Evaluation of C-reactive protein/albumin ratio in women with polycystic ovarian syndrome and women without polycystic ovarian syndrome
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252938Keywords:
Polycystic ovary syndrome, CRP/albumin ratio, Inflammation, BiomarkerAbstract
Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology. Emerging evidence suggests a role of chronic low-grade inflammation in PCOS pathophysiology. The C-reactive protein (CRP)/albumin ratio, reflecting both inflammation and nutritional status, may serve as a sensitive biomarker in PCOS.
Methods: A cross-sectional study was conducted over one year on 100 women aged 20–40 years attending the Obstetrics and Gynaecology department of Navodaya Medical College, Raichur. Group A included 50 women without PCOS, and group B included 50 women with PCOS (diagnosed by Rotterdam criteria). Serum CRP and albumin were measured, and the CRP/albumin ratio was calculated. Data were analysed using independent t-test, Chi-square test, and ROC curve analysis. A p-value <0.05 was considered statistically significant.
Results: Women with PCOS had significantly higher BMI and waist circumference (p<0.001). CRP levels were higher (4.8±1.4 mg/l versus 1.9±0.8 mg/l) and albumin levels lower (3.2±0.5 g/dl versus 4.1±0.4 g/dl) in PCOS compared to controls, resulting in a higher CRP/albumin ratio (2.8±1.2 versus 1.4±0.6, p<0.001). Elevated ratios were present even in lean PCOS cases. ROC curve analysis yielded an AUC of 0.89, with sensitivity 70% and specificity 84% at a cut-off >2.0.
Conclusions: CRP/albumin ratio is significantly elevated in PCOS, independent of obesity, and may serve as a simple, cost-effective marker of inflammation and metabolic dysfunction, aiding early diagnosis and risk stratification.
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References
Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham FG. Williams Gynecology. 2016;3.
Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016;31(12):2841-55. DOI: https://doi.org/10.1093/humrep/dew218
Berek JS. Berek & Novak’s Gynecology. 16th edition. Philadelphia: Lippincott Williams & Wilkins. 2020.
Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN, et al. The management of anovulatory infertility in women with PCOS: WHO guidance. Hum Reprod Update. 2016;22(6):687-708. DOI: https://doi.org/10.1093/humupd/dmw025
Rosenfield RL, Ehrmann DA. Pathogenesis of polycystic ovary syndrome. N Engl J Med. 2016;374(13):1298-309.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to PCOS. Fertil Steril. 2004;81(1):19-25. DOI: https://doi.org/10.1016/j.fertnstert.2003.10.004
González F. Inflammation in polycystic ovary syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012;77(4):300-5. DOI: https://doi.org/10.1016/j.steroids.2011.12.003
Saeedi S, Sabet S, Setoodeh A, Afkhami-Ardekani M, Tabatabaei-Malazy O, Amouzegar A, et al. The role of chronic inflammation in polycystic ovarian syndrome: a systematic review and meta-analysis focusing on circulating CRP levels in PCOS. J Inflamm Res. 2023;16:123-36.
Carmina E, Bucchieri S, Esposito A, Del Puente A, Mansueto P, Orio F. Abdominal fat quantity and distribution in women with polycystic ovary syndrome and extent of its relation to insulin resistance. J Clin Endocrinol Metab. 2007;92(7):2500-5. DOI: https://doi.org/10.1210/jc.2006-2725
Lim SS, Davies MJ, Norman RJ, Moran LJ. Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2012;18(6):618-37. DOI: https://doi.org/10.1093/humupd/dms030
Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflammatory markers in polycystic ovary syndrome: a systematic review and meta-analysis. Fertil Steril. 2011;95(3):1048-58. DOI: https://doi.org/10.1016/j.fertnstert.2010.11.036
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
Begum B, Polly P, Neha K, Zaman S, Mozumder SA. C-reactive protein to albumin ratio in polycystic ovarian syndrome. Int J Reprod Contracept Obstet Gynecol. 2023;12(12):3404-10. DOI: https://doi.org/10.18203/2320-1770.ijrcog20231906
Upadhyay N, Sharma S, Yadav M, Jain N, Mishra P, Sharma A. Evaluation of CRP/Albumin Ratio in Polycystic Ovarian Syndrome: A Case-Control Study. J Obstet Gynaecol India. 2023;74(2):165-9. DOI: https://doi.org/10.1007/s13224-023-01897-y
Daan NMP, Louwers YV, Koster MPH, Eijkemans MJC, de Rijke YB, Lentjes EW, et al. Biomarker profiles in women with PCOS and PCOS offspring. PLoS One. 2016;11(11):e0165033. DOI: https://doi.org/10.1371/journal.pone.0165033
Duleba AJ, Dokras A. Is PCOS an inflammatory process? Fertil Steril. 2012;97(1):7-12. DOI: https://doi.org/10.1016/j.fertnstert.2011.11.023
Ganie MA, Sahar T, Rashid A, Wani IA, Nisar S, Sathyapalan T, et al. Comparative evaluation of biomarkers of inflammation among Indian women with PCOS consuming vegetarian vs non-vegetarian diet. Front Endocrinol (Lausanne). 2019;10:699. DOI: https://doi.org/10.3389/fendo.2019.00699
Özgökçe C, Elçi E, Yıldızhan R. C-reactive protein, fibrinogen, leptin, and adiponectin levels in women with polycystic ovary syndrome. J Obstet Gynaecol India. 2020;70(6):490-6. DOI: https://doi.org/10.1007/s13224-020-01331-7
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