Quantitative Changes in White Blood Cells: Correlation with the Hallmarks of Polycystic Ovary Syndrome

• Published in: Medicina (Kaunas, Lithuania) Vol. 58; no. 4; p. 535
• Main Authors: Almaeen, Abdulrahman H, Alduraywish, Abdulrahman Abdulwahab, Nabi, Mudasar, Shah, Naveed Nazir, Shaik, Rahiman, Tantry, Bilal Ahmad
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12.04.2022; MDPI
• Subjects: Age; Atherosclerosis; Biomarkers; Blood platelets; Case-Control Studies; Cholesterol; Confidence intervals; Female; Hematology; High density lipoprotein; hormonal profile; Humans; Infertility; Inflammation; Laboratories; Leukocyte Count; Lipids; low-grade inflammation; Lymphocytes; Menstruation; Metabolic syndrome; neutrophil count; Neutrophils; neutrophil–lymphocyte ratio; Obesity; Ovaries; Polycystic ovary syndrome; Polycystic Ovary Syndrome - complications; Regression analysis; reproductive age women; Statistical analysis; Testosterone; Thyroid gland; Triglycerides; Ultrasonic imaging; hormonal profile; metabolic syndrome; neutrophil count; metabolic profile; low-grade inflammation; neutrophil–lymphocyte ratio; reproductive age women; polycystic ovary syndrome
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina58040535

Background and Objectives: In women of reproductive age, leukocytosis is a risk factor that bridges low-grade chronic inflammation (metabolic inflammation), metabolic changes, and polycystic ovary syndrome (PCOS) and is a potential early predictor of PCOS. This study aims to explore the predictive role of quantitative changes in white blood cells (WBCs) and neutrophils in PCOS-associated metabolic changes. Materials and Methods: A total number of 176 blood samples were obtained from age-matched women of the reproductive period, comprising 88 PCOS cases and 88 healthy controls. Hematological, metabolic, and anthropometric indices and ultrasonic assessment were recorded. Results: Elevated levels of luteinizing hormone, testosterone, and lipid parameters except HDL-C levels, and the prevalence of metabolic syndrome in PCOS were statistically significant (p < 0.001). The neutrophil count and neutrophil−lymphocyte ratio (NLR) in PCOS patients were significantly higher (p < 0.001) than their counterparts. The predictive ability of the neutrophil count and neutrophil−lymphocyte ratio (NLR) for PCOS, and possibly its associating subclinical inflammation at optimum cut-off values for the neutrophil count and NLR of >46.62% (sensitivity 94.32% and specificity 74.42%) and >1.23 (sensitivity 71.59% and specificity 100%), respectively. With regard to the areas under the curve (AUC) and Youden indices, they constituted 0.922 and 0.697 for neutrophil count and 0.926 and 0.716 for NLR, respectively. The comparative ROC z-statistic value was 2.222 and a p = 0.026. The multiple linear regression analysis revealed no significant influence for hormonal and metabolic independent variables on the neutrophil count in PCOS cases, but, as can be expected, revealed a significant negative relationship with the other components of WBCs. Conclusion: In conclusion, relative neutrophilia and elevated NLR are potential cost-effective, sensitive, and specific predictors of PCOS that may also shed light on the mechanism of chronic low-grade inflammation that is characteristic of the disease.