Halis Doğukan Ozkan, Merve Ayas Ozkan, Ruken Dayanan, Dilara Duygulu Bulan, Ahmet Arif Filiz, Yaprak Engin-Ustun
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Composite inflammatory markers were calculated from complete blood count parameters, and their association with clinical, hormonal, and ultrasonographic findings was analyzed. ROC analysis assessed the discriminatory value of each marker.</p><p><strong>Results: </strong>Inflammatory markers were significantly higher in the oligo-/amenorrhea and PCOM groups. In oligo-/amenorrhea, NLR (2.42 vs. 1.96, p = 0.028), AISI (282.16 vs. 188.73, p = 0.005), SII (664.59 vs. 519.86, p = 0.008), and SIRI (0.97 vs. 0.70, p = 0.005) were elevated. In PCOM, NLR (2.85 vs. 2.25, p = 0.025), AISI (323.15 vs. 262.78, p = 0.049), SII (738.52 vs. 641.27, p = 0.030), and SIRI (1.10 vs. 0.90, p = 0.046) were also higher. AISI showed the best discrimination for oligo-/amenorrhea (AUC = 0.652), while NLR was most predictive for PCOM (AUC = 0.617).</p><p><strong>Conclusions: </strong>Composite inflammatory markers are elevated in specific PCOS phenotypes, especially oligo-/amenorrhea and PCOM, and may reflect low-grade inflammation. These markers may help identify patients at higher cardiometabolic risk and guide preventive strategies.</p>","PeriodicalId":9204,"journal":{"name":"BMC Women's Health","volume":"25 1","pages":"463"},"PeriodicalIF":2.7000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481869/pdf/","citationCount":"0","resultStr":"{\"title\":\"Inflammatory status and clinical phenotypes of PCOS: the role of NLR, SII, SIRI, and AISI.\",\"authors\":\"Halis Doğukan Ozkan, Merve Ayas Ozkan, Ruken Dayanan, Dilara Duygulu Bulan, Ahmet Arif Filiz, Yaprak Engin-Ustun\",\"doi\":\"10.1186/s12905-025-04033-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder in women of reproductive age, often associated with low-grade chronic inflammation. This study aimed to investigate the relationship between composite inflammatory markers-Neutrophil-to-Lymphocyte Ratio (NLR), Systemic Immune Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)-and clinical phenotypes of PCOS, including oligo-/amenorrhea, hyperandrogenism, and polycystic ovarian morphology (PCOM). METHODS : In this retrospective cross-sectional study, women with PCOS were categorized into subgroups based on clinical phenotypes. Composite inflammatory markers were calculated from complete blood count parameters, and their association with clinical, hormonal, and ultrasonographic findings was analyzed. ROC analysis assessed the discriminatory value of each marker.</p><p><strong>Results: </strong>Inflammatory markers were significantly higher in the oligo-/amenorrhea and PCOM groups. In oligo-/amenorrhea, NLR (2.42 vs. 1.96, p = 0.028), AISI (282.16 vs. 188.73, p = 0.005), SII (664.59 vs. 519.86, p = 0.008), and SIRI (0.97 vs. 0.70, p = 0.005) were elevated. In PCOM, NLR (2.85 vs. 2.25, p = 0.025), AISI (323.15 vs. 262.78, p = 0.049), SII (738.52 vs. 641.27, p = 0.030), and SIRI (1.10 vs. 0.90, p = 0.046) were also higher. AISI showed the best discrimination for oligo-/amenorrhea (AUC = 0.652), while NLR was most predictive for PCOM (AUC = 0.617).</p><p><strong>Conclusions: </strong>Composite inflammatory markers are elevated in specific PCOS phenotypes, especially oligo-/amenorrhea and PCOM, and may reflect low-grade inflammation. 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引用次数: 0
摘要
背景：多囊卵巢综合征（PCOS）是育龄妇女常见的内分泌代谢紊乱，常伴有低度慢性炎症。本研究旨在探讨炎症综合标志物中性粒细胞与淋巴细胞比值（NLR）、全身免疫炎症指数（SII）、全身炎症反应指数（SIRI）和全身炎症综合指数（AISI）与PCOS临床表型（包括少/闭经、高雄激素症和多囊卵巢形态（PCOM））的关系。方法：在这项回顾性横断面研究中，多囊卵巢综合征女性根据临床表型被分为亚组。根据全血细胞计数参数计算复合炎症标志物，并分析其与临床、激素和超声检查结果的关系。ROC分析评估各标志物的鉴别价值。结果：少经/闭经组和PCOM组炎症指标明显升高。在少经/闭经中，NLR （2.42 vs. 1.96, p = 0.028）、AISI （282.16 vs. 188.73, p = 0.005）、SII （664.59 vs. 519.86, p = 0.008）和SIRI （0.97 vs. 0.70, p = 0.005）升高。在PCOM中，NLR （2.85 vs. 2.25, p = 0.025）、AISI （323.15 vs. 262.78, p = 0.049）、SII （738.52 vs. 641.27, p = 0.030）和SIRI （1.10 vs. 0.90, p = 0.046）也较高。AISI对寡经/闭经的预测效果最好（AUC = 0.652）， NLR对PCOM的预测效果最好（AUC = 0.617）。结论：复合炎症标志物在特定PCOS表型中升高，特别是少经/闭经和PCOM，可能反映低级别炎症。这些标志物可能有助于识别心脏代谢风险较高的患者，并指导预防策略。
Inflammatory status and clinical phenotypes of PCOS: the role of NLR, SII, SIRI, and AISI.
Background: Polycystic ovary syndrome (PCOS) is a common endocrine-metabolic disorder in women of reproductive age, often associated with low-grade chronic inflammation. This study aimed to investigate the relationship between composite inflammatory markers-Neutrophil-to-Lymphocyte Ratio (NLR), Systemic Immune Inflammation Index (SII), Systemic Inflammation Response Index (SIRI), and Aggregate Index of Systemic Inflammation (AISI)-and clinical phenotypes of PCOS, including oligo-/amenorrhea, hyperandrogenism, and polycystic ovarian morphology (PCOM). METHODS : In this retrospective cross-sectional study, women with PCOS were categorized into subgroups based on clinical phenotypes. Composite inflammatory markers were calculated from complete blood count parameters, and their association with clinical, hormonal, and ultrasonographic findings was analyzed. ROC analysis assessed the discriminatory value of each marker.
Results: Inflammatory markers were significantly higher in the oligo-/amenorrhea and PCOM groups. In oligo-/amenorrhea, NLR (2.42 vs. 1.96, p = 0.028), AISI (282.16 vs. 188.73, p = 0.005), SII (664.59 vs. 519.86, p = 0.008), and SIRI (0.97 vs. 0.70, p = 0.005) were elevated. In PCOM, NLR (2.85 vs. 2.25, p = 0.025), AISI (323.15 vs. 262.78, p = 0.049), SII (738.52 vs. 641.27, p = 0.030), and SIRI (1.10 vs. 0.90, p = 0.046) were also higher. AISI showed the best discrimination for oligo-/amenorrhea (AUC = 0.652), while NLR was most predictive for PCOM (AUC = 0.617).
Conclusions: Composite inflammatory markers are elevated in specific PCOS phenotypes, especially oligo-/amenorrhea and PCOM, and may reflect low-grade inflammation. These markers may help identify patients at higher cardiometabolic risk and guide preventive strategies.
期刊介绍：
BMC Women''s Health is an open access, peer-reviewed journal that considers articles on all aspects of the health and wellbeing of adolescent girls and women, with a particular focus on the physical, mental, and emotional health of women in developed and developing nations. The journal welcomes submissions on women''s public health issues, health behaviours, breast cancer, gynecological diseases, mental health and health promotion.
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