Inflammatory markers and visceral fat are inversely associated with maximal oxygen consumption in women with polycystic ovary syndrome

Background: We investigated whether several different inflammatory markers including C-reactive protein (CRP) and fibrinogen, and white blood cells (WBCs) count, are associated with maximal oxygen consumption (VO(2max)) in women with polycystic ovary syndrome (PCOS). Methods: In PCOS women (n = 124, 24.1 +/- 4.5 yrs old) VO(2max) was measured during symptom-limited cardiopulmonary exercise test. Abdominal fat distribution was determined by ultrasound. Physical activity level was assessed by a standardized questionnaire. CRP was measured by immunoassays, fibrinogen by the Clauss method, and WBCs count with a Coulter counter. Results: Pearson's analysis showed a significant correlation between VO(2max) and LogCRP (r=-0.437, P<0.001), fibrinogen (r=-0.479, P<0.001), and WBCs count (r=-0.438, P<0.001). Multivariable logistic regression model showed that age [beta=-0.127, P=0.005], AUC(INS )(beta=-0.335, P<0.001), HDL-C (beta=0.390, P<0.001), physical activity score (beta=0.238, P=0.002), visceral fat (beta=-0.184), P=0.023), FAI (beta=-0.291, P=0.028); CRP (beta=-0.216, P=0.011), fibrinogen (beta=-0.113, P=0.008) and WBCs count (beta=-0.177, P<0.001) were significantly associated with VO(2max). Conclusions: Acute-phase reactants, such as CRP and fibrinogen, and WBCs count were independently and inversely associated with a direct measure of cardiorespiratory fitness (VO(2max)) in women with PCOS, even after adjustment for physical activity level and other potential confounding factors. These findings add to the growing body of evidence linking inflammation to cardiorespiratory fitness in PCOS women.