Association Between Renin-Angiotensin System Peptides and Inflammatory Cytokines in Polycystic Ovary Syndrome

Background & Objective: Polycystic Ovary Syndrome (PCOS) involves chronic inflammation and alterations in the Renin-Angiotensin System (RAS). This study was conducted with aim to examine the relationship between key RAS peptides and pro-inflammatory cytokines in PCOS. Materials & Methods: This case-control study was conducted between December ۲۰۲۴ and March ۲۰۲۵ at Fallujah Teaching Hospital for Women and Children, in Fallujah, Anbar, Iraq. Ninety reproductive-aged women (۱۸-۴۰ years) were enrolled, including ۴۵ newly diagnosed PCOS patients and ۴۵ healthy controls. Anthropometric, metabolic, and reproductive parameters were evaluated. Serum levels of Angiotensin II, Angiotensin (۱-۷), IL-۶, and TNF-α were measured. Data were analyzed using IBM SPSS Statistics (version ۲۷.۰) and independent t-test or Mann–Whitney U test, ANCOVA, Spearman correlation, ROC analysis, and regression model. P<۰.۰۵ was considered statistically significant. Results: Pro-inflammatory cytokines were elevated in the PCOS group (serum concentrations of IL-۶ (۸.۲ vs ۴.۱ pg/mL, P=۰.۰۱۳) and TNF-α (۸.۰ vs ۱.۷ pg/mL, P=۰.۰۳۹), whereas Ang (۱-۷) levels were lower (۱۸.۱ vs ۲۱.۲ pg/mL, P<۰.۰۱) compared with controls); however, after BMI adjustment, IL-۶ became borderline and TNF-α lost statistical significance. Correlation analysis revealed LH and FSH were moderately correlated with TNF-α (r=۰.۴۷۹ and r=۰.۴۶۴, respectively; both P=۰.۰۰۱). ROC analysis identified AMH as the strongest discriminator for PCOS (AUC=۰.۸۶۶), followed by total testosterone (AUC=۰.۷۶۵), while Angiotensin (۱-۷) showed moderate diagnostic accuracy with an inverse relationship (AUC=۰.۷۱۸). Conclusion: This study identified alterations RAS in women with PCOS, evidenced by lower Ang (۱-۷) levels, along with associations between inflammatory markers and reproductive hormones. Further prospective studies are required to confirm these findings.

کلیدواژه ها:

Polycystic Ovary Syndrome ، Renin-angiotensin system ، Cytokines ، Angiotensin II ، Angiotensin ۱-۷