CARDIAC RISK IN POLYCYSTIC CYSTIC OVARY SYNDROME WOMEN: DIAGNOSTIC VALUE OF DETERMINATION OF PERCENTAGE OF CD4+CD28 NULL T LYMPHOCYTES
1Mohamed Farag El Sherbeny, 2Maha M. Hagras
1Department of Obstetrics & Gynecology, Faculty of Medicine, Benha University
2Department of Clinical Pathology, Faculty of Medicine, Tanta University
Objectives: To estimate the percentage of CD4+CD28null T cells among lymphocytic cells in women with polycyctic ovary syndrome (PCOS) categorized as hyper-androgenemic (HA) and normo-androgenemic (NA) PCOS compared to control non-PCOS women. Patients & Methods: The study included 63 HA-PCOS, 37 NA-PCOS women and 50 non-PCOS women. Diagnosis of PCOS was based on the Rotterdam criteria. All patients and controls were evaluated for extent and severity of hirsutism according to the modified Ferriman-Gallwey map, underwent complete gynecological examination including transvaginal ultrasonography (TVU) and gave blood samples for estimation of fasting blood glucose (FBG), serum total testosterone, dehydroepiandrosterone sulfate (DHEA-S) and lipid profile. Total lymphocytic count, quantitative determination of CD4+ T cells and percentage of CD4+CD28null T cells were determined using Axetris Impedence Flow Cytometry. Estimated laboratory parameters were evaluated as predictors for cardiac risk manifested as the cardiac risk ratio (CRR). Results: FBG and total cholesterol, triglycerides and low-density lipoprotein (LDL) levels were significantly higher with significantly lower high-density lipoprotein (HDL) levels in PCOS than control women with significantly higher CRR and frequency of PCOS women showed CRR of ≥3.5. Serum testosterone and DHEA-S were significantly higher in PCOS women and in HA-PCOS than NA-PCOS women. Total lymphocytic count and percentage of CD4+CD28null were significantly higher in PCOS women with significantly higher percentage of CD4+CD28null in NA-PCOS than HA-PCOS women. Percentage of CD4+CD28null showed positive significant correlation with FBG and LDL-c levels, while showed negative significant correlation with serum testosterone, DHEA-S and HDL-c. Statistical analyses defined high CD4+CD28null percentage and serum testosterone as significant predictors for calculated CRR. Conclusion: PCOS is associated with all cardiac risk factors including hyperglycemia, dyslipidemia, increased total lymphocytic count and high percentage of CD4+CD28null. PCOS women had high CRR with high frequency of women at cardiac risk. Non-androgenic PCOS women were at higher cardiac risk with higher CRR than hyper-androgenic PCOS women.
December 2016