Advertisement

Hormones

, Volume 14, Issue 2, pp 251–257 | Cite as

Obesity, but not polycystic ovary syndrome, affects circulating markers of low-grade inflammation in young women without major cardiovascular risk factors

  • Cristiano Roberto Grimaldi Barcellos
  • Michelle Patrocínio Rocha
  • Sylvia Asaka Yamashita Hayashida
  • Wagner Silva Dantas
  • Viviane dos Reis Vieira Yance
  • José Antonio Miguel Marcondes
Research paper

Abstract

OBJECTIVE

The aim of this study was to evaluate the influence of polycystic ovary syndrome (PCOS) and obesity on circulating markers of low-grade inflammation—tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) and high sensitive C-reactive protein (hsCRP)—in young women without major cardiovascular (CV) risk factors (diabetes, dyslipidemia and arterial hypertension).

DESIGN

Twenty-five young women with PCOS and 23 eumenorrheic women without major CV risk factors and matched for body mass index (BMI) were studied. They were subdivided according to BMI and PCOS status and comparisons were made between the PCOS and Control groups, regardless of BMI, and between the Obese and Lean groups, regardless of the presence of PCOS.

RESULTS

Levels of TNF-α, IL-6 and hsCRP were similar between the PCOS group and the Control group (2.1 vs 1.9 pg/ml, p=0.397, 3.8 vs 5.7 pg/ml, p=0.805 and 0.9 vs 0.5 ng/ml, p=0.361, respectively). Levels of TNF-α were similar between the obese group and the lean group (2.1 vs 1.9 pg/ml, p=0.444). Levels of IL-6 and hsCRP were higher in the obese group than in the lean group (8.7 vs 2.0, p <0.001 and 1.4 vs 0.2 ng/ml, p <0.001, respectively).

CONCLUSION

Obesity, but not polycystic ovary syndrome, affects circulating markers of low-grade inflammation in young women without major CV risk factors.

Key words

CV risk Circulating markers of low-grade inflammation Obesity PCOS 

References

  1. 1.
    Toulis KA, Goulis DG, Mintziori G, et al, 2011 Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome. Hum Reprod Update 17: 741–760.CrossRefGoogle Scholar
  2. 2.
    Escobar-Morreale HF, Luque-Ramírez M, González F, 2011 Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril 95: 1048–1058.CrossRefGoogle Scholar
  3. 3.
    Diamanti-Kandarakis E, Paterakis T, Kandarakis HA, 2006 Indices of low-grade inflammation in polycystic ovary syndrome. Ann N Y Acad Sci 1092: 175–186.CrossRefGoogle Scholar
  4. 4.
    Escobar-Morreale HF, Calvo RM, Sancho J, San Millan JL, 2001 TNF-alpha and hyperandrogenism: a clinical, biochemical, and molecular genetic study. J Clin Endocrinol Metab 86: 3761–3767.PubMedGoogle Scholar
  5. 5.
    Peral B, San Millan JL, Castello R, Moghetti P, Escobar-Morreale HF, 2002 The methionine 196 arginine polymorphism in exon 6 of the TNF receptor 2 gene (TNFRSF1B) is associated with the polycystic ovary syndrome and hyperandrogenism. J Clin Endocrinol Metab 87: 3977–3983.CrossRefGoogle Scholar
  6. 6.
    Villuendas G, San Millan JL, Sancho J, Escobar-Morreale HF, 2002 The -597 G-&gt;A and -174 G-&gt;C polymorphisms in the promoter of the IL-6 gene are associated with hyperandrogenism. J Clin Endocrinol Metab 87: 1134–1141.PubMedGoogle Scholar
  7. 7.
    Erdogan M, Karadeniz M, Berdeli A, Alper G, Caglayan O, Yilmaz C, 2008 The relationship of the interleukin-6 -174 G&gt;C gene polymorphism with oxidative stress markers in Turkish polycystic ovary syndrome patients. J Endocrinol Invest 31: 624–629.CrossRefGoogle Scholar
  8. 8.
    Escobar-Morreale HF, Calvo RM, Villuendas G, Sancho J, San Millan JL, 2003 Association of polymorphisms in the interleukin 6 receptor complex with obesity and hyperandrogenism. Obes Res 11: 987–996.CrossRefGoogle Scholar
  9. 9.
    Tracey KJ, Cerami A, 1993 Tumor necrosis factor, other cytokines and disease, 1993 Annu Rev Cell Biol 9: 317–343.CrossRefGoogle Scholar
  10. 10.
    Miller AM, McInnes IB, 2011 Cytokines as therapeutic targets to reduce cardiovascular risk in chronic inflammation. Curr Pharm Des 17: 1–8.CrossRefGoogle Scholar
  11. 11.
    Tedgui A, Mallat Z, 2006 Cytokines in atherosclerosis: pathogenic and regulatory pathways. Physiol Rev 86: 515–581.CrossRefGoogle Scholar
  12. 12.
    Ridker PM, Rifai N, Stampfer MJ, Hennekens CH, 2000 Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation 101: 1767–1772.CrossRefGoogle Scholar
  13. 13.
    Festa A, D’Agostino R Jr, Howard G, Mykkänen L, Tracy RP, Haffner S, 2000 Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102: 42–47.CrossRefGoogle Scholar
  14. 14.
    Sarwar N, Thompson AJ, Di Angelantonio E, 2009 Markers of inflammation and risk of coronary heart disease. Dis Markers 26: 217–225.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Clearfield MB, 2005 C-reactive protein: a new risk assessment tooll for cardiovascular disease. J Am Osteopath Assoc 105: 409–416.PubMedGoogle Scholar
  16. 16.
    Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH, 1998 Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation 98: 731–733.CrossRefGoogle Scholar
  17. 17.
    Hotamisligil GS, Murray DL, Choy LN, Spielgeman BM, 1994 Tumor necrosis factor alpha inhibits signaling from the insulin receptor. Proc Natl Acad Sci USA 91: 4854–4858.CrossRefGoogle Scholar
  18. 18.
    Indulekha K, Surendar J, Mohan V, 2011 High sensitivity C-reactive protein, tumor necrosis factor-α, interleukin-6, and vascular cell adhesion molecule-1 levels in Asian Indians with metabolic syndrome and insulin resistance (CURES-105). J Diabetes Sci Technol 5: 982–988.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Olson NC, Callas PW, Hanley AJ, et al, 2012 Circulating levels of TNF-α are associated with impaired glucose tolerance, increased insulin resistance, and ethnicity: the Insulin Resistance Atherosclerosis Study. J Clin Endocrinol Metab 97: 1032–1040.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Musialik K, 2012 The influence of chosen adipocytokines on blood pressure values in patients with metabolic syndrome. Kardiol Pol 70: 1237–1242.PubMedGoogle Scholar
  21. 21.
    Mathieu P, Poirier P, Pibarot P, Lemieux I, Després JP, 2009 Visceral obesity: the link among inflammation, hypertension, and cardiovascular disease. Hypertension 53: 577–584.CrossRefGoogle Scholar
  22. 22.
    Bautista LE, Vera LM, Arenas IA, Gamarra G, 2005 Independent association between inflammatory markers (C-reactive protein, interleukin-6, and TNF-alpha) and essential hypertension. J Hum Hypertens 19: 149–154.CrossRefGoogle Scholar
  23. 23.
    Popa C, Netea MG, van Riel PL, van der Meer JW, Stalenhoef AF, 2007 The role of TNF-alpha in chronic inflammatory conditions, intermediary metabolism, and cardiovascular risk. J Lipid Res 48: 751–762.CrossRefGoogle Scholar
  24. 24.
    Balistreri CR, Caruso C, Candore G, 2010 The role of adipose tissue and adipokines in obesity-related inflammatory diseases. Mediators Inflamm 2010: 802078.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Barcellos CR, Lage SH, Rocha MP, et al, 2013 Polycystic ovary syndrome and obesity do not affect vascular parameters related to early atherosclerosis in young women without glucose metabolism disturbances, arterial hypertension and severe abnormalities of lipid profile. Gynecol Endocrinol 29: 370–374.CrossRefGoogle Scholar
  26. 26.
    Genuth S, Alberti KG, Bennett P, et al, 2003 The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26: 3160–3167.CrossRefGoogle Scholar
  27. 27.
    World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report of a WHO consultation, 1999 Part I. Diagnosis and classification of diabetes mellitus. WHO: Geneva ADA.Google Scholar
  28. 28.
    Rotterdam ESHRE/ASRM — Sponsored PCOS Consensus Workshop Group, 2004 Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 81: 19–25.Google Scholar
  29. 29.
    Ferriman DM, Gallwey JD, 1961 Clinical assessment of body hair growth in women. J Clin Endocrinol 21: 1440–1447.CrossRefGoogle Scholar
  30. 30.
    Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report, 2002 Circulation 106: 3143–3421.Google Scholar
  31. 31.
    Rocha MP, Maranhão RC, Seydell TM, et al, 2010 Metabolism of trygliceride-rich lipoproteins and lipid transfer to high-density lipoprotein in young obese and normal-weight patients with polycystic ovary syndrome. Fertil Steril 93: 1948–1956.CrossRefGoogle Scholar
  32. 32.
    Möhlig M, Spranger J, Osterhoff M, et al, 2004 The polycystic ovary syndrome per se is not associated with increased chronic inflammation. Eur J Endocrinol 150: 525–532.CrossRefGoogle Scholar
  33. 33.
    Olszanecka-Glinianowicz M, Banás M, Zahorska-Markiewicz B, et al, 2007 Is the polycystic ovary syndrome associated with chronic inflammation per se? Eur J Obstet Gynecol Reprod Biol 133: 197–202.CrossRefGoogle Scholar
  34. 34.
    Soares GM, Vieira CS, Martins WP, et al, 2009 Increased arterial stiffness in nonobese women with polycystic ovary syndrome (PCOS) without comorbidities: one more characteristic inherent to the syndrome? Clin Endocrinol (Oxf) 71: 406–411.CrossRefGoogle Scholar
  35. 35.
    Jakubowska J, Bohdanowicz-Pawlak A, Milewicz A, Szymczak J, Bednarek-Tupikowska G, Demissie M, 2008 Plasma cytokines in obese women with polycystic ovary syndrome, before and after metformin treatment. Gynecol Endocrinol 24: 378–384.CrossRefGoogle Scholar
  36. 36.
    Gonzalez F, Thusu K, Abdel-Rahman E, Prabhala A, Tomani M, Dandona P, 1999 Elevated serum levels of tumor necrosis factor alpha in normal-weight women with polycystic ovary syndrome. Metabolism 48: 437–441.CrossRefGoogle Scholar
  37. 37.
    Vgontzas AN, Trakada G, Bixler EO, et al, 2006 Plasma interleukin 6 levels are elevated in polycystic ovary syndrome independently of obesity or sleep apnea. Metabolism 55: 1076–1082.CrossRefGoogle Scholar
  38. 38.
    Zawadeski JK, Dunaif A 1992 Diagnostic criteria for PCOS: towards a more rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam MR (eds) PCOS. Boston: Blackwell Scientific.Google Scholar
  39. 39.
    Azziz R, Carmina E, Dewailly D, et al, 2006 Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 91: 4237–4245.CrossRefGoogle Scholar
  40. 40.
    Wild RA, Carmina E, Diamanti-Kandarakis E, et al, 2010 Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab 95: 2038–2049.CrossRefGoogle Scholar
  41. 41.
    Ciaraldi TP, Aroda V, Mudaliar SR, Henry RR, 2013 Inflammatory cytokines and chemokines, skeletal muscle and polycystic ovary syndrome: Effects of pioglitazone and metformin treatment. Metabolism 62: 1587–1596.CrossRefGoogle Scholar
  42. 42.
    Rocha MP, Marcondes JA, Barcellos CR, et al, 2011 Dyslipidemia in women with polycystic ovary syndrome: incidence, pattern and predictors. Gynecol Endocrinol 27: 814–819.CrossRefGoogle Scholar
  43. 43.
    González F, Rote NS, Minium J, Kirwan JP, 2006 In vitro evidence that hyperglycemia stimulates tumor necrosis factor-alpha release in obese women with polycystic ovary syndrome. J Endocrinol 188: 521–529.CrossRefGoogle Scholar
  44. 44.
    Barcellos CR, Rocha MP, Hayashida SA, Nery M, Marcondes JA, 2007 Prevalence of abnormalities of glucose metabolism in patients with polycystic ovary syndrome. Arq Bras Endocrinol Metabol 51: 601–605.CrossRefGoogle Scholar
  45. 45.
    Meyer ML, Malek AM, Wild RA, Korytkowski MT, Talbott EO, 2012 Carotid artery intima-media thickness in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update 18: 112–126.CrossRefGoogle Scholar
  46. 46.
    Kahal H, Aburima A, Ungvari T, et al, 2013 Polycystic ovary syndrome has no independent effect on vascular, inflammatory or thrombotic markers when matched for obesity. Clin Endocrinol (Oxf) 79: 252–258.CrossRefGoogle Scholar
  47. 47.
    Ridker PM, Buring JE, Cook NR, Rifai N, 2003 C-Reactive Protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14 719 initially healthy american women. Circulation 107: 391–397.CrossRefGoogle Scholar
  48. 48.
    Bastard JP, Maachi M, Lagathu C, et al, 2006 Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw 17: 4–12.PubMedGoogle Scholar
  49. 49.
    Barcellos CR, Rocha MP, Hayashida SA, Mion Junior D, Lage SG, Marcondes JÁ, 2007 Impact of body mass index on blood pressure levels in patients with polycystic ovary syndrome. Arq Bras Endocrinol Metabol 51: 1104–1109.CrossRefGoogle Scholar

Copyright information

© Hellenic Endocrine Society 2015

Authors and Affiliations

  • Cristiano Roberto Grimaldi Barcellos
    • 1
    • 3
  • Michelle Patrocínio Rocha
    • 1
  • Sylvia Asaka Yamashita Hayashida
    • 2
  • Wagner Silva Dantas
    • 1
  • Viviane dos Reis Vieira Yance
    • 1
  • José Antonio Miguel Marcondes
    • 1
  1. 1.Endocrinlogy UnitUniversity of Sao Paulo, School of MedicineSao PauloBrazil
  2. 2.Gynecology UnitUniversity of Sao Paulo, School of MedicineSao PauloBrazil
  3. 3.Sao Paulo, Sao PauloBrazil

Personalised recommendations