Polikistik Over Sendromlu Kadınlarda Plazma Açilli Ghrelin Düzeylerine GHRL rs696217 Gen Polimorfizminin Etkisi

Öz

ÖZ Amaç: Polikistik over sendromu (PKOS), doğurganlık çağındaki kadınlar arasında sık karşılaşılan, çok faktörlü, sosyal yaşamı ileri derecede etkileyen, belirti ve bulguları bireyler arasında farklılık gösteren önemli bir halk sağlığı problemidir. Son yıllarda insülin düzeyi ve kan şekeri üzerindeki etkisi yapılan çalışmalarda gösterilen ghrelin hormonunun, PKOS etiyopatogenezinde rol oynayabileceği ileri sürülmektedir. Türk PKOS hastalarında ghrelin hormonunu kodlayan GHRL rs696217 gen polimorfizminin PKOS duyarlılığına ve plazma açilli ghrelin düzeylerine etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Kadın Doğum Kliniği’ne başvuran Rotterdam (2003) kriterlerine göre PKOS Fenotip I tanısı alan 51 kadın ile siklusları düzenli, klinik ve laboratuvar olarak hiperandrojenizm bulguları göstermeyen, ultrasonografik görüntülemede overleri polikistik görünümde olmayan, insülin direnci, tip 2 diyabet ve glukoz intoleransı gibi metabolik bir hastalığı olmayan 48 sağlıklı kadın dahil edilmiştir. GHRL rs696217 gen polimorfizmi PCR-RFLP, plazma açilli ghrelin düzeyleri ise ELISA yöntemiyle belirlenmiştir. Bulgular: PKOS hastalarında GHRL rs696217 G ve T alel frekansları sırasıyla %91 ve %9, karşılaştırma grubunda ise %95 ve %5 olarak hesaplanmıştır. Plazma açilli ghrelin düzeyi PKOS hastalarında 18,3 pg/ml ve karşılaştırma grubunda 18,6 pg/ml olarak ölçülmüştür. İki grup arasında alel frekansları ve plazma açilli ghrelin düzeyleri açısından istatistiksel olarak anlamlı bir farklılık gözlenmemiştir (sırasıyla p=0,739 ve p=0,923). PKOS tanılı kadınlarda GT+TT genotipli bireylerde plazma açilli ghrelin düzeyinin (25,08 pg/ml) GG genotipli bireylere (18,01 pg/ml) göre istatistiksel olarak anlamlı bir şekilde daha yüksek olduğu belirlenmiştir (p=0,026). Sonuçlar: Türk PKOS hastalarında GHRL rs696217 polimorfizmi variant aleli ile yüksek plazma açilli ghrelin düzeyi arasındaki ilişki ilk kez gösterilmiştir.

Anahtar Kelimeler

• Açilli Ghrelin
• GHRL rs696217
• Polikistik over sendromu (PKOS)

Effect of GHRL rs696217 Gene Polymorphism on Plasma Acylated Ghrelin Levels in Women with Polycystic Ovary Syndrome

Abstract

Objective: Polycystic ovary syndrome (PCOS) represents a significant public health problem, frequently encountered among women of childbearing age. It is a complex disorder with a profound impact on social life and a high degree of clinical variability. The hormone ghrelin which affects insulin level and blood glucose may play a role in the etiopathogenesis of PCOS. The effect of GHRL rs696217 polymorphism on PCOS susceptibility and plasma acylated ghrelin levels in Turkish patients was investigated. Material and Methods: Fifty-one women diagnosed with PCOS Phenotype I according to Rotterdam (2003) criteria and 48 women with regular cycles, no clinical and laboratory signs of hyperandrogenism, no polycystic ovaries on ultrasonographic imaging, and no metabolic diseases such as insulin resistance, type 2 diabetes and glucose intolerance were included. GHRL rs696217 was analysed by PCR-RFLP and ghrelin levels were determined by ELISA. Results: GHRL rs696217 G and T allele frequencies were 91% and 9% in PCOS patients and 95% and 5% in the comparison group, respectively. Ghrelin level was 18.3 pg/ml in PCOS patients and 18.6 pg/ml in the comparison group. A statistically significant difference was not observed between the two groups in terms of allele frequencies and plasma acylated ghrelin levels (p=0.739 and p=0.923, respectively). In women with PCOS, plasma acylated ghrelin levels in individuals with GT+TT genotype (25.08 pg/ml) were significantly higher than those in individuals with GG genotype (18.01 pg/ml) (p=0.026). Conclusion: The association between GHRL rs696217 variant allele and high plasma acylated ghrelin levels in Turkish PCOS patients was demonstrated for the first time.

Keywords

• Ghrelin
• GHRL rs696217
• Polycystic ovary syndrome (PCOS)

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