Research Article
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Year 2021, Volume: 38 Issue: 4, 577 - 582, 09.10.2021

Abstract

References

  • [1] Besenek M, Gurlek B. Hyperandrogenism in polycystic ovary syndrome affects psychological well-being of adolescents. J Obstet Gynaecol Res 2021 Jan;47(1):137-146 (doi: 10.1111/jog.14444). Epub 2020 Aug 23.
  • [2] Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89(6):2745-9 (doi:10.1210/jc.2003-032046).
  • [3] González F, Sia CL, Shepard MK, Rote NS, Minium J. Inflammation in response to glucose ingestion is independent of excess abdominal adiposity in normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2012;97(11):4071-9 (doi:10.1210/jc.2012-2131).
  • [4] Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015;149(5):R219-27 (doi:10.1530/rep-14-0435).
  • [5] Shorakae S, Teede H, de Courten B, Lambert G, Boyle J, Moran LJ. The emerging role of chronic low-grade inflammation in the pathophysiology of polycystic ovary syndrome. Semin Reprod Med 2015;33(4):257-69 (doi:10.1055/s-0035-1556568).
  • [6] Orio F, Jr., Palomba S, Cascella T, et al. The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90(1):2-5 (doi:10.1210/jc.2004-0628).
  • [7] Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril 2012;97(1):7-12 (doi:10.1016/j.fertnstert.2011.11.023).
  • [8] Hu W, Qiao J, Yang Y, Wang L, Li R. Elevated C-reactive protein and monocyte chemoattractant protein-1 in patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2011;157(1):53-6 (doi:10.1016/j.ejogrb.2011.03.015).
  • [9] Kebapcilar L, Taner CE, Kebapcilar AG, Sari I. High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome. Arch Gynecol Obstet 2009;280(2):187-93 (doi:10.1007/s00404-008-0884-0).
  • [10] Herlihy AC, Kelly RE, Hogan JL, O'Connor N, Farah N, Turner MJ. Polycystic ovary syndrome and the peripheral blood white cell count. J Obstet Gynaecol 2011;31(3):242-4 (doi:10.3109/01443615.2011.553693).
  • [11] Delcea C, Buzea CA, Dan GA. The neutrophil to lymphocyte ratio in heart failure: a comprehensive review. Rom J Intern Med 2019;57(4):296-314 (doi:10.2478/rjim-2019-0018).
  • [12] Monteiro Júnior JGM, de Oliveira Cipriano Torres D, Filho DCS. Hematological parameters as prognostic biomarkers in patients with cardiovascular diseases. Curr Cardiol Rev 2019;15(4):274-82 (doi:10.2174/1573403x15666190225123544).
  • [13] DiGangi C. Neutrophil-lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes. J Am Assoc Nurse Pract 2016;28(8):410-4 (doi:10.1002/2327-6924.12366).
  • [14] Liu R, Zheng S, Yuan Q, et al. The prognostic significance of combined pretreatment fibrinogen and neutrophil-lymphocyte ratio in various cancers: A systematic review and meta-analysis. Dis Markers 2020;2020:4565379 (doi:10.1155/2020/4565379).
  • [15] Can M, Duran C, Guney I, Elmas H, Ayhan M, Erdem SS. The relationship between glomerular filtration rate, and metabolic and inflammatory parameters in obese and non-obese patients with polycystic ovary syndrome. Clin Investig Arterioscler 2020;32(6):256-62 (doi:10.1016/j.arteri.2020.04.003).
  • [16] Pergialiotis V, Trakakis E, Parthenis C, et al Correlation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS. Horm Mol Biol Clin Investig. 2018;34(3) (doi:10.1515/hmbci-2017-0073).
  • [17] Agacayak E, Tunc SY, Sak S, et al. Levels of neopterin and other inflammatory markers in obese and non-obese patients with polycystic ovary syndrome. Med Sci Monit 2015;21:2446-55 (doi:10.12659/msm.894368).
  • [18] Aydın GA, Turan Özsoy HG, Ankaralı H, Özgen G, Neşelioğlu S. The association of dynamic thiol-disulfide homeostasis and inflammatory markers in patients with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2020 Jan;59(1):79-84 (doi: 10.1016/j.tjog.2019.11.012).
  • [19] Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol 2018 May;14(5):270-84.
  • [20] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-7 (doi: 10.1093/humrep/deh098).
  • [21] Albareda M, Rodríguez-Espinosa J, Murugo M, de Leiva A, Corcoy R. Assessment of insulin sensitivity and β-cell function from measurements in the fasting state and during an oral glucose tolerance test. Diabetologia 2000;43:1507-11 (doi: 10.1007/s001250051561).
  • [22] Zafari Zangeneh F, Naghizadeh MM, Masoumi M. Polycystic ovary syndrome and circulating inflammatory markers. Int J Reprod Biomed 2017 Jun;15(6):375-82.
  • [23] Boulman N, Levy Y, Leiba R, et al. Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 2004;89(5):2160-5 (doi:10.1210/jc.2003-031096).
  • [24] Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2001;86(6):2453-5 (doi:10.1210/jcem.86.6.7580).
  • [25] Paliogiannis P, Fois AG, Sotgia S, et al. Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives. Eur Respir Rev 2018;27(147) (doi:10.1183/16000617.0113-2017).
  • [26] Mertoglu C, Gunay M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr 2017;11 Suppl 1:S127-s31 (doi:10.1016/j.dsx.2016.12.021).
  • [27] Adamstein NH, MacFadyen JG, Rose LM, et al. The neutrophil-lymphocyte ratio and incident atherosclerotic events: analyses from five contemporary randomized trials. Eur Heart J 2021 (doi:10.1093/eurheartj/ehaa1034).
  • [28] Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016;26(3):372-6 (doi:10.3109/14397595.2015.1091136).
  • [29] Çakıroğlu Y, Vural F, Vural B. The inflammatory markers in polycystic ovary syndrome: association with obesity and IVF outcomes. J Endocrinol Invest 2016;39(8):899-907 (doi:10.1007/s40618-016-0446-4).
  • [30] Rudnicka E, Kunicki M, Suchta K, Machura P, Grymowicz M, Smolarczyk R. Inflammatory markers in women with polycystic ovary syndrome. Biomed Res Int 2020;2020:4092470 (doi:10.1155/2020/4092470).
  • [31] Phelan N, O'Connor A, Kyaw Tun T, et al. Leucocytosis in women with polycystic ovary syndrome (PCOS) is incompletely explained by obesity and insulin resistance. Clin Endocrinol (Oxf) 2013;78(1):107-13 (doi:10.1111/j.1365-2265.2012.04454.x).
  • [32] Papalou O, Livadas S, Karachalios A, et al. White blood cells levels and PCOS: direct and indirect relationship with obesity and insulin resistance, but not with hyperandogenemia. Hormones(Athens) 2015;14(1):91-100 (doi:10.14310/horm.2002.1563).
  • [33] Yilmaz MA, Duran C, Basaran M. The mean platelet volume and neutrophil to lymphocyte ratio in obese and lean patients with polycystic ovary syndrome. J Endocrinol Invest 2016;39(1):45-53 (doi:10.1007/s40618-015-0335-2).
  • [34] Pinna A, Porcu T, D'Amico-Ricci G, et al. Complete blood cell count-derived inflammation biomarkers in men with age-related macular degeneration. Ocul Immunol Inflamm 2019;27(6):932-6 (doi:10.1080/09273948.2018.1485960).

Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?

Year 2021, Volume: 38 Issue: 4, 577 - 582, 09.10.2021

Abstract

Abstract
Objective: This study has aimed to contribute to the literature by investigating the value of inflammatory biomarkers of polycystic ovary syndrome (PCOS) that can be tested via a complete blood count. Methods: This retrospectively designed case-control study included 197 women in early reproductive age; who were in the age range of 18-24 years and who were admitted to the gynecology outpatient clinic. A total of 111 PCOS patients; in whom the diagnosis of PCOS was made based on Rotterdam criteria, were included in the study. A control group was formed by including 86 healthy women. All measurements of inflammatory biomarkers were obtained from the complete blood count test results. Results: Of the inflammatory markers; the neutrophil count and the neutrophil/lymphocyte ratio were statistically significantly higher in the PCOS group compared to the control group (p=0.016 and p=0.002, respectively); however, the measured values of other parameters were similar between two groups. To evaluate whether or not the neutrophil count and neutrophil/lymphocyte ratio could be used as a screening tool to exclude PCOS, we constructed a receiver-operating characteristic curve (ROC). The ROC curve for the neutrophil count was 0.60 (p=0.016) and NLR was 0.627 (p=0.002).
Conclusions: The neutrophil count and NLR were higher in the PCOS cases compared to the age-matched individuals in the control group. This finding confirms the presence of inflammation in PCOS cases of early reproductive age. However, it has been demonstrated that the diagnostic values of these markers are not strong in distinguishing PCOS patients from healthy individuals.

References

  • [1] Besenek M, Gurlek B. Hyperandrogenism in polycystic ovary syndrome affects psychological well-being of adolescents. J Obstet Gynaecol Res 2021 Jan;47(1):137-146 (doi: 10.1111/jog.14444). Epub 2020 Aug 23.
  • [2] Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004;89(6):2745-9 (doi:10.1210/jc.2003-032046).
  • [3] González F, Sia CL, Shepard MK, Rote NS, Minium J. Inflammation in response to glucose ingestion is independent of excess abdominal adiposity in normal-weight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2012;97(11):4071-9 (doi:10.1210/jc.2012-2131).
  • [4] Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015;149(5):R219-27 (doi:10.1530/rep-14-0435).
  • [5] Shorakae S, Teede H, de Courten B, Lambert G, Boyle J, Moran LJ. The emerging role of chronic low-grade inflammation in the pathophysiology of polycystic ovary syndrome. Semin Reprod Med 2015;33(4):257-69 (doi:10.1055/s-0035-1556568).
  • [6] Orio F, Jr., Palomba S, Cascella T, et al. The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90(1):2-5 (doi:10.1210/jc.2004-0628).
  • [7] Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril 2012;97(1):7-12 (doi:10.1016/j.fertnstert.2011.11.023).
  • [8] Hu W, Qiao J, Yang Y, Wang L, Li R. Elevated C-reactive protein and monocyte chemoattractant protein-1 in patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2011;157(1):53-6 (doi:10.1016/j.ejogrb.2011.03.015).
  • [9] Kebapcilar L, Taner CE, Kebapcilar AG, Sari I. High mean platelet volume, low-grade systemic coagulation and fibrinolytic activation are associated with androgen and insulin levels in polycystic ovary syndrome. Arch Gynecol Obstet 2009;280(2):187-93 (doi:10.1007/s00404-008-0884-0).
  • [10] Herlihy AC, Kelly RE, Hogan JL, O'Connor N, Farah N, Turner MJ. Polycystic ovary syndrome and the peripheral blood white cell count. J Obstet Gynaecol 2011;31(3):242-4 (doi:10.3109/01443615.2011.553693).
  • [11] Delcea C, Buzea CA, Dan GA. The neutrophil to lymphocyte ratio in heart failure: a comprehensive review. Rom J Intern Med 2019;57(4):296-314 (doi:10.2478/rjim-2019-0018).
  • [12] Monteiro Júnior JGM, de Oliveira Cipriano Torres D, Filho DCS. Hematological parameters as prognostic biomarkers in patients with cardiovascular diseases. Curr Cardiol Rev 2019;15(4):274-82 (doi:10.2174/1573403x15666190225123544).
  • [13] DiGangi C. Neutrophil-lymphocyte ratio: Predicting cardiovascular and renal complications in patients with diabetes. J Am Assoc Nurse Pract 2016;28(8):410-4 (doi:10.1002/2327-6924.12366).
  • [14] Liu R, Zheng S, Yuan Q, et al. The prognostic significance of combined pretreatment fibrinogen and neutrophil-lymphocyte ratio in various cancers: A systematic review and meta-analysis. Dis Markers 2020;2020:4565379 (doi:10.1155/2020/4565379).
  • [15] Can M, Duran C, Guney I, Elmas H, Ayhan M, Erdem SS. The relationship between glomerular filtration rate, and metabolic and inflammatory parameters in obese and non-obese patients with polycystic ovary syndrome. Clin Investig Arterioscler 2020;32(6):256-62 (doi:10.1016/j.arteri.2020.04.003).
  • [16] Pergialiotis V, Trakakis E, Parthenis C, et al Correlation of platelet to lymphocyte and neutrophil to lymphocyte ratio with hormonal and metabolic parameters in women with PCOS. Horm Mol Biol Clin Investig. 2018;34(3) (doi:10.1515/hmbci-2017-0073).
  • [17] Agacayak E, Tunc SY, Sak S, et al. Levels of neopterin and other inflammatory markers in obese and non-obese patients with polycystic ovary syndrome. Med Sci Monit 2015;21:2446-55 (doi:10.12659/msm.894368).
  • [18] Aydın GA, Turan Özsoy HG, Ankaralı H, Özgen G, Neşelioğlu S. The association of dynamic thiol-disulfide homeostasis and inflammatory markers in patients with polycystic ovary syndrome. Taiwan J Obstet Gynecol 2020 Jan;59(1):79-84 (doi: 10.1016/j.tjog.2019.11.012).
  • [19] Escobar-Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol 2018 May;14(5):270-84.
  • [20] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-7 (doi: 10.1093/humrep/deh098).
  • [21] Albareda M, Rodríguez-Espinosa J, Murugo M, de Leiva A, Corcoy R. Assessment of insulin sensitivity and β-cell function from measurements in the fasting state and during an oral glucose tolerance test. Diabetologia 2000;43:1507-11 (doi: 10.1007/s001250051561).
  • [22] Zafari Zangeneh F, Naghizadeh MM, Masoumi M. Polycystic ovary syndrome and circulating inflammatory markers. Int J Reprod Biomed 2017 Jun;15(6):375-82.
  • [23] Boulman N, Levy Y, Leiba R, et al. Increased C-reactive protein levels in the polycystic ovary syndrome: a marker of cardiovascular disease. J Clin Endocrinol Metab 2004;89(5):2160-5 (doi:10.1210/jc.2003-031096).
  • [24] Kelly CC, Lyall H, Petrie JR, Gould GW, Connell JM, Sattar N. Low grade chronic inflammation in women with polycystic ovarian syndrome. J Clin Endocrinol Metab 2001;86(6):2453-5 (doi:10.1210/jcem.86.6.7580).
  • [25] Paliogiannis P, Fois AG, Sotgia S, et al. Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives. Eur Respir Rev 2018;27(147) (doi:10.1183/16000617.0113-2017).
  • [26] Mertoglu C, Gunay M. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as useful predictive markers of prediabetes and diabetes mellitus. Diabetes Metab Syndr 2017;11 Suppl 1:S127-s31 (doi:10.1016/j.dsx.2016.12.021).
  • [27] Adamstein NH, MacFadyen JG, Rose LM, et al. The neutrophil-lymphocyte ratio and incident atherosclerotic events: analyses from five contemporary randomized trials. Eur Heart J 2021 (doi:10.1093/eurheartj/ehaa1034).
  • [28] Qin B, Ma N, Tang Q, et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016;26(3):372-6 (doi:10.3109/14397595.2015.1091136).
  • [29] Çakıroğlu Y, Vural F, Vural B. The inflammatory markers in polycystic ovary syndrome: association with obesity and IVF outcomes. J Endocrinol Invest 2016;39(8):899-907 (doi:10.1007/s40618-016-0446-4).
  • [30] Rudnicka E, Kunicki M, Suchta K, Machura P, Grymowicz M, Smolarczyk R. Inflammatory markers in women with polycystic ovary syndrome. Biomed Res Int 2020;2020:4092470 (doi:10.1155/2020/4092470).
  • [31] Phelan N, O'Connor A, Kyaw Tun T, et al. Leucocytosis in women with polycystic ovary syndrome (PCOS) is incompletely explained by obesity and insulin resistance. Clin Endocrinol (Oxf) 2013;78(1):107-13 (doi:10.1111/j.1365-2265.2012.04454.x).
  • [32] Papalou O, Livadas S, Karachalios A, et al. White blood cells levels and PCOS: direct and indirect relationship with obesity and insulin resistance, but not with hyperandogenemia. Hormones(Athens) 2015;14(1):91-100 (doi:10.14310/horm.2002.1563).
  • [33] Yilmaz MA, Duran C, Basaran M. The mean platelet volume and neutrophil to lymphocyte ratio in obese and lean patients with polycystic ovary syndrome. J Endocrinol Invest 2016;39(1):45-53 (doi:10.1007/s40618-015-0335-2).
  • [34] Pinna A, Porcu T, D'Amico-Ricci G, et al. Complete blood cell count-derived inflammation biomarkers in men with age-related macular degeneration. Ocul Immunol Inflamm 2019;27(6):932-6 (doi:10.1080/09273948.2018.1485960).
There are 34 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Sabri Colak 0000-0002-4301-6104

Beril Gürlek 0000-0002-4050-3193

Publication Date October 9, 2021
Submission Date April 20, 2021
Acceptance Date May 3, 2021
Published in Issue Year 2021 Volume: 38 Issue: 4

Cite

APA Colak, S., & Gürlek, B. (2021). Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?. Journal of Experimental and Clinical Medicine, 38(4), 577-582.
AMA Colak S, Gürlek B. Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?. J. Exp. Clin. Med. October 2021;38(4):577-582.
Chicago Colak, Sabri, and Beril Gürlek. “Are Neutrophil Count and neutrophil/Lymphocyte Ratio Useful As Markers of Polycystic Ovary Syndrome in Early Reproductive Age?”. Journal of Experimental and Clinical Medicine 38, no. 4 (October 2021): 577-82.
EndNote Colak S, Gürlek B (October 1, 2021) Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?. Journal of Experimental and Clinical Medicine 38 4 577–582.
IEEE S. Colak and B. Gürlek, “Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?”, J. Exp. Clin. Med., vol. 38, no. 4, pp. 577–582, 2021.
ISNAD Colak, Sabri - Gürlek, Beril. “Are Neutrophil Count and neutrophil/Lymphocyte Ratio Useful As Markers of Polycystic Ovary Syndrome in Early Reproductive Age?”. Journal of Experimental and Clinical Medicine 38/4 (October 2021), 577-582.
JAMA Colak S, Gürlek B. Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?. J. Exp. Clin. Med. 2021;38:577–582.
MLA Colak, Sabri and Beril Gürlek. “Are Neutrophil Count and neutrophil/Lymphocyte Ratio Useful As Markers of Polycystic Ovary Syndrome in Early Reproductive Age?”. Journal of Experimental and Clinical Medicine, vol. 38, no. 4, 2021, pp. 577-82.
Vancouver Colak S, Gürlek B. Are neutrophil count and neutrophil/lymphocyte ratio useful as markers of polycystic ovary syndrome in early reproductive age?. J. Exp. Clin. Med. 2021;38(4):577-82.