Assesment of inflammatory markers and epicardial adipose tissue thickness in women with polycystic ovary syndrome

Abstract

Aim: Polycystic ovary syndrome (PCOS), one of the most common reproductive system disorders in women, is a clinical condition in which chronic inflammatory parameters increase. In this study, we aimed to evaluate the epicardial adipose tissue (EAT) thickness, inflammatory parameters and their relationships with each other by comparing PCOS patients and healthy controls. Methods: Serum complement 3 (C3) and complement 4 (C4) levels were evaluated and EAT was measured by transthoracic echocardiography. Results: Thirty-two patients with PCOS (mean age=24 +/- 6 years) and 27 healthy controls (mean age=26 +/- 3 years) were included in the study. EAT (p=0.000), abdominal subcutaneous thickness (p=0.000), C3 (p=0.023), C4 (p=0.039), hsCRP (p=0.026), GGT (p=0.012) and fibrinogen (p=0.035) levels were significantly increased in the PCOS group compared to the control group. It was found that EAT thickness was positively correlated with body mass index (BMI) (r=0.84, p=0.000), abdominal subcutaneous adipose tissue thickness (r=0.82, p=0.000), HOMA-IR (r=0.62, p=0.000), hsCRP (r=0.58, p=0.000), C3 (r=0.52, p=0.000), C4 (r=0.44, p=0.000), and fibrinogen (r=0.50, p=0.000) levels. In logistic regression analysis, Regardless of the BMI and abdominal subcutaneous thickness, EAT was found to have a significant relationship with PCOS. According to linear regression analysis; C4, HOMA-IR and hsCRP were found to have a significant relationship with EAT. Conclusion: Increased EAT, which was found to be significantly associated with PCOS, was showed to have a significant relationship with insulin resistance and C4 and hsCRP levels in this study. Clinically, the evaluation of the levels of inflammatory and immune parameters together with the measurement of EAT thickness in PCOS patients may be helpful in determining the cardiovascular risk. Prospective randomized controlled trials are needed to show this relationship more clearly./ Öz: Amaç: Polikistik over sendromu (PKOS) kronik enflamatuvar parametrelerin arttığı bir üreme sistemi düzensizliğidir. Bu çalışmada, PKOS hastalarında epikardiyal adipoz doku (EAD) kalınlığı, enflamatuvar parametrelerin ölçümü ve birbirleriyle olan ilişkilerinin değerlendirilmesi hedeflenmiştir. Yöntemler: Serumda kompleman 3 (C3), kompleman 4 (C4) gibi parametreler ve ekokardiyografik olarak EAD ölçüldü. Bulgular: Otuz iki kişi PKOS grubuna (ortalama yaş=24±6 yıl), 27 sağlıklı kişi (ortalama yaş=26±3 yıl) ise kontrol grubuna alındı (p=0,08). EAD (p=0,000), abdominal deri altı kalınlığı (p=0,000), C3 (p=0,023), C4 (p=0,039), hsCRP (p=0,026), GGT (p=0,012) ve fibrinojen (p=0,035) kontrol grubuna göre PKOS grubunda anlamlı olarak artmış bulundu. EAD ile vücut kitle indeksi (VKİ) (r=0,84, p=0,000), deri altı kalınlığı (r=0,82, p=0,000), HOMA-IR (r=0,62, p=0,000), hsCRP (r=0,58, p=0,000), C3 (r=0,52, p=0,000), C4 (r=0,44, p=0,000), fibrinojen (r=0,50, p=0,000) arasında pozitif korelasyon saptandı. Lojistik regresyon analizinde; VKİ ve deri altı kalınlığından bağımsız olarak, PKOS ile EAD arasında anlamlı ilişki bulundu. Lineer regresyon analizinde ise; C4, HOMA-IR ve hsCRP’nin EAD ile anlamlı ilişkisi saptandı. Sonuç: Çalışmamızda PKOS ile anlamlı ilişkisi bulunan EAD artışının, insülin direnci, C4, hsCRP ile anlamlı ilişkisi gösterilmiştir. Klinikte bu hastalarda EAD ölçümü ile birlikte enflamatuvar parametrelerin düzeyinin değerlendirilmesi, kardiyovasküler riskin belirlenmesinde yol gösterici olabilir. Bu ilişkiyi daha net gösterebilecek prospektif randomize kontrollü çalışmalara ihtiyaç vardır.