Obesity, depression, and chronic low-grade inflammation in women with polycystic ovary syndrome

• Published in: Brain, behavior, and immunity Vol. 22; no. 2; pp. 177 - 184
• Main Authors: Benson, S, Janssen, O.E, Hahn, S, Tan, S, Dietz, T, Mann, K, Pleger, K, Schedlowski, M, Arck, P.C, Elsenbruch, S
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.02.2008
• Subjects: Adult; Allergy and Immunology; Biomarkers - blood; Body Mass Index; Cardiovascular Diseases - epidemiology; Chronic Disease; Chronic low-grade inflammation; Cross-Sectional Studies; Cytokines; Depression; Depressive Disorder - epidemiology; Depressive Disorder - immunology; Depressive Disorder - psychology; Female; Humans; Inflammation - epidemiology; Inflammation - immunology; Inflammation - psychology; Obesity; Obesity - epidemiology; Obesity - immunology; Obesity - psychology; Polycystic ovary syndrome; Polycystic Ovary Syndrome - epidemiology; Polycystic Ovary Syndrome - immunology; Polycystic Ovary Syndrome - psychology; Predictive Value of Tests; Psychiatry; Risk Factors; Polycystic ovary syndrome; Obesity; Depression; Chronic low-grade inflammation; Cytokines
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2007.07.003

Abstract Background and objective Women with polycystic ovary syndrome (PCOS) present with multiple risk factors for cardiovascular diseases at a young age, including obesity and chronic low-grade inflammation. Since depression is common in PCOS, this study aimed to address whether depression correlates with indices of chronic low-grade inflammation beyond the association with obesity. Methods Serum concentrations of IL-6, the stimulated production of IFN-γ, TNF-α, IL-2, IL-4, IL-5, and IL-10, leukocyte numbers, and hsCRP were analyzed in 57 PCOS patients and 28 healthy women, together with clinical parameters, including body mass index (BMI), testosterone, and insulin resistance (HOMA-IR), and psychological parameters, including Beck Depression Inventory (BDI) and health-related quality-of-life (SF-36) scores. Results PCOS patients demonstrated significantly increased hsCRP, IL-6, and leukocyte numbers. Group differences in IL-6 and leukocyte numbers, but not hsCRP, disappeared after controlling for BMI. The stimulated production of IFN-γ, TNF-α, IL-2, IL-4, and IL-5 was significantly decreased, irrespective of BMI. In PCOS, hsCRP, IL-6, and leukocyte numbers were correlated with BMI, HDL, diastolic blood pressure, and with insulin resistance. On the other hand, no correlations were found with depression scores or with PCOS-specific endocrine abnormalities. In regression models, BMI was a significant predictor of the key immune markers, and explained a large amount of variance, whereas BDI was not included in either model. Conclusions These data confirm that obesity plays a pivotal role in inflammatory processes relevant to cardiovascular risk in women with PCOS. However, even lean PCOS patients may display subtle alterations in specific aspects of immunity. Our findings did not support a correlation of depression with chronic low-grade inflammation in PCOS.