Chronic low-grade inflammation plays a crucial role in the
pathophysiology of polycystic ovary syndrome (PCOS). Although there is an
overwhelming number of studies investigating inflammatory markers in PCOS,
inconsistencies and disparities in findings have made it challenging for
clinicians and researchers to draw clear conclusions and design future studies.
This systematic review aims to synthesise recent evidence on key inflammatory
markers in PCOS, with a particular focus on the role of interleukin-6 (IL-6),
to provide greater clarity and guidance for clinical decision-making and
research directions. A comprehensive literature search was conducted using the
PubMed, Web of Science, Cochrane Library, and Google Scholar databases. Studies
published between 2014 and 2024 were screened based on predefined eligibility
criteria. Both observational and interventional studies that reported levels of
inflammatory markers in patients with polycystic ovary syndrome (PCOS) were
included. Data were systematically extracted, and the quality of the studies
was assessed using the Newcastle-Ottawa Scale (NOS) for observational studies,
the Cochrane Risk of Bias tool for randomised controlled trials (RCTs), and the
ROBINS-1 tool for non-randomised controlled trials. A statistical synthesis of
IL-6 levels was performed for the meta-analysis using a random-effects model in
R. A total of 44 studies met the inclusion criteria for qualitative analysis
and identified 94 biomarkers. The most commonly used biomarkers across the majority
of studies, listed in descending order, are as follows: high-sensitivity
C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha
(TNF-α), CRP, adiponectin, IL-18, vascular endothelial growth factor (VEGF),
IL-8, IL-1β, sex hormone binding globulin (SHBG), leptin, and vascular cell
adhesion protein 1 (VCAM-1). Additionally, four case-control studies conducted
in four countries (Taiwan, Russia, Spain, and Turkey) were included in the
quantitative analysis, which involved 689 participants (PCOS group: n = 365;
Control group: n = 324). The pooled mean difference (MD), calculated using the
random-effects model, was 0.72 (0.47; 0.98) (p < 0.0001), indicating a
significant increase in IL-6 levels among PCOS patients compared to the control
group. Compared to hs-CRP, a broad
marker of systemic inflammation, VCAM-1 provides a more precise measure of
vascular injury, making it a strong predictor of cardiovascular complications
in PCOS. Unlike adiponectin, which has anti-inflammatory and insulin-sensitising
properties and is reduced in PCOS, VCAM-1 is elevated, reflecting an increased
risk of vascular inflammation and cardiovascular events. Chronic low-grade
inflammation plays a crucial role in PCOS, and IL-6 levels in women with PCOS
were elevated. Potential markers that can be investigated to assess
inflammatory status in PCOS include hs-CRP, TNFα, CRP, adiponectin, IL-18,
VEGF, IL-8, iIL-1β, SHBG, leptin, and VCAM-1. The results of this review
suggest that IL-6 may serve as a valuable diagnostic and prognostic marker for
assessing inflammation in PCOS.
Author(s) Details
Bhavit Bansal
Research, Central Council for Research in Yoga and
Naturopathy, Delhi, India.
Avelyn Thazhuthadath
Kishore
Department of Plastic and Reconstructive Surgery, Jubilee Mission Medical
College and Research Institute, Thrissur, India.
Sasikala Kathiresan
Department of Obstetrics and Gynaecology, All India Institute of Medical
Sciences, Madurai, India.
Arzina Farook Ghachi
Department of Internal Medicine, Shroff Hospital, Vadodara, India.
Swetapadma Pradhan
Medical College, European University Faculty of Medicine, Tbilisi, Georgia.
Sheuli Paul
Department of Paediatrics, Dr. D. Y. Patil Medical College, Hospital and
Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pimpri,
India.
Khyati Chaturvedi
Department of Naturopathy and Yogic Science, Sant Hirdaram Medical College
of Naturopathy and Yogic Sciences for Women, Bhopal, India.
Mukul Singh
Department of Surgery, All India Institute of Medical Sciences, Gorakhpur,
India.
Sauvit Patil
Department of Molecular Neuroscience, Bristol Medical School, Faculty of
Health and Life Sciences, University of Bristol, Bristol, GBR, England.
Lalitha Soumya
Johnson
Department of Biotechnology and Microbiology, Dr. Janaki Ammal Campus,
Kannur, India.
Akshay V P
Department of Biomedical Research and Molecular Biology, Mansarovar Global
University, Bhopal, India and Department of Biomedical Sciences, BioDeskINDIA
Labs, Bhopal, India.
Delna N S
Department of Allied Health Sciences, Al-Azhar Medical College and Super
Specialty Hospital, Thodupuzha, India.
Ajita Pillai
Department of Biomedical Sciences, BioDeskINDIA Labs, Bhopal, India.
Please see the book here :- https://doi.org/10.9734/bpi/msraa/v10/6254
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