrome with multiple clinical characters caused by dysfunctions of nerve-endocrine-metabolism system, mainly hypothalam-pituitary-ovarian axis. Its key features are hyperandrogenemia, chronic anovulation or oligovulation, menstrual disorder and polycystic ovary in pathologic changes. The frequency of PCOS is 16%~21%. It is a main reason leading to anovulation sterility in sexual maturity women and disturbs their reproductive health severely.Investigators have paid considerable attentions on PCOS, but so far, its etiology and pathogenesis have not been identified. Now it is believed that insulin resistance (IR) and hyperinsulinemia (HI) is the important pathological and physiological characters of PCOS patients. In the sexual maturity they promote the reproductive endocrine and metabolic disorders of PCOS patients. At a future date they have an association with metabolic syndrome (MS) easily suffered by PCOS patients and impair their health.Recently it was found that chronic subclinical inflammation plays an important role in metabolic syndrome. Obesity can be looked as a chronic subclinical inflammation status. It refers to the inflammation status below thelevel of acute infection and autoimmune diseases. Involved factors have a close relation with insulin resistance. Among them adiponectin (APN) is exclusively decreased substance in insulin resistance yet. It is a protective factor against inflammation, insulin resistance and atherosclerosis. Interleukin 6 (IL-6) is one weighty member of the family of inflammatory cytokines. It plays a role in chronic subclinical inflammation and stimulates hepatic cells to secret C-reactive protein (CRP). The latter is also one of important members in defence system and a sensitive index to chronic subclinical inflammation. APN, IL-6 and CRP all contribute to insulin resistance. Few reports about these factors in PCOS patients are found.ObjectiveTo detect adiponectin, CRP and IL-6 in PCOS patients, analyze the relation among chronic subclinical inflammation, PCOS and insulin resistance, study the role of chronic subclinical inflammation on the pathogenesis of PCOS, and exploit a new approach to cure PCOS patients.Materials and Methods1. Eighty enrolled subjects were from department of reproductive medicine, the Third Affiliated Hospital of ZhengZhou University between December 2003 and October 2004. PCOS patients were diagnosed according to the international criterion.They were divided into four groups: ?non-obese control group(n=21); (Dobese control group(n=ll); ?non-obese PCOS group(n=28);@obese PCOS group(n=20). All subjects did not use hormone in three months recently and were excluded from other medical complications and inflammation.2. We recorded the clinical characteristics of all subjects and detected adiponectin, CRP by an enzyme-linked immunosorbent assay (ELISA) and IL-6 by radioimmunity assay (RIA) in all samples.3. All data were expressed with x ± s. Statistics analysis was performed bySPSS 11.5 software. A P value <0.05 was considered statistically significant. Results1. There were no significant differences in these four groups in age (all P >0.05). So the differences in age do not influence the detection;2. LFL LH/FSH and T were all significantly increased in non-obese PCOS group and obese PCOS group (P < 0.05). Especially in non-obese PCOS group , LH and LH/FSH were significantly increased compared with obese PCOS group (P < 0.05);3. BMK WHR and HOMA-IR were significantly higher in obese control group and obese PCOS group than in non-obese control group (P < 0.05). In non-obese PCOS group HOMA-IR was significantly higher than in non-obese control group and significantly lower than in obese PCOS group (P < 0.05);4. Compared with non-obese control group, adiponectin was all significantly decreased in other three groups (all P < 0.05). In obese control group CRP was significantly increased than in non-obese control group (P < 0.05); In obese PCOS group IL-6 and CRP were significantly increased than in non-obese control group (P < 0.05);5. BMK WHR and T were all significantly positively correlative with HOMA-IR. BMI was significantly positively correlative with WHR and no correlative with T;6. Adiponectin was significantly negatively correlative with BMI ^ HOMA-IR and T (P < 0.05). After BMI controlled, adiponectin was still significantly negatively correlative with HOMA-IR (P < 0.05). After HOMA-IR controlled, there was no correlation between adiponectin and T (P >0.05);7. CRP and IL-6 were both significantly positively correlative with HOMA-IR {P < 0.05);8. Adiponectin was significantly negatively correlative with IL-6 and CRP (P < 0.05); IL-6 was significantly positively correlative with CRP.Conclusions1. PCOS may be a chronic subclinical inflammation status. Inflammation inhibitor may be decreased firstly and followed by increased inflammation promoters. They lead to immune damage together. They have a close relationwith IR, and consequently may contribute to the clinical characteristics of PCOS at the present and a future date.2. Obesity also may be at the chronic subclinical inflammation status and aggravate the abnormal of PCOS patients.