Circulating high-sensitivity C-reactive protein and soluble CD40 ligand are inter-related in a cohort of women with polycystic ovary syndrome

Objective: Insulin resistance (IR), the fundamental metabolic alteration in women with polycystic ovary syndrome (PCOS), has recently been reported to represent, in part, a chronic low-grade inflammatory state. This study aimed to assess the inter-relationship between the plasma levels of high-sensitivity C-reactive protein (hs-CRP) and soluble CD40 ligand (sCD40L) - both inflammatory factors - and the pathogenesis of IR among women with PCOS. Study design: This study compared 44 women with PCOS with a group of control women without PCOS (n = 39). Participants were matched for age, blood pressure and degree of obesity. Enzyme-linked immunosorbent assay was used to measure the two inflammatory factors. Fasting glucose and insulin were assayed and used to calculate the IR indices. Results: Significant elevations in the plasma levels of both inflammatory factors were observed in women with PCOS compared with the control women: 3.17 (2.23-3.89) vs 2.05 (0.93-2.82) mg/l for hs-CRP and 2.46 (1.08-4.16) vs 0.82 (0.43-1.26) ng/ml for sCD40L, respectively. Interestingly, among women with PCOS, the two inflammatory factors were significantly positively correlated with each other (r = 0.465, p = 0.002), as well as with the IR indices. This association remained significant even after adjustment for body mass index as a measure of obesity. Conclusion: Independent of obesity, women with PCOS suffer low-grade inflammation that is correlated with IR. The observed inter-relationships suggest that CRP in collaboration with the CD40-CD40L system may have a role in the pathogenesis of PCOS. (C) 2013 Elsevier Ireland Ltd. All rights reserved.