Evaluation of C-reactive protein/albumin ratio in women with polycystic ovarian syndrome and women without polycystic ovarian syndrome

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology. Emerging evidence suggests a role of chronic low-grade inflammation in PCOS pathophysiology. The C-reactive protein (CRP)/albumin ratio, reflecting both inflammation and nutritional status, may serve as a sensitive biomarker in PCOS. Methods: A cross-sectional study was conducted over one year on 100 women aged 20–40 years attending the Obstetrics and Gynaecology department of Navodaya Medical College, Raichur. Group A included 50 women without PCOS, and group B included 50 women with PCOS (diagnosed by Rotterdam criteria). Serum CRP and albumin were measured, and the CRP/albumin ratio was calculated. Data were analysed using independent t-test, Chi-square test, and ROC curve analysis. A p-value <0.05 was considered statistically significant. Results: Women with PCOS had significantly higher BMI and waist circumference (p<0.001). CRP levels were higher (4.8±1.4 mg/l versus 1.9±0.8 mg/l) and albumin levels lower (3.2±0.5 g/dl versus 4.1±0.4 g/dl) in PCOS compared to controls, resulting in a higher CRP/albumin ratio (2.8±1.2 versus 1.4±0.6, p<0.001). Elevated ratios were present even in lean PCOS cases. ROC curve analysis yielded an AUC of 0.89, with sensitivity 70% and specificity 84% at a cut-off >2.0. Conclusions: CRP/albumin ratio is significantly elevated in PCOS, independent of obesity, and may serve as a simple, cost-effective marker of inflammation and metabolic dysfunction, aiding early diagnosis and risk stratification.