Circulating inflammatory markers in polycystic ovary syndrome

A systematic review and metaanalysis

Héctor F. Escobar-Morreale, Manuel Luque-Ramírez, Frank González

Research output: Contribution to journalArticle

211 Citations (Scopus)

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.

Original languageEnglish
JournalFertility and Sterility
Volume95
Issue number3
DOIs
StatePublished - Mar 1 2011

Fingerprint

Polycystic Ovary Syndrome
C-Reactive Protein
Interleukin-6
Tumor Necrosis Factor-alpha
Obesity
Confidence Intervals
Search Engine
PubMed
Blood Proteins
Biomarkers
Outcome Assessment (Health Care)
Inflammation
Serum

Keywords

  • adipose tissue
  • Chronic low-grade inflammation
  • glucose tolerance
  • insulin resistance
  • obesity

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Circulating inflammatory markers in polycystic ovary syndrome : A systematic review and metaanalysis. / Escobar-Morreale, Héctor F.; Luque-Ramírez, Manuel; González, Frank.

In: Fertility and Sterility, Vol. 95, No. 3, 01.03.2011.

Research output: Contribution to journalArticle

Escobar-Morreale, Héctor F. ; Luque-Ramírez, Manuel ; González, Frank. / Circulating inflammatory markers in polycystic ovary syndrome : A systematic review and metaanalysis. In: Fertility and Sterility. 2011 ; Vol. 95, No. 3.
@article{a9f7543670f44d4cb75246a69f56e969,
title = "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.",
keywords = "adipose tissue, Chronic low-grade inflammation, glucose tolerance, insulin resistance, obesity",
author = "Escobar-Morreale, {H{\'e}ctor F.} and Manuel Luque-Ram{\'i}rez and Frank Gonz{\'a}lez",
year = "2011",
month = "3",
day = "1",
doi = "10.1016/j.fertnstert.2010.11.036",
language = "English",
volume = "95",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Circulating inflammatory markers in polycystic ovary syndrome

T2 - A systematic review and metaanalysis

AU - Escobar-Morreale, Héctor F.

AU - Luque-Ramírez, Manuel

AU - González, Frank

PY - 2011/3/1

Y1 - 2011/3/1

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.

AB - 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.

KW - adipose tissue

KW - Chronic low-grade inflammation

KW - glucose tolerance

KW - insulin resistance

KW - obesity

UR - http://www.scopus.com/inward/record.url?scp=79951956890&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79951956890&partnerID=8YFLogxK

U2 - 10.1016/j.fertnstert.2010.11.036

DO - 10.1016/j.fertnstert.2010.11.036

M3 - Article

VL - 95

JO - Fertility and Sterility

JF - Fertility and Sterility

SN - 0015-0282

IS - 3

ER -