Elevation of markers of endotoxemia in women with polycystic ovary syndrome.
Level 4 - case-series / case-control
Cross-sectional comparative study
PubMed 32869098 · doi:10.1093/humrep/deaa194
What was done
A cross-sectional study compared markers of endotoxemia across three groups: women with polycystic ovary syndrome (PCOS, n = 62), healthy ovulatory women with polycystic ovary morphology (PCOM, n = 39), and healthy ovulatory control women without PCOM (NL, n = 43). Lipopolysaccharide (LPS) was measured via chromogenic assay and LPS-binding protein (LBP) by ELISA. Lipids were assessed by colorimetric methods, glucose by hexokinase enzymatic assay, and androgens, gonadotrophins, prolactin, insulin, high-sensitivity C-reactive protein (hs-CRP), and sex hormone-binding globulin by electrochemiluminescence.
What was found
Compared with normal controls, women with PCOS had significantly higher mean LPS (P = 0.045), LPS/HDL ratio (P = 0.007), and LBP (P = 0.01), with PCOM subjects showing intermediate levels. Across all groups, endotoxemia markers correlated positively with testosterone level, ovarian volume, antral follicle count, and hirsutism score, and negatively with spontaneous menses per year. In multiple regression analysis, all endotoxemia measures correlated independently and positively with hs-CRP and ovarian volume. Absolute values (means, standard deviations, effect sizes) were not provided in the abstract.
Why it matters
This study shows that endotoxemia markers are elevated in young women with PCOS and correlate with hallmark clinical and endocrine features. It suggests gut-derived inflammatory factors could be linked to the pathogenesis or cardiovascular/metabolic risks of PCOS.
Limits
The cross-sectional design cannot establish causality or underlying mechanisms. Steroids were measured by electrochemiluminescence instead of the gold-standard liquid chromatography-mass spectrometry (LC-MS). The sample size is modest (n = 144 total), and numerical baseline and outcome data are omitted from the abstract.
Cited by
- contradicts Elevated lipopolysaccharide (LPS) can reduce testosterone production in women.