Neutrophil leucocytosis and polycystic ovarian syndrome - Could elevated noradrenaline levels due to obstructive sleep apnoea be a contributing mechanism?

摘要

I read with interest the study by Phelan et al. reporting neutro-phil leucocytosis in polycystic ovarian syndrome (PCOS) incompletely explained by obesity and insulin resistance.1 The high prevalence of obstructive sleep apnoea (OSA) in women with PCOS, and resulting increased sympathetic activity may be a contributing factor.Forty-four to seventy per cent of obese women with PCOS have OSA - a prevalence 4-30 times higher than in age- and weight-matched controls.2 OSA is associated with elevated levels of systemic inflammatory markers including C-reactive protein, interleukin-6 and tumour necrosis factor-alpha, proportionate to the degree of nocturnal hypoxia, and independent of body weight. A study in overweight children and adolescents with sleep-disordered breathing revealed a significant increase in total white blood cell and neutrophil counts correlating with the degree of oxygen desaturation, and independent of insulin resistance measured by Homeostasis Model of Assessment.