الفهرس 
1. IntroductionOnly 14 pages are availabe for public view
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Abstract
Polycystic ovary syndrome is the most common complex endocrine disorder, recent studies have reported its prevalence to be as high as 12%–21%. According to the Rotterdam criteria and National Institute of Health criteria, hyperandrogenism, chronic anovulation, and polycystic ovaries on ultrasonography are the three main clinical features of PCOS patients. PCOS is a complex heterogeneous disease with obesity, insulin resistance, and metabolic syndrome are common in women with PCOS.
Women with PCOS have an increased prevalence of subclinical atherosclerosis. Given that CVD is one of the leading causes of female morbidity and mortality, and that the diagnosis of PCOS is associated with cardiovascular risk, the timely identification of cardiometabolic risk factors will have a significant impact on the overall health of this population
PCOS has major reproductive, psychologic, metabolic and cardiovascular risk factors impact. Although the exact cause of PCOS remains to be established, most studies have demonstrated that abdominal obesity, insulin resistance, and oxidative stress are of vital importance for its Pathogenesis
Additionally, several studies suggest that chronic low-grade inflammation in PCOS is an important risk factor for long-term metabolic disorders, cardiovascular complications, and ovarian dysfunction. Moreover, there is a strong association between hyperandrogenism, insulin resistance, and abdominal obesity with inflammation in PCOS. Those studies considered PCOS as proinflammatory state.
In both lean and obese PCOS patients, circulating markers of low-grade inflammation are elevated, suggesting that inflammation can promote insulin resistance, atherosclerosis, and other pathologies associated with PCOS.
We conducted our thesis to study role of inflammatory cytokines in females with polycystic ovarian syndrome and their association with cardiovascular risk. We fashioned our study design that included 3 groups: group 1 of 32 non-obese healthy females as a control group, group 2 of 20 non-obese PCOS patients, and group 3 of 31 obese PCOS patients.
The mean age for subjects included in group 1 was 27.4±5.5, while in group 2 was 24.7±3.4, and in group 3 was 27.2±5.4. We found no statistically significant correlation among the three groups regarding the age of the subjects.
The mean BMI for subjects included in group 1 was 22.1±1.5, while in group 2 was 23±1.5, and in group 3 was 35.6±7.2. We found a highly statistical significant correlation among the three groups regarding the body mass index of the subjects with higher BMI in group 3 subjects compared to the other groups.
The mean WC for subjects included in group 1 was 70.1±4.6, while in group 2 was 76.3±7.5, and in group 3 was 111±17.1. We found a highly statistical significant correlation among the three groups regarding the waist circumference of the subjects with higher WC in group 3 subjects compared to the other groups.
The mean waist/hip ratio for subjects included in group 1 was 0.78±0.03, while in group 2 was 0.8±0.02, and in group 3 was 0.88±0.04. We found a highly statistical significant correlation among the three groups regarding Waist/hip ratio of the subjects with higher ratio in group 3 compared to the other groups and also higher ratio in group 2 compared to group 1.
The mean SBP for subjects included in group 1 was 107.2±8.8, while in group 2 was 106.5±8.8, and in group 3 was 114.2±9.5. We found a highly statistical
significant correlation among the three groups regarding the systolic blood pressure of the subjects with higher readings in group 3 compared to the other groups.
The mean DBP for subjects included in group 1 was 68.1±7.2, while in group 2 was 70±8.1, and in group 3 was 72.3±7.1. We found no statistically significant correlation among the three groups regarding the diastolic blood pressure of the subjects.
The mean total cholesterol for subjects included in group 1 was 162.2±20.1, while in group 2 was 163.4±28.5, and in group 3 was 189.4±30.7. We found a highly statistical significant correlation among the three groups regarding the total cholesterol level of the subjects as the levels higher in group 3 than the other groups.
The mean HDL for subjects included in group 1 was 53.5±5.2, while in group 2 was 50.4±5.7, and in group 3 was 47.3±7. We found a statistically significant correlation among the three groups regarding HDL level of the subjects with significant intergroup correlation only between group 3 and group 1.
The mean LDL for subjects included in group 1 was 94.8±11.1, while in group 2 was 99.2±35.6, and in group 3 was 112.3±31.2. We found a statistically significant correlation among the three groups regarding LDL level of the subjects with significant intergroup correlation only between group 3 and group 1.
The mean triglycerides for subjects included in group 1 was 87.3±15.9, while in group 2 was 99.1±46.7, and in group 3 was 127.7±42.3. We found a highly statistically significant correlation among the three groups regarding triglycerides level of the subjects with significant intergroup correlation only between group 3 and the other two groups The mean LAP for subjects included in group 1 was 11.6±4.5, while in group 2 was 21.9±19.6, and in group 3 was 74.7±31.2. We found a highly statistical significant correlation among the three groups regarding LAP of the subjects with significant intergroup correlation only between group 3 and the other two groups.
The mean FBS for subjects included in group 1 was 82.7±1.9, while in group 2 was 84.9±4.2, and in group 3 was 86.1±4.2. We found a highly statistical significant correlation among the three groups regarding FBS of the subjects with significant intergroup correlation only between group 1 and the other two groups.
The mean HOMA-IR for subjects included in group 1 was 1.7±0.3, while in group 2 was 2.97±0.3, and in group 3 was 7.9±2.2. We found a highly statistical significant correlation among the three groups regarding HOMA-IR of the subjects with significant intergroup correlation between every two groups showing increasing levels progressively from group 1 to group 2 then more than 2-fold increase in group 3 from group 2.
The mean fasting insulin for subjects included in group 1 was 8.4±1.4, while in group 2 was 14.2±1, and in group 3 was 37.1±9.4. We found a highly statistical significant correlation among the three groups regarding fasting insulin of the subjects with significant intergroup correlation between every two groups showing increasing levels progressively from group 1 to group 2 then more than 2-fold increase in group 3 from group 2.
The mean TNF for subjects included in group 1 was 176.9±12.1, while in group 2 was 659.15±110.5, and in group 3 was 1360.3±139.8. We found a highly statistical significant correlation among the three groups regarding TNF of the subjects with significant intergroup correlation between every two groups showing increasing levels progressively from group 1 to 3-fold increase in group 2 then nearly 2-fold increase in group 3 from group 2.
The mean IL-18 for subjects included in group 1 was 145.3±29.2, while in group 2 was 315±42.2, and in group 3 was 647.4±133.3. We found a highly statistical significant correlation among the three groups regarding IL-18 of the subjects with significant intergroup correlation between every two groups showing increasing levels progressively from group 1 to 2-fold increase in group 2 then another 2-fold increase in group 3 from group 2.
The mean cardiovascular risk for subjects included in group 1 was 0.27±0.2, while in group 2 was 0.46±0.4, and in group 3 was 0.87±1.1. We found a statistically significant correlation among the three groups regarding cardiovascular risk of the subjects with significant intergroup correlation only between group 3 and the other two groups showing increasing levels progressively from group 1 to group 2 then nearly 2-fold increase in group 3 from group 2.
On analyzing the cardiovascular risk relation to other variables in our study, we found a statistically significant correlation between cardiovascular risk and BMI, WC, Waist/hip ratio, Systolic BP, Total cholesterol, HDL, LDL, LAP, HOMA-IR, Fasting insulin, TNF-ɑ, IL-18 while we found no statistically significant correlation with age, Diastolic BP, TG, FBS.
On analyzing TNF relation to other variables in our study, we found a statistically significant correlation between TNF and BMI, WC, Waist/hip ratio, Systolic BP, Diastolic BP, Total cholesterol, HDL, LDL, TG, LAP, FBS, HOMA-IR, Fasting insulin, IL-18 while we found no statistically significant correlation with age.
On analyzing IL-18 relation to other variables in our study, we found a statistically significant correlation between IL-18 and BMI, WC, Waist/hip ratio, Systolic BP, Diastolic BP, Total cholesterol, HDL, LDL, TG, LAP, FBS, HOMA-IR, Fasting insulin, while we found no statistically significant correlation with age.