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Satoshi Kawamura1, Chihaya Maesawa2, Koji Nakamura1, Kazuhiko Nakayama1, Michiaki Morita1, Yohei Hiruma1, Tomoyuki Yoshida3, Akio Sakai3, Tomoyuki Masuda41Department of Psychiatry, Tokyo Jikei University school of Medicine, Tokyo, Japan; 2Department of Tumor Biology, Division of Bioscience, center for Advanced Medical science, Iwate Medical University school of Medicine, Morioka, Japan; 3Department of Neuropsychiatry, Iwate Medical University school of Medicine, Morioka, Japan; 4Department of Pathology, Iwate Medical University school of Medicine, Morioka, JapanAbstract: Polycystic ovary syndrome (PCOS) is a common lifestyle-related endocrinopathy in women of reproductive age and is associated with several mental health problems. We examined the genotypic distributions of IRS-1 Gly972Arg and CYP11B2 -344T/C, which were previously described as influencing PCOS, and assayed the serum levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), in a set of female patients with borderline personality disorder (BPD) with comorbid major depressive disorder (MDD) (n = 50) and age-matched control subjects (n = 100), to investigate the predisposition for BPD with MDD. The results showed that the patients were more frequently IRS-1 972Arg variant allele carriers (P = 0.013; OR 6.68; 95% CI = 1.30-34.43) and homozygous for the CYP11B2 -344C variant allele (P = 0.022; OR = 3.32; 95% CI = 1.18-9.35) than the control subjects. The IL-6 level was significantly higher in the patients than in the controls (P < 0.0001). There was no significant difference in the serum TNF-α level between patients with BPD with MDD and the healthy comparison group (P = 0.5273). In conclusion, the predisposition for BPD with MDD is associated with that for PCOS, in the female Japanese population. An elevated serum IL-6 level is considered to be a possible biomarker of BPD with MDD.Keywords: borderline personality disorder, depression, polycystic ovary syndrome, genetic polymorphism, insulin resistance