Objective:

To explore the impact of low-grade systemic inflammation on endometrial dysfunction in women with PCOS and assess the relationship between inflammatory markers and metabolic factors.

Approach:

• Statistical Analysis: Statistical analyses included t-tests for between-group differences and Pearson correlation coefficients for assessing relationships among variables.

Key Findings:

• PCOS group had significantly higher BMI, LH/FSH ratio, testosterone, and HOMA-IR compared to controls (P<0.001).
• Increased levels of pro-inflammatory cytokines (IL-1β, IL-6, TNF-α) and reduced levels of anti-inflammatory cytokines (IL-4, IL-10) were observed in the PCOS group (P<0.001).
• Endometrial blood flow patterns were poorer in the PCOS group, with higher uterine artery PI and RI (P<0.001).
• Pro-inflammatory cytokines correlated positively with BMI, LH/FSH ratio, testosterone, HOMA-IR, and uterine artery PI and RI (r=0.44-0.58, P<0.001).
• Anti-inflammatory cytokines correlated negatively with these measures (r=-0.43 to -0.63, P<0.001).

Interpretation:

The findings suggest that low-grade systemic inflammation in PCOS, characterized by elevated pro-inflammatory cytokines and reduced anti-inflammatory cytokines, is associated with insulin resistance and hyperandrogenemia, potentially contributing to endometrial dysfunction.

Limitations:

• The study is retrospective, which may introduce bias.
• The sample size, while adequate, may not represent the broader population of women with PCOS.
• Potential confounding factors were not controlled for, which may affect the validity of the findings.

Conclusion:

The inflammatory state in PCOS may contribute to endometrial dysfunction by increasing uterine artery blood flow resistance.