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. 2018 Dec 1;37(4):476-485.
doi: 10.2478/jomb-2018-0008. eCollection 2018 Dec.

Evaluation of a Summary Score for Dyslipidemia, Oxidative Stress and Inflammation (the Doi Score) in Women with Polycystic Ovary Syndrome and its Relationship with Obesity

Iva Perović Blagojević  1 , Svetlana Ignjatović  2   3 , Djuro Macut  4   5 , Jelena Kotur-Stevuljević  2 , Ivana Božić-Antić  4   5 , Jelena Vekić  2 , Jelica Bjekić-Macut  6   5 , Biljana Kastratović-Kotlica  7   5 , Zoran Andrić  6 , Dušan Ilić  4
Affiliations

Evaluation of a Summary Score for Dyslipidemia, Oxidative Stress and Inflammation (the Doi Score) in Women with Polycystic Ovary Syndrome and its Relationship with Obesity

Iva Perović Blagojević et al. J Med Biochem. .

Abstract
in English, Serbian

Background: Polycystic ovary syndrome (PCOS) is a cardiometabolic disorder whose features include dyslipidemia, increased oxidative stress (OS, oxy) and chronic inflammation. The aim of this study was to investigate the ability of a summary score for dyslipidemia, OS and inflammation (the DOI score) to discriminate PCOS patients from healthy individuals and to evaluate the effect of obesity on individual scores and the DOI score in patients.

Methods: Lipid status parameters, OS status parameters (advanced oxidation protein products; total oxidative status; prooxidant-antioxidant balance; malondialdehyde; total protein sulphydryl groups and paraoxonase 1 activity) and CRP were measured in 114 patients and 50 controls using standardised assays. The DOI score was calculated as the sum of dyslipidemia, oxy and inflammation scores, determined as Z-score values for every subject in relation to the controls.

Results: PCOS patients had significantly higher oxy-score compared to controls (P<0.001). In addition, the DOI score was significantly higher in PCOS patients (P<0.001) as the dyslipidemia (P<0.05) and inflammatory scores (P<0.001) were greater. According to ROC analysis, the oxy-score showed better diagnostic accuracy in discriminating PCOS patients compared to the DOI score (AUC>0.9, P<0.01). Furthermore, obesity affected the risk scores in patients, especially the DOI score (significantly higher DOI scores in such patients, P<0.001).

Conclusion: PCOS patients had greater dyslipidemia, chronic inflammation and OS compared to controls and could be segregated using all four scores. Our data suggest that weight gain could be the common factor responsible for induction and propagation of dyslipidemia, OS and inflammation in PCOS patients.

Uvod: Sindrom policističnih jajnika (PCOS) je kardiometabolički poremećaj čije su karakteristike dislipidemija, povišen oksidativni stres (OS) i hronična inflamacija. Cilj ove studije je bio da se ispita sposobnost zbirnog skora dislipidemije, OS i inflamacije (DOI skor) da razlikuje pacijentkinje sa PCOS u poređenju sa zdravim osobama i da se proceni uticaj gojaznosti na pojedinačne skorove i DOI skor kod pacijentkinja.

Metode: Parametri lipidnog statusa, parametri oksidativnog stresa (uznapredovali produkti oksidacije proteina; ukupni oksidativni status; prooksidativno-antioksidativni balans; malondialdehid; ukupne sulfhidrilne grupe i aktivnost paraoksonaze 1) i CRP su određivani kod 114 pacijentkinja i 50 kontrolnih ispitanica primenom standardizovanih testova. DOI skor je izračunat kao zbir skora dislipidemije, oksidativnog skora i skora inflamacije, određen kao vrednosti Z-skora za svaki subjekt u odnosu na kontrole.

Rezultati: PCOS pacijentkinje su imale značajno više vrednosti oksidativnog skora u poređenju sa kontrolnom grupom (P<0,001). Zatim, DOI skor je bio značajno viši kod pacijentkinja sa PCOS (P<0,001) kao i skorovi dislipidemije (P<0,05) i inflamacije (P<0,001). Prema rezultatima ROC analize, oksidativni skor je pokazao bolju dijagnostičku tačnost u razlikovanju PCOS pacijentkinja u odnosu na zdrave osobe u poređenju sa DOI skorom (AUC>0,9, P<0,01). Osim toga, gojaznost je imala uticaj na vrednosti skorova rizika, posebno na DOI skor (vrednosti DOI skora su bile značajno više kod tih pacijentkinja, P<0,001).

Zaključak: Pacijentkinje sa PCOS su imale izraženiju dislipidemiju, hroničnu inflamaciju i oksidativni stres u poređenju sa kontrolnim ispitanicama i mogu se od njih razlikovati primenom sva četiri skora. Naši rezultati ukazuju da povećanje telesne težine može biti zajednički faktor odgovoran za nastanak i napredovanje dislipidemije, OS i inflamacije kod pacijentkinja sa PCOS.

Keywords: DOI score; Polycystic ovary syndrome; dyslipidemia; inflammation; obesity; oxidative stress.

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Conflict of interest statement

Conflict of interest statement The authors stated that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
OS parameters in PCOS patients and the CG. ***P<0.001, *P<0.05 compared to PCOS patients, according to the Mann-Whitney U test
Figure 2
Figure 2
Risk scores (dyslipidemia, inflammation and oxy scores) in PCOS patients and the CG. ***P<0.001, *P<0.05 compared to the PCOS patients
Figure 3
Figure 3
ROC curves for calculated scores as markers of PCOS.
See this image and copyright information in PMC

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