Inflammatory biomarkers and lipoprotein (a) for cardiovascular risk assessment in polycystic ovary syndrome: a comparative cross-sectional study
摘要
Polycystic Ovary Syndrome (PCOS) is the major cause of female infertility which also precipitates meta-inflammation associated with cardiovascular diseases (CVDs). The research focus is less inclined toward the management of CVDs intertwined with these disorders. This study delineates the association of novel lipid and inflammatory biomarkers in PCOS.
MethodsAmong 70 women with PCOS and 60 normal controls visiting the Infertility Clinic, the baseline lipid parameters, gonadal hormones, and inflammatory biomarkers (hsCRP, Interleukin-6, lipoprotein (a), Apolipoprotein B-100) were measured in Abbott ARCHITECT ci4100 analyzer, Mispa i3 protein analyzer, and Biotime BIOT-YF I FIA Analyzer. Using SPSS version 23.0, descriptive statistics were used to express the data as mean, standard deviation, median and interquartile ranges. An ROC curve was evaluated to assess the efficiency of different biomarkers. Univariate and multivariate logistic regression analyses were used to determine the significant variables that escalate cardiovascular risks.
ResultsThe inflammatory markers (hsCRP, Interleukin-6, and Apolipoprotein B-100) were higher in PCOS patients as compared to their normal contingents with 15.17 times greater likelihood of having higher hsCRP in PCOS [OR-15.17 (6.15, 37.42)]. Similarly, the odds of having higher Interleukin-6 and LAP score in PCOS were 5.52 [2.48, 12.32] and 3.58 [1.71, 7.46], respectively. Despite having a normal BMI, 24.28% (n = 17) of the PCOS cohorts had lipoprotein (a) levels above the desirable range. Individuals with a combined increase in hsCRP and lipoprotein (a) had a higher LAP score. The hsCRP was an excellent marker of assessing CVD risk with an AUC of 0.807 [0.729, 0.884], sensitivity and specificity of 74.3% and 75%, respectively. Age, body mass index (BMI), total cholesterol, and ApoB100 emerged as independent and significant predictors (p < 0.05) of increased hsCRP levels. After further adjustment for age and BMI, HDL (Exp(B) = 1.108, 95% CI 1.004–1.223, p = 0.042) and ApoB100 (Exp(B) = 1.033, 95% CI 1.009–1.058, p = 0.006) remained significant.
ConclusionsThe risk of cardiovascular diseases is more common in females with PCOS. The elevated levels of Lp(a) and Apo B100 are independent of BMI. The hsCRP combined with Lp(a) and Apo B100 underscores their potential role as key biochemical markers in assessment of cardiovascular risk in PCOS.