Abstract
Our aim was to analyze levels of proinflammatory biomarker interleukin-18 (IL-18) in healthy controls and patients with polycystic ovary syndrome (PCOS) focusing on its association with obesity, clinical, hormonal, and metabolic characteristics. Fifty-eight patients with PCOS were enrolled in the study fulfilling the Rotterdam criteria and were matched for age, body mass index (BMI), and ethnicity with 30 healthy controls. Detailed anthropometric measurements, clinical investigations, hormonal and biochemical tests were obtained between the 3rd and 5th day of a menstrual cycle. A subanalysis of the PCOS group was performed separating patients into several groups according to a waist-to-height ratio (WHtR), insulin resistance (IR), and free androgen index (FAI). Serum IL-18 levels were measured using the ELISA method. Levels of IL-18 were similar between PCOS patients and controls. IL-18 was higher in overweight/obese women compared to normal-weight women when analyzing all participants together and separately PCOS or controls group (p < 0.001, p < 0.001, p = 0.01, respectively). Additionally, IL-18 levels were higher in high-WHtR and IR subgroups compared to low-WHtR (p < 0.001) and non-IR PCOS women (p < 0.001). PCOS women with high FAI had greater serum IL-18 levels than normal-FAI patients (p = 0.002). Levels of IL-18 correlated positively with most of the anthropometric and metabolic parameters. In multiple linear regression, age, waist circumference, and fasting insulin were independently related factors with IL-18. Elevated levels of IL-18 were related to several indices of general and visceral adiposity and insulin resistance in PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age [1]
The population in our study consisted of 58 PCOS patients and 30 healthy women who were matched for age, body mass index (BMI), and ethnicity
Women with PCOS had significantly higher levels of testosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, 17-OH-progesterone, free androgen index (FAI), and luteinizing hormone (LH)/follicle stimulating hormone (FSH) ratio compared to controls
Summary
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age [1]. PCOS is perceived as both a reproductive syndrome, presenting clinically with hyperandrogenism, ovulatory dysfunction (including oligo-amenorrhea), polycystic ovaries, and infertility [1], and a metabolic disorder [2]. Our research aimed to determine the IL-18 levels in women with PCOS and compare them with healthy controls, to analyze its association with different markers for global and central adiposity, insulin resistance, and hyperandrogenism, and to determine which of those variables independently predict IL-18 levels. Patients with PCOS were divided into two androgen groups according to FAI: normal FAI (FAI < 5, n = 39) and high FAI (FAI ≥ 5, n = 19) [34]. Parametric tests (Independent Samples T-Test) were carried out when data were normally distributed and the hypotheses were presented as the difference between the mean values ± standard deviation (SD). P < 0.05 was chosen as the level of significance at which the null hypothesis was rejected
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