Relationship between proinflammatory cytokines and clomiphene resistance in patients with polycystic ovary syndrome.

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of childbearing age. We aimed to investigate the correlations between proinflammatory cytokine levels and clomiphene resistance in patients with PCOS. Between January 2019 and January 2020, a total of 72 PCOS patients who attended our department were administered clomiphene 50-100 mg/day on days 5-9 of the menstrual cycle to induce ovulation. Patients were divided into a clomiphene-sensitive group (n=42) and a clomiphene-resistant group (n=30). The proinflammatory cytokines interleukin-23 (IL-23), monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor α (TNF-α), angiopoietin-2, and adiponectin were measured by an enzyme-linked immunosorbent assay (ELISA). The receiver-operating characteristic curve was employed to determine the capability of various parameters to distinguish clomiphene resistance. The univariate logistic regression analysis was used to analyze the associations between pro-inflammatory cytokine levels and clomiphene resistance in PCOS. Serum IL-23 levels showed no statistically significant difference between the clomiphene-sensitive and the clomiphene-resistant groups, whereas MCP-1, TNF-α, angiopoietin-2, and adiponectin levels were significantly different between the two groups (all P<0.05). Univariate logistic regression analysis indicated that elevated serum TNF-α [odds ratio (OR) =1.88, P<0.001], decreased angiopoietin-2 (OR =0.61, P=0.007), and adiponectin (OR =0.39, P=0.012) levels were significantly associated with clomiphene resistance. The sensitivity of TNF-α and angiopoietin-2 to distinguish clomiphene resistance in patients with PCOS was 100%. Moreover, the diagnostic efficiency of TNF-α and adiponectin in identifying clomiphene resistance was significantly higher than that of MCP-1 and angiopoietin-2 (all P<0.05). Abnormal TNF-α, angiopoietin-2, and adiponectin levels may be associated with clomiphene resistance in PCOS patients. The serum proinflammatory cytokines TNF-α and adiponectin are helpful discriminators of clomiphene resistance in PCOS patients.