Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2011 Mar 1;95(3):1048-58.e1-2.
doi: 10.1016/j.fertnstert.2010.11.036. Epub 2010 Dec 17.

Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis

Héctor F Escobar-Morreale  1 , Manuel Luque-Ramírez, Frank González
Affiliations
Meta-Analysis

Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and metaanalysis

Héctor F Escobar-Morreale et al. Fertil Steril. .

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Meta-analysis of serum C-reactive protein (CRP) levels in women with PCOS and controls. Evidence dissemination bias was assessed by funnel plot and Egger’s regression. NIH, National Institute of Health, ESHRE/ASRM, European Society of Human Reproduction and Embryology / American Society of Reproductive Medicine.
Figure 2
Figure 2
Meta-analysis of serum interleukin-6 (IL-6) levels in women with PCOS and controls. Evidence dissemination bias was assessed by funnel plot and Egger’s regression. NIH, National Institute of Health, ESHRE/ASRM, European Society of Human Reproduction and Embryology / American Society of Reproductive Medicine.
Figure 3
Figure 3
Meta-analysis of serum tumor necrosis factor- α (TNF- α) levels in women with PCOS and controls. Evidence dissemination bias was assessed by funnel plot and Egger’s regression. NIH, National Institute of Health, ESHRE/ASRM, European Society of Human Reproduction and Embryology / American Society of Reproductive Medicine.
See this image and copyright information in PMC

Comment in

References

    1. Fernandez-Real JM, Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev. 2003;24:278–301. - PubMed
    1. González F, Minium J, Rote NS, Kirwan JP. Hyperglycemia alters tumor necrosis factor-alpha release from mononuclear cells in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90:5337–42. - PubMed
    1. González F, Rote NS, Minium J, Kirwan JP. Reactive oxygen species-induced oxidative stress in the development of insulin resistance and hyperandrogenism in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:336–40. - PubMed
    1. González F, Rote NS, Minium J, Kirwan JP. Increased activation of nuclear factor κB triggers inflammation and insulin resistance in polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91:1508–12. - PubMed
    1. González F, Rote NS, Minium J, Kirwan JP. In vitro evidence that hyperglycemia stimulates tumor necrosis factor-alpha release in obese women with polycystic ovary syndrome. J Endocrinol. 2006;188:521–9. - PubMed

Publication types