Objective: PCOS patients are often characterized by insulin resistance, abdominal obesity, and low-grade inflammation. Insulin sensitizing treatment reduces the inflammatory state, but the effect on serum levels of chemokines such as migration inhibitor factor (MIF), monocyte chemoattractant protein (MCP)-1, and macrophage inflammatory protein (MIP)-1α have not previously been evaluated in PCOS.
Research design and methods: Plasma chemokine levels (MCP-1, MIP-1α, and MIF) were measured in two study designs. 1) 51 hirsute patients and 63 matched controls and 2) 30 PCOS patients before and after randomized treatment with 30 mg pioglitazone/placebo for 16 weeks. Clinical evaluations and whole body DXA-scans were performed in all participants.
Results: Hirsute patients (n=51) had significantly increased MCP-1 (121 (15950) vs 81 (18365) pg/ml; P<0.05) and MIP-1α (179 (84202) vs 103 (41598) pg/ml; P<0.05) than controls of matched body composition (geometric mean (−2 to +2S.D.)). In PCOS (n=30), MCP-1, MIP-1α, and MIF correlated positively with central fat mass. A BMI independent positive association was found between MIF-1 and free testosterone (r=0.49, P=0.01) in PCOS.
Pioglitazone treatment significantly improved insulin sensitivity without affecting testosterone, body composition, MCP-1, MIP-1α, and MIF levels.
Conclusions: Chemokine levels were significantly increased and showed close associations with measures of adiposity in PCOS patients, but were unchanged during insulin sensitizing treatment with pioglitazone. Our data suggests a fat mass independent association between testosterone and MIF-1 levels in PCOS and the effect of antiandrogen treatment on chemokine levels needs to be examined.
25 - 29 Apr 2009
European Society of Endocrinology