May the Systemic Immune-Inflammation Index be an Indicator of Premature Ovarian Insufficiency?

Anahtar Kelimeler:

Complete blood count, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, platelet-lymphocyte-ratio, premature ovarian insufficiency

May the Systemic Immune-Inflammation Index be an Indicator of Premature Ovarian Insufficiency?

Objective: This study aimed to determine whether there was a correlation between the systemic im-mune-inflammation index and ovarian reserve markers such as follicle stimulant hormone, estradiol, and anti-mullerian hormone Methods: The study comprised 65 people with premature ovarian insufficiency and 71 controls with sim-ilar demographics. The concentrations of hemoglobin, hematocrit, platelets, white blood cells, neutro-phils, and lymphocytes were evaluated. The neutrophil leukocyte ratio, platelet lymphocyte ratio, and systemic immune-inflammation index were calculated. The antral follicle count reserves of all patients were evaluated by transvaginal ultrasonography. An independent t-test was used for the comparison of the study and control groups. Correlations between variables were analyzed using Pearson's correlation test. A p value of 0.05 was considered significant. Results: The results of the neutrophil-to-lymphocyte ratio and the platelet-lymphocyte ratio showed a significant difference between the groups (p = 0.043). The Systemic Immune Inflammation Index value was the statistically significant difference found between the groups. There was a significant positive correlation between the systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-lymphocyte ratio, and follicle stimulant hormone, while a significant negative correlation was found between the systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-lymphocyte ratio, antral follicle count, and anti-mullerian hormone. In ROC analysis for SII at a cut-off level of 441.35, the sensitivity was 72.1% and the specificity was 68.9. Conclusion: Our study was the first in this field to reveal the relationship between premature ovarian failure and the systemic immune-inflammation index. According to our study results, the systemic im-mune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-lymphocyte ratio are significant-ly higher in individuals with ovarian failure.

Keywords:

Complete blood count, neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, platelet-lymphocyte-ratio, premature ovarian insufficiency,

PDF

___

1. Penzias A, Azziz R, Bendikson K, Falcone T, Hansen K, Hill M, et al. Testing and in-terpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020 Dec;114(6):1151–7.
2. Hansen KR, Knowlton NS, Thyer AC, Charleston JS, Soules MR, Klein NA. A new model of reproductive aging: the dec-line in ovarian non-growing follicle num-ber from birth to menopause. Human Rep-roduction. 2008 Mar 1;23(3):699–708.
3. Bukulmez O. Definitions and Relevance: Diminished Ovarian Reserve, Poor Ovarian Response, Advanced Reproductive Age, and Premature Ovarian Insufficiency. In: Diminished Ovarian Reserve and Assisted Reproductive Technologies. Cham: Sprin-ger International Publishing; 2020. p. 55–61.
4. Rudnicka E, Kruszewska J, Klicka K, Kowalczyk J, Grymowicz M, Skórska J, et al. Premature ovarian insufficiency – aeti-opathology, epidemiology, and diagnostic evaluation. Menopausal Review. 2018;17(3):105–8.
5. Jewelewicz R, Schwartz M. Premature ova-rian failure. Bull N Y Acad Med. 1986 Apr;62(3):219–36.
6. Straub RH. The Complex Role of Estro-gens in Inflammation. Endocr Rev. 2007 Aug 1;28(5):521–74.
7. Fest J, Ruiter R, Mulder M, Groot Koer-kamp B, Ikram MA, Stricker BH, et al. The systemic immune‐inflammation index is associated with an increased risk of inci-dent cancer—A population‐based cohort study. Int J Cancer. 2020 Feb 16;146(3):692–8.
8. Chen JH, Zhai ET, Yuan YJ, Wu KM, Xu JB, Peng JJ, et al. Systemic immune-inflammation index for predicting progno-sis of colorectal cancer. World J Gastroen-terol. 2017;23(34):6261.
9. Geraghty JR, Lung TJ, Hirsch Y, Katz EA, Cheng T, Saini NS, et al. Systemic Immu-ne-Inflammation Index Predicts Delayed Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage. Neurosurgery. 2021 Nov 18;89(6):1071–9.
10. Tanacan A, Uyanik E, Unal C, Beksac MS. A cut‐off value for systemic immune‐inflammation index in the prediction of adverse neonatal out-comes in preterm premature rupture of the membranes. Journal of Obstetrics and Gynaecology Research. 2020 Aug;46(8):1333–41.
11. Orgul G, Agbal T, Celen S, Caglar AT. Neuroprotective magnesium sulfate admi-nistration increases maternal Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index. Arch Gynecol Obstet. 2021 Jun 21;303(6):1433–7.
12. Lliberos C, Liew SH, Mansell A, Hutt KJ. The Inflammasome Contributes to Deple-tion of the Ovarian Reserve During Aging in Mice. Front Cell Dev Biol. 2021 Feb 11;8.
13. Ilhan G, Atmaca FFV, Altan E, Zebitay AG, Sozen H, Akyol H, et al. Evaluation of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Red Blood Cell Distribution Width-Platelet Ratio for Di-agnosis of Premature Ovarian Insuffici-ency. J Family Reprod Health. 2016 Dec;10(4):211–6.
14. İlhan M, İlhan G, Gök AFK, Bademler S, Verit Atmaca F, Ertekin C. Evaluation of neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and red blood cell distri-bution width–platelet ratio as early predic-tor of acute pancreatitis in pregnancy. The Journal of Maternal-Fetal & Neonatal Me-dicine. 2016 May 2;29(9):1476–80.
15. Tanoglu A, Karagoz E. Predictive Role of the Neutrophil-to-Lymphocyte Ratio in Pa-tients with Advanced Hepatocellular Car-cinoma Receiving Sorafenib. Asian Pacific Journal of Cancer Prevention. 2014 Jan 30;15(2):1063–1063.
16. Zheng YB, Zhao W, Liu B, Lu LG, He X, Huang JW, et al. The Blood Neutrophil-to-lymphocyte Ratio Predicts Survival in Pa-tients with Advanced Hepatocellular Car-cinoma Receiving Sorafenib. Asian Pacific Journal of Cancer Prevention. 2013 Sep 30;14(9):5527–31.
17. Stotz M, Gerger A, Eisner F, Szkandera J, Loibner H, L Ress A, et al. Increased neut-rophil-lymphocyte ratio is a poor prognos-tic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer. 2013 Jul 23;109(2):416–21.
18. Guthrie GJK, Charles KA, Roxburgh CSD, Horgan PG, McMillan DC, Clarke SJ. The systemic inflammation-based neut-rophil–lymphocyte ratio: Experience in pa-tients with cancer. Crit Rev Oncol Hema-tol. 2013 Oct;88(1):218–30.
19. Azab B, Jaglall N, Atallah JP, Lamet A, Raja-Surya V, Farah B, et al. Neutrophil-Lymphocyte Ratio as a Predictor of Adver-se outcomes of Acute Pancreatitis. Pancre-atology. 2011 Aug;11(4):445–52.
20. Cho H, Hur HW, Kim SW, Kim SH, Kim JH, Kim YT, et al. Pre-treatment neutrop-hil to lymphocyte ratio is elevated in epit-helial ovarian cancer and predicts survival after treatment. Cancer Immunology, Im-munotherapy. 2009 Jan 15;58(1):15–23.
21. Yamanaka T, Matsumoto S, Teramukai S, Ishiwata R, Nagai Y, Fukushima M. The Baseline Ratio of Neutrophils to Lymp-hocytes Is Associated with Patient Progno-sis in Advanced Gastric Cancer. Oncology. 2007;73(3–4):215–20.
22. Shuster LT, Rhodes DJ, Gostout BS, Grossardt BR, Rocca WA. Premature me-nopause or early menopause: Long-term health consequences. Maturitas. 2010 Feb;65(2):161–6.
23. Schmidt PJ, Cardoso GMP, Ross JL, Haq N, Rubinow DR, Bondy CA. Shyness, So-cial Anxiety, and Impaired Self-esteem in Turner Syndrome and Premature Ovarian Failure. JAMA. 2006 Mar 22;295(12):1373.
24. van der Voort DJM, van der Weijer PHM, Barentsen R. Early menopause: increased fracture risk at older age. Osteoporosis In-ternational. 2003 Jun 30;14(6):525–30.
25. Betterle C, Volpato M, Smith BR, Fur-maniak J, Chen S, Greggio NA, et al. I. Ad-renal Cortex and Steroid 21-Hydroxylase Autoantibodies in Adult Patients with Or-gan-Specific Autoimmune Diseases: Mar-kers of Low Progression to Clinical Addi-son’s Disease. J Clin Endocrinol Metab. 1997 Mar 1;82(3):932–8.
26. de Vet A, Laven JSE, de Jong FH, Themmen APN, Fauser BCJM. Antimülle-rian hormone serum levels: a putative marker for ovarian aging. Fertil Steril. 2002 Feb;77(2):357–62.
27. la Marca A, Sunkara SK. Individualiza-tion of controlled ovarian stimulation in IVF using ovarian reserve markers: from theory to practice. Hum Reprod Update. 2014 Jan 1;20(1):124–40.
28. Rudnicka E, Kruszewska J, Klicka K, Kowalczyk J, Grymowicz M, Skórska J, et al. Premature ovarian insufficiency – aeti-opathology, epidemiology, and diagnostic evaluation. Menopausal Review. 2018;17(3):105–8.
29. Reato G, Morlin L, Chen S, Furmaniak J, Smith BR, Masiero S, et al. Premature Ovarian Failure in Patients with Autoim-mune Addison’s Disease: Clinical, Gene-tic, and Immunological Evaluation. J Clin Endocrinol Metab. 2011 Aug;96(8):E1255–61.
30. Sharif K, Watad A, Bridgewood C, Kan-duc D, Amital H, Shoenfeld Y. Insights in-to the autoimmune aspect of premature ovarian insufficiency. Best Pract Res Clin Endocrinol Metab. 2019 Dec;33(6):101323.
31. Demir B, Sarıdaş Demir S, Özkan Kara-caer K, Paşa S, Sılan F. Evaluation inf-lammatory markers of hemogram parame-ters in primary ovarian insufficiency. Jour-nal of Turkish Society of Obstetric and Gynecology. 2020 Apr 6;17(1):9–14.
32. Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwan J Obstet Gynecol. 2018 Apr;57(2):289–94.