Endocrine Abstracts

Objective

Policystic ovary syndrome (PCOS) is a multifactorial disease characterized by reproductive and metabolic impairments. PCOS patients could present anovulation, hirsutism and infertility as well as higher prevalence of metabolic syndrome, glucose intolerance and diabetes. Insulin-resistance (IR) together with hyperandrogenism represent the main players, with reciprocal influences in a vicious circle: insulin promotes androgen secretion in thecal cells and hyperandrogenism has been related to adipose tissue dysfunction that lead to IR and hyperinsulinemia. Both factors contribute to create in PCOS patients a state of chronic low-grade inflammation (LGI), which may have an important role in the physiopathology of the disease; however, it is predominantly evaluated in obese PCOS. Therefore, we performed an observational case–control study to investigate inflammatory and immunological parameters, such as IgG subclasses and free light chains (FLCs) and hemolytic complement activity (CH50) in non-obese PCOS, evaluating their relations with metabolic and hormonal parameters.

Methods

36 subjects were studied: 16 PCOS patients (mean ± s.e.m. 27.13 ± 1.82 age; BMI 24.1±0.9 kg/m²); 20 controls (aged 26.05 ± 0.73). Blood sample was collected for metabolic and hormonal parameters, IgG subclasses, k and λ FLCs, CH50. Hormones were measured by immunochemiluminometric assays; Metabolic parameters by enzymatic assays; subclasses of IgG, FLCs and CH50 were evaluated by turbidimetric method.

Results

PCOS patients showed significant lower IgG1, IgG2, IgG3 compared with controls (mean ± s.e.m. 3.76 ± 0.29 g/l, 2.63 ± 0.20, 0.62 ± 0.06, 0.34 ± 0.08 vs 6.49 ± 0.35, 4.28 ± 0.25, 0.84 ± 0.07, 0.33 ± 0.04, respectively) and higher levels of FLCs (k 12.22 ± 0.71 vs 6.03 ± 0.30, λ 10.10 ± 0.79 vs 8.04 ± 0.48 g/l) and CH50 (48.64 ± 2.65 vs 36.51 ± 1.38 U/ml); we found correlation between IgG2 and free-testosterone (r = 0.72, P = 0.005) and CH50 and vitamin D (r = 0.54, P = 0.04); an inverse correlation was found between IgG1 and, respectively, ACTH (r = -0.57, P = 0.02) and cortisol (r = 0.78, P = 0.001) in PCOS.

Conclusions

In the complex scenario of low-grade inflammation in non-obese PCOS, we showed lower levels of main subclasses of IgG and higher CH50 levels, suggesting involvement of other mechanisms other than “classical” pathway of complement activation; FLCs could be attractive to monitor inflammation degree, disease activity and influence on hormonal status.