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. 2020 Aug 18:13:441-450.
doi: 10.2147/JIR.S260770. eCollection 2020.

Peripheral Blood Inflammatory-Immune Cells as a Predictor of Infertility in Women with Polycystic Ovary Syndrome

ShuQiong He #  1 , XiaoDan Mao #  2   3 , HuiFang Lei  2   3 , BinHua Dong  2   3 , DanHua Guo  1 , BeiHong Zheng  4 , PengMing Sun  2   3
Affiliations

Peripheral Blood Inflammatory-Immune Cells as a Predictor of Infertility in Women with Polycystic Ovary Syndrome

ShuQiong He et al. J Inflamm Res. .

Abstract

Purpose: This study aimed to investigate the inflammatory-immune cells in the peripheral blood of women with polycystic ovary syndrome (PCOS) and assessed the potential correlation between inflammatory-immune cells and infertility in PCOS women.

Materials and methods: In this case-control study, the profiles of lymphocyte subsets were analyzed by flow cytometry. White blood cells (WBC), neutrophils (Neu), lymphocytes, Ferriman-Gallwey (F-G) score, testosterone, prolactin, follicle-stimulating hormone, luteinizing hormone, fasting blood glucose, and fasting plasma insulin were measured, together with body mass index. Association between inflammatory-immune cells and PCOS was evaluated. Moreover, inflammatory-immune cells of the PCOS women with infertility were evaluated, and the relative operating characteristic (ROC) curve and cutoff values were calculated.

Results: The number of WBC, Neu, and lymphocytes was higher in PCOS women than controls (P<0.05). The percentages of total T lymphocytes, CD4+T, and NK were significantly increased in the PCOS group (P<0.001). The CD4/CD8 ratio was obviously elevated for increasing CD4+T (P<0.05). Consequently, T%, CD4+T%, and NK% were found to be the independent risk factors of PCOS by ROC curve and multivariate logistic regression analysis. Furthermore, only NK% was significantly higher in PCOS women with infertility than those who had PCOS without infertility (P<0.001). To diagnose infertility in PCOS, the cutoff value of NK% was calculated as 16.43%.

Conclusion: These findings suggest that the pathogenesis of PCOS is related to immune cells including T, CD4+T, and NK cells. NK cells are likely to be a potential predictive factor for PCOS women with infertility.

Keywords: immunocompetent cells; inflammatory cells; lymphocyte subsets; natural killer cells; pathogenesis.

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Conflict of interest statement

The authors declare that they have no conflicts of interest for this work.

Figures

Figure 1
Figure 1
The flowchart of inclusion and exclusion criteria of the study population. Abbreviations: PCOS, polycystic ovary syndrome; FBG, fasting blood glucose; FINS, fasting plasma insulin; WBC, white blood cells; Neu, neutrophil granulocyte; A phenotype, patients with hyperandrogenism (H) + oligomenorrhea (O) + the observation of polycystic ovaries on a sonogram (PCO); B phenotype, patients with H + O; C phenotype, patients with H + PCO; D phenotype, patients with O + PCO.
Figure 2
Figure 2
ROC curve analysis of inflammatory immune cells of study groups. (A) ROC curve analysis of WBC in peripheral blood (PB); (B) ROC curve analysis of Neu in PB. (C) ROC curve analysis of lymphocyte (Lym) in PB. (D) ROC curve analysis the percentage of T lymphocyte (T%) in PB. (E) ROC curve analysis the percentage of CD4+ cell (CD4%) in PB. (F) ROC curve analysis the ratio of CD4:CD8 cells (CD4/CD8) in PB. (G) ROC curve analysis the percentage of natural killer cells (NK%) in PB. The cutoff values for these indicators were identified. P <0.05 is considered significantly different.
Figure 3
Figure 3
Risk factors for the identification of PCOS in the Rotterdam Criteria in different inflammatory immune cells. OR values were adjusted for age, WBC, Neu, Lym, T%, CD4%, CD8%, CD4/CD8, B%, and NK%. P <0.05 is considered significantly different.
Figure 4
Figure 4
ROC curve analysis of NK% between PCOS with and without infertility groups.
See this image and copyright information in PMC

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Grants and funding

This work was supported by the Natural Science Foundation of Fujian Province (grant no. 2017J01233) and the Innovation Fund of Fujian Provincial Maternity and Children’s Hospital (grant no. YCXQ 18-19).