ENHANCING DIAGNOSTIC ACCURACY IN POLYCYSTIC OVARY SYNDROME USING NOVEL INFLAMMATORY INDICES

Objectives: Polycystic ovary syndrome (PCOS) is characterized by a complicated and incompletely understood pathophysiology. This study investigates the role of inflammation in its pathophysiology, compares the diagnostic performance of inflammatory indices, and assesses the clinical utility of novel biomarkers. Material and Methods: This retrospective study included 30 patients with PCOS and 32 healthy controls. Inflammatory indices including neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), neutrophil to monocyte ratio (NMR), platelet to lymphocyte ratio (PLR), platelet large cell ratio (PLCR), mean platelet volume to lymphocyte ratio (MPVLR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), multi-inflammatory index (MII), and monocyte to high density lipoprotein ratio (MHR) were calculated. Receiver operating characteristic (ROC) curve analysis evaluated their diagnostic performance. Biochemical, hormonal, hematological, and inflammatory parameters were measured using ELISA and an automated analyzer. Results: Inflammatory indices SII (p=0.006), SIRI (p=0.022), MII (p=0.013), and MHR (p=0.003) were significantly higher in patients, while PLCR was lower (p=0.024). Biochemical parameters CRP (p=0.027), insulin (p=0.021), and LDL (p=0.027) were elevated, HDL decreased (p=0.035). ROC analysis identified MHR as the most accurate biomarker (AUC=0.747, 100% specificity), followed by CRP (AUC=0.726) and MII (AUC=0.713). SII and SIRI showed moderate but relevant accuracy. All were statistically significant (p< 0.05). Conclusion: The present study highlights the potential of inflammation-based indices particularly MHR, MII, SII, SIRI, and CRP as valuable biomarkers in PCOS diagnosis. MHR showed the strongest diagnostic performance (100% specificity), while CRP and MII also demonstrated good accuracy. SIRI’s high sensitivity supports its role in early detection, and both SII and SIRI may serve as complementary markers. Overall, the results underscore the significance of inflammation in PCOS and support the clinical utility of these markers. PCOS influences hematological and biochemical parameters as well as inflammatory indices.