INTRODUCTION: AND METHODS: Patients were selected from

INTRODUCTION:

              
The Polycystic Ovary Syndrome (PCOS)
is a common endocrine disorder in the women of reproductive age, which is
characterised by chronic anovulation and biochemical

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or clinical hyperandrogenism. In
addition, Polycystic Ovary Syndrome also causes obesity,

 insulin resistance arterial hypertension and
disturbances of the clotting mechanism (1). All

 these disorders are related to clinical
conditions, such as cardiovascular disease, mostly

through low-grade intravascular
chronic inflammation (2). C- reactive protein (CRP) is an acute phases protein,
which is measured in the serum. It is widely used in routine clinical practice
for the monitoring of  bacterial
infections,as well as the efficacy of the antimicrobial          therapy (3). CRP serves not only as a
marker for severe infection and also of 
low-grade chronic inflammation. It constitutes a useful screening marker
of intravascular inflammatory processes (4). It is found that CRP levels have
important prognostic implications for patients (5). The JUPITER study showed
that reduced CRP levels can mitigate this risk (6). A number of previous
studies reported that PCOS is associated with increased hsCRP levels (7). Hence

PCOS is a proinflammatory state and
studies suggest that,  chronic low-grade
inflammation

underpins the development of
metabolic disturbances and ovarian dysfunction in this disorder (8,9). Many
studies have demonstrated a positive relationship between CRP values and
insulin resistance, body weight and fatty mass in women with PCOS (10,11).

                 Women with PCOS are
predisposed to increased visceral adiposity 
and this appearto be across all the categories of BMI. Using DEXA it has
been shown that subjects with

PCOS  had similar percentage of total and trunk fat
but have a higher percentage of central

 abdominal fat compared with weight-matched
controls (12). The presence of increased

visceral adipose tissue is
associated with insulin resistance, hyperglycemia and dyslipidemia which  has mentioned above are co-morbidities
associated with PCOS. Furthermore recent

 studies raises the possibility of an
intriguing association of PCOS with low-grade infections. One of the most
important markers of inflammation is CRP. CRP is an acute-phase reactant

`produced by hepatocytes under the
stimulatory control of pro-inflammatory cytokines such as interleukin (IL)-6
and tumor necrosis factor alpha (13).

                  Hence this study aims to
comparatively analyse the high sensitivity C- reactive

 protein levels in women with and without
Polycystic Ovary Syndrome.

 

MATERIALS
AND METHODS:

              
Patients were selected from those
attending the out patient department of Saveetha Dental College, and hospitals
and divided into two groups as follows:

 

Group I – Normal healthy individuals
– 25 individuals

Group II – Poly cystic ovarian
syndrome patients – 25 individuals

 

Inclusion
criteria:

?Individuals with the age group of
twenty to thirty years

?PCOS Patients

 

Exclusion
Criteria:

? *Individuals with other systemic
illness like cardio vascular disease, Renal failure, Stroke, endocrine illness.

? *Individuals with acute illness
like fever.

? *Immunocompromised individuals

 

Sample
collection:

?Informed consent was obtained from
the patient before sample collection. 3ml of venous blood was collected and
distributed in plain collection tubes and centrifuged in 3000rpm for  

serum. Then serum was separated and
analysed to estimate the CRP by Turbilatex Method using ERBA CHEM 5 plus
autoanalyser.

 

RESULTS
AND DISCUSSION:

              
All the data were analysed by using
SPSS package. Paired sample t test analysis was done to find out significant differences
between the two groups. All the tests were considered significant at p < 0.05 level.                              Table 1: Mean, SD, p values of two groups                              CRP level       Mean              SD         p value         Control          3.4           1.43             0.0001           PCOS         12.75           3.75            0.0001                        Women with PCOS are known to be at high risk for insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus. Women with PCOS are prone to obesity, which is strongly associated with insulin resistance and chronic low-grade inflammation 14-16. Circulating levels of the proinflammatory cytokine tumor necrosis factor-? (TNF?) are  elevated in obesity, and are also elevated in PCOS independent of obesity 17,18. The TNF? elevations in PCOS indicated that PCOS is a proinflammatory state. It seems there is a genetic basis for the chronic low-grade inflammation observed in PCOS. CRP is an acute-phase reactant produced by the liver following stimulation by IL-6 which is a cytokine produced by mononuclear cells and adipose tissue. It seems that IL-6 is directly responsible for stimulating hepatic C-reactive production 8,14. Alterations in circulating CRP levels reflect an exacerbation or inflammation, by making it a useful measurement of inflammatory load in  clinical practice 19-21. Among the many biomarkers of inflammation proposed for diagnostic use, CRP measured by a highly sensitive assay (hs-CRP) has generated considerable attention.   CONCLUSION:    The Polycystic Ovary Syndrome (PCOS), one of the most common reproductive abnormality which shares some components of the metabolic cardiovascular syndrome. Therefore the  PCOS patients may represent the largest group of women at high risk for the development o early onset cardiovascular disease. C reactive protein is a strong independent predictor of future CVD. CRP levels are elevated in patients with PCOS and maybe a marker of early onset of cardiovascular disease. Consequently, PCOS women with increased CRP levels awaits further clinical experience.