Serum High-Sensitivity C-Reactive Protein Levels in Women with Polycystic Ovary Syndrome: A Case-Control Study
DOI:
https://doi.org/10.55489/ijmr.1401202690Keywords:
PCOS, hs-CRP, inflammation, metabolic risk, diagnostic marker, Rotterdam criteriaAbstract
Introduction: Polycystic Ovary Syndrome is a prevalent endocrine disorder marked by reproductive and metabolic disturbances, often accompanied by chronic low-grade inflammation. High-sensitivity C-reactive protein (hs-CRP) has gained attention as a potential marker reflecting this inflammatory burden and its metabolic consequences. This study aimed to assess the diagnostic value of hs-CRP and its association with clinical features in women with PCOS.
Method: A case-control study was done over one year at a tertiary care center, including 42 women diagnosed with PCOS based on Rotterdam criteria and 83 age-matched healthy controls. Demographic, anthropometric, clinical, and biochemical parameters were recorded. hs-CRP levels were estimated using standardized laboratory methods. Statistical analysis included independent t-tests, chi-square tests, and ROC curve analysis, with p < 0.05 considered significant.
Result: PCOS patients had significantly higher hs-CRP levels (3.9 ± 3.6 mg/L) than controls (1.0 ± 1.1 mg/L; p < 0.001). ROC analysis showed good diagnostic performance (AUC 0.827). A cutoff of 1.17 mg/L showed 85.7% sensitivity and 68.7% specificity. Dysmenorrhea showed a significant association with higher hs-CRP categories, while other symptoms showed non-significant trends toward elevated levels.
Conclusion: hs-CRP is a valuable marker for identifying inflammatory and metabolic risk in PCOS and may support early risk stratification.
References
1. Shukla A, Rasquin LI, Anastasopoulou C. Polycystic Ovarian Syndrome. Encyclopedia of Genetics, Genomics, Proteomics and Informatics 2025:1528-1528. DOI: https://doi.org/10.1007/978-1-4020-6754-9_13178
2. Upadhyay N, Almeida EA, Singh A, Madhu SV, Puri D, Mehndiratta M. Evaluation of CRP/Albumin Ratio in Polycystic Ovarian Syndrome. J Obstet Gynaecol India. 2024 Apr;74(2):165-169. DOI: https://doi.org/10.1007/s13224-023-01897-y PMid:38707880 PMCid:PMC11065824
3. Bril F, Ezeh U, Amiri M, Hatoum S, Pace L, Chen YH, Bertrand F, Gower B, Azziz R. Adipose Tissue Dysfunction in Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023 Dec 21;109(1):10-24. DOI: https://doi.org/10.1210/clinem/dgad356 PMid:37329216 PMCid:PMC10735305
4. da Cunha Junior AD, Carrilho LAO, Nunes Filho PRS, Cantini L, Vidal L, Mendes MCS, et al. The Role of Metabolic Inflammation and Insulin Resistance in Obesity-Associated Carcinogenesis-A Narrative Review. Onco 2025;5(4):47. DOI: https://doi.org/10.3390/onco5040047
5. Lonardo A, Weiskirchen R. Insulin Resistance at the Crossroads of Metabolic Inflammation, Cardiovascular Disease, Organ Failure and Cancer. Biomolecules. 2025 Dec 17;15(12):1745. DOI: https://doi.org/10.3390/biom15121745 PMid:41463398 PMCid:PMC12730331
6. Mansoori A, Allahyari M, Mirvahabi MS, Tanbakuchi D, Ghoflchi S, Derakhshan-Nezhad E, et al. Predictive properties of novel anthropometric and biochemical indexes for prediction of cardiovascular risk. Diabetol Metab Syndr. 2024 Dec 19;16(1):304. DOI: https://doi.org/10.1186/s13098-024-01516-4 PMid:39696688 PMCid:PMC11657368
7. Bagherniya M, Khayyatzadeh SS, Heidari Bakavoli AR, Ferns GA, Ebrahimi M, Safarian M, et al. Serum high-sensitive C-reactive protein is associated with dietary intakes in diabetic patients with and without hypertension: a cross-sectional study. Ann Clin Biochem. 2018 Jul;55(4):422-429. DOI: https://doi.org/10.1177/0004563217733286 PMid:28882065
8. Dayal D, Jain H, Attri SV, Bharti B, Bhalla AK. Relationship of High Sensitivity C-Reactive Protein Levels to Anthropometric and other Metabolic Parameters in Indian Children with Simple Overweight and Obesity. J Clin Diagn Res 2014;8(8):PC05-PC08. DOI: https://doi.org/10.7860/JCDR/2014/8191.4685 PMid:25300641 PMCid:PMC4190765
9. Lejman-Larysz K, Pietrzyk D, Ćwiertnia A, Kozłowski M, Kwiatkowski S, Szydłowska I, et al. Influence of hsCRP Parameter on the Occurrence of Metabolic Syndrome in Patients with Polycystic Ovary Syndrome. Biomedicines 2023;11(7):1953. DOI: https://doi.org/10.3390/biomedicines11071953 PMid:37509592 PMCid:PMC10377555
10. Wang R, Mol BWJ. The Rotterdam criteria for polycystic ovary syndrome: evidence-based criteria? Human Reproduction 2017;32(2):261-264. DOI: https://doi.org/10.1093/humrep/dew287 PMid:28119448
11. Bhatti M, Amin N, Satti IA, Khan HG, Rauf A, Zahra RT. Association of Socio-demographic factors with Polycystic Ovarian Syndrome; A Comparative Study. Pakistan Armed Forces Medical Journal 2024;74(1):224-227. DOI: https://doi.org/10.51253/pafmj.v74i1.11187
12. Bokka SLA, Maktha VK. Impact of Polycystic Ovary Syndrome on Health-Related Quality of Life: A Cross-Sectional Study Using the PCOSQOL Scale. Natl J Community Med. 2026;17(3):182-186. DOI: https://doi.org/10.55489/njcm.170320266119
13. Karaca Adıyeke S, Karaca I, Yıldırım S, Adıyeke M, Uyar İ, Türe G. Anterior Segment Findings in Women with Polycystic Ovary Syndrome. Turk J Ophthalmol. 2017 Jan;47(1):24-27. DOI: https://doi.org/10.4274/tjo.73659 PMid:28182154 PMCid:PMC5282537
14. Fakhoury H, Tamim H, Ferwana M, Siddiqui IA, Adham M, Tamimi W. Age and BMI Adjusted Comparison of Reproductive Hormones in PCOS. J Family Med Prim Care. 2012 Jul;1(2):132-136. DOI: https://doi.org/10.4103/2249-4863.104984 PMid:24479022 PMCid:PMC3893977
15. Mohapatra I, Samantaray SR. BMI and Polycystic Ovary Syndrome: Demographic Trends in Weight and Health. Cureus. 2024 Mar 3;16(3):e55439. DOI: https://doi.org/10.7759/cureus.55439 PMID: 38567220; PMCID: PMC10986768
16. Essah PA, Nestler JE. The metabolic syndrome in polycystic ovary syndrome. J Endocrinol Invest. 2006 Mar;29(3):270-80. DOI: https://doi.org/10.1007/BF03345554 PMid:16682845
17. Mellembakken JR, Mahmoudan A, Mørkrid L, Sundström-Poromaa I, Morin-Papunen L, et al. Higher blood pressure in normal weight women with PCOS compared to controls. Endocr Connect. 2021 Feb;10(2):154-163. DOI: https://doi.org/10.1530/EC-20-0527 PMid:33416512 PMCid:PMC7983477
18. Berbrier DE, Coovadia Y, Malenda D, Usselman CW. Polycystic ovary syndrome potentiates blood pressure and vascular responses to the cold pressor test. J Appl Physiol (1985). 2025 Feb 1;138(2):404-414. DOI: https://doi.org/10.1152/japplphysiol.00697.2024 PMid:39661365
19. Bhumika Pareek1 CKABMV. Comparison of Lipid Profile in Women Suffering from Polycystic Ovarian Syndrome and Healthy Women: A Cross Sectional Study . International Journal of Pharmaceutical and Clinical Research. 2024;16(3);1745-1750.
20. Wild RA, Rizzo M, Clifton S, Carmina E. Lipid levels in polycystic ovary syndrome: Systematic review and meta-analysis. Fertil Steril. 2011 Mar 1;95(3):1073-9.e1-11. DOI: https://doi.org/10.1016/j.fertnstert.2010.12.027 PMid:21247558
21. Kalyan S, Goshtesabi A, Sarray S, Joannou A, Almawi WY. Assessing C reactive protein/albumin ratio as a new biomarker for polycystic ovary syndrome: a case-control study of women from Bahraini medical clinics. BMJ Open 2018;8(10):e021860. DOI: https://doi.org/10.1136/bmjopen-2018-021860 PMid:30368447 PMCid:PMC6224721
22. D. R, K. SV. Evaluation of C-reactive protein/albumin ratio in women with polycystic ovarian syndrome and women without polycystic ovarian syndrome. Int J Res Med Sci. 2025 Sep. 18;13(10):4035-40. DOI: https://doi.org/10.18203/2320-6012.ijrms20252938
23. Begum A, Morshed MS, Banu H, Zamila BM, Shah S, Hasanat M. Association of High Sensitivity C-Reactive Protein in Polycystic Ovary Syndrome. Journal of Dhaka Medical College 2023;30:142-148. DOI: https://doi.org/10.3329/jdmc.v30i2.56918
24. Ramanand S, Ramanand J, Raparti G, Ghanghas R, Halasawadekar N, Patil P, et al. High sensitivity C - reactive protein (hs-CRP) and clinical characteristics, endocrine, metabolic profile in Indian women with PCOS: a correlation. Int J Reprod Contracept Obstet Gynecol 2016;3(1):118-126. DOI: https://doi.org/10.5455/2320-1770.ijrcog20140324
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