Serum Ferritin as a Marker of Systemic Inflammation in Patients with Poly cystic ovary.
Keywords:
insulin resistance, inflammation, ferritin, PCOSAbstract
Background: Polycystic ovary syndrome (PCOS) has far-reaching impacts in society, including amenorrhea, excess androgens, and metabolic syndrome, which are all indicators of this syndrome. Most recently, the role of chronic low-grade inflammation in the pathogenesis of the syndrome has gained traction. Ferritin, an inflammatory protein, reflects an underlying inflammatory state in the metabolic syndrome and is thus proposed as an inexpensive and accurate biomarker to evaluate systemic inflammation in the syndrome.
Objectives: To assess serum ferritin concentrations in women with polycystic ovary syndrome (PCOS), compare these levels with those of healthy control participants, and evaluate the associations between ferritin and inflammatory markers, insulin resistance, and key metabolic parameters.
Methodology: This cross-sectional study conducted at Department of Obstetrics and Gynecology, Bacha Khan Medical College, Mardan Medical Complex Mardan from Jan 2025 to June 2025.women between the ages of 18 and 40 who had the diagnosis of PCOS according to the Rotterdam criteria were included. Healthy, age-matched women were included as controls. The following laboratory assessments were made: serum ferritin, C-reactive protein (CRP), fasting glucose, fasting insulin, and a lipid profile. The HOMA-IR score was utilized to assess insulin resistance. Data analysis was conducted on the 24.0 version of SPSS using t-tests and correlation analysis at the 0.05 significance level.
Results: A total of 60 women with PCOS were included in the study. The mean age was 26.8 ± 4.9 years. Serum ferritin levels were significantly elevated in PCOS patients compared with age-matched healthy controls (p < 0.001). Higher ferritin concentrations showed positive correlations with CRP (p = 0.002), fasting insulin (p = 0.01), HOMA-IR (p = 0.003), and triglycerides (p = 0.02), indicating increased inflammatory and metabolic burden.
Conclusion: Elevated serum ferritin was noted in women with PCOS and was strongly associated with systemic inflammation and insulin resistance. Its positive correlation with metabolic parameters suggests that ferritin may be a valuable, readily available marker of metabolic and inflammatory risk. Routine ferritin measurements improve patient evaluations, enhance clinical management of PCOS, and aid in planning preventive measures.
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References
1. Abraham Gnanadass S, Divakar Prabhu Y, Valsala Gopalakrishnan A. Association of metabolic and inflammatory markers with polycystic ovarian syndrome (PCOS): an update. Archives of gynecology and obstetrics. 2021;303(3):631-43.
2. Armanini D, Boscaro M, Bordin L, Sabbadin C. Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism. International journal of molecular sciences. 2022;23(8).
3. Barrea L, Arnone A, Annunziata G, Muscogiuri G, Laudisio D, Salzano C, et al. Adherence to the Mediterranean Diet, Dietary Patterns and Body Composition in Women with Polycystic Ovary Syndrome (PCOS). Nutrients. 2019;11(10).
4. Bednarz K, Kowalczyk K, Cwynar M, Czapla D, Czarkowski W, Kmita D, et al. The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome. International journal of molecular sciences. 2022;23(8).
5. Bril F, Ezeh U, Amiri M, Hatoum S, Pace L, Chen YH, et al. Adipose Tissue Dysfunction in Polycystic Ovary Syndrome. The Journal of clinical endocrinology and metabolism. 2023;109(1):10-24.
6. Dabravolski SA, Nikiforov NG, Eid AH, Nedosugova LV, Starodubova AV, Popkova TV, et al. Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome. International journal of molecular sciences. 2021;22(8).
7. Deng H, Chen Y, Xing J, Zhang N, Xu L. Systematic low-grade chronic inflammation and intrinsic mechanisms in polycystic ovary syndrome. Frontiers in immunology. 2024;15:1470283.
8. Giampaolino P, Foreste V, Di Filippo C, Gallo A, Mercorio A, Serafino P, et al. Microbiome and PCOS: State-of-Art and Future Aspects. International journal of molecular sciences. 2021;22(4).
9. He FF, Li YM. Role of gut microbiota in the development of insulin resistance and the mechanism underlying polycystic ovary syndrome: a review. Journal of ovarian research. 2020;13(1):73.
10. Kiani AK, Donato K, Dhuli K, Stuppia L, Bertelli M. Dietary supplements for polycystic ovary syndrome. Journal of preventive medicine and hygiene. 2022;63(2 Suppl 3):E206-e13.
11. Serum ferritin levels in polycystic ovary syndrome and their association with inflammatory markers.J Obstet Gynaecol Res. 2017;43(5):781–786.
12. Li C, Xing C, Zhang J, Zhao H, Shi W, He B. Eight-hour time-restricted feeding improves endocrine and metabolic profiles in women with anovulatory polycystic ovary syndrome. Journal of translational medicine. 2021;19(1):148.
13. Li J, Zheng R, Shen Y, Zhuo Y, Lu L, Song J, et al. Jiawei Qi Gong Wan improves liver fibrosis and inflammation in PCOS mice via the Akt2-FoxO1 and YAP/TAZ signaling pathways. Phytomedicine : international journal of phytotherapy and phytopharmacology. 2025;136:156294.
14. Morgante G, Darino I, Spanò A, Luisi S, Luddi A, Piomboni P, et al. PCOS Physiopathology and Vitamin D Deficiency: Biological Insights and Perspectives for Treatment. Journal of clinical medicine. 2022;11(15).
15. Orisaka M, Mizutani T, Miyazaki Y, Shirafuji A, Tamamura C, Fujita M, et al. Chronic low-grade inflammation and ovarian dysfunction in women with polycystic ovarian syndrome, endometriosis, and aging. Frontiers in endocrinology. 2023;14:1324429.
16. Patel S. Polycystic ovary syndrome (PCOS), an inflammatory, systemic, lifestyle endocrinopathy. The Journal of steroid biochemistry and molecular biology. 2018;182:27-36.
17. Qi X, Yun C, Sun L, Xia J, Wu Q, Wang Y, et al. Gut microbiota-bile acid-interleukin-22 axis orchestrates polycystic ovary syndrome. Nature medicine. 2019;25(8):1225-33.
18. Rudnicka E, Suchta K, Grymowicz M, Calik-Ksepka A, Smolarczyk K, Duszewska AM, et al. Chronic Low Grade Inflammation in Pathogenesis of PCOS. International journal of molecular sciences. 2021;22(7).
19. Senthilkumar H, Arumugam M. Gut microbiota: a hidden player in polycystic ovary syndrome. Journal of translational medicine. 2025;23(1):443.
20. Siddiqui S, Mateen S, Ahmad R, Moin S. A brief insight into the etiology, genetics, and immunology of polycystic ovarian syndrome (PCOS). Journal of assisted reproduction and genetics. 2022;39(11):2439-73.
21. Su P, Chen C, Sun Y. Physiopathology of polycystic ovary syndrome in endocrinology, metabolism and inflammation. Journal of ovarian research. 2025;18(1):34.
22. Zheng R, Shen H, Li J, Zhao J, Lu L, Hu M, et al. Qi Gong Wan ameliorates adipocyte hypertrophy and inflammation in adipose tissue in a PCOS mouse model through the Nrf2/HO-1/Cyp1b1 pathway: Integrating network pharmacology and experimental validation in vivo. Journal of ethnopharmacology. 2023;301:115824
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