Disturbed stress responses in women with polycystic ovary syndrome

Background: We analyzed the neuroendocrine and immune cell responses to psychosocial stress in PCOS patients compared to BMI-matched healthy controls. Methods: Responses to public speaking stress were analyzed in 32 PCOS patients and 32 BMI-matched healthy controls. At baseline, during, and 10- and 45-min after stress, state anxiety, cardiovascular responses, cortisol, ACTH, as welt as circulating leukocyte subpopulations were analyzed, together with hsCRP and serum IL-6 concentrations. Results: In response to public speaking stress, both groups showed significant but comparable increases in state anxiety, and blood pressure (all p < 0.001; time effects). The ACTH and cortisol stress responses were significantly enhanced in PCOS (both p < 0.05; interaction effect). In addition, heart rate was significantly higher in PCOS (p < 0.05; group effect). PCOS patients displayed a reduced upregulation of IL-6 levels in response to stress (p < 0.05; interaction effect). Baseline levels of circulating leukocyte subpoputations, IL-6 and hsCRP concentrations did not differ between BMI-matched controls and PCOS patients. PCOS patients were characterized by markedly increased psychological distress. Conclusions: PCOS patients showed enhanced HPA-axis and heart rate reactivity as well as a reduced upregulation of IL-6 in response to stress. The altered stress reactivity in PCOS patients may constitute a link between depression, overweight, and the cardiovascular and diabetes risks associated with the diagnosis. (C) 2008 Elsevier Ltd. All rights reserved.