Elevated circulating levels of macrophage migration inhibitory factor in polycystic ovary syndrome

Women with polycystic ovary syndrome (PCOS) have chronic low level inflammation which can increase the risk of atherogenesis. We evaluated the status of circulating macrophage migration inhibitory factor (MIF), a proinflammatory cytokine involved in atherogenesis, in women with PCOS and weight-matched controls. Two-way analysis of variance models adjusted for age were fit to evaluate the effect of PCOS status (PCOS vs. controls) and weight-class (obese vs. lean) on MIF and other parameters. MIF levels were significantly (p < 0.001) higher in women with PCOS (lean: 37.7 ± 10.6 ng/ml; obese: 54.6 ± 15.2 ng/ml) compared to controls (lean: 4.8 ± 0.6 ng/ml; obese: 17.5 ± 8.0 ng/ml) regardless of weight-class. CRP levels were significantly (p < 0.001) higher in obese subjects (PCOS: 6.2 ± 1.9 mg/l; controls: 6.7 ± 1.4 mg/l) compared to lean subjects (PCOS: 0.9 ± 0.4 mg/l; controls: 0.2 ± 01 mg/l) after controlling for PCOS status. MIF levels directly correlated with % truncal fat (r = 0.41, p < 0.05), and plasma levels of CRP (r = 0.42, p = 0.05), LH (r = 0.45, p = 0.04), testosterone (r = 0.53, p < 0.008), androstendione (r = 0.58, p < 0.005). ISOGTT inversely correlated with plasma levels of MIF (r = −0.51, p < 0.02) and CRP (r = -0.73, p < 0.001). Circulating MIF is elevated in PCOS independent of obesity, but both PCOS and obesity contribute to a proatherogenic state. In PCOS, abdominal adiposity and hyperandrogenism may exacerbate the risk of atherosclerosis.