Polikistik over sendromlu Türk kadınlarında insülin direncinin değerlendirilmesinde yeni bir yöntem olarak Trigliserid Glukoz İndeksi

Abstract

Giriş: Polikistik over sendromu (PKOS), üreme çağındaki kadınlarda insülin direnci (IR), hiperandrojenizm ve polikistik over morfolojisi ile karakterize yaygın bir endokrin bozukluktur. IR, PKOS'un patogenezine ve uzun vadeli komplikasyonlarına önemli katkıda bulunur, ancak IR'yi değerlendirmek için mevcut altın standart yöntemler rutin klinik kullanım için genellikle pratik değildir. Amaçlar: Bu çalışma, PKOS'lu Türk kadınları arasında IR'yi belirlemede trigliserid glukoz (TyG) indeksinin performansını değerlendirmeyi ve farklı PKOS fenotipleri arasındaki değişkenliğini değerlendirmeyi amaçlamaktadır. Yöntemler: Bu tek merkezli, retrospektif çalışmaya 2003 Rotterdam kriterlerine göre PKOS tanısı konmuş 247 hasta dahil edildi. IR varlığı; hem TyG indeksi hem de HOMA-IR kullanılarak değerlendirildi. Çalışmada açlık plazma glukozu, lipid parametreleri ve diğer metabolik parametreler dahil olmak üzere klinik ve demografik veriler analiz edildi. IR'yi tespit etmek için optimum TyG indeksi sınır değerini belirlemek için ROC eğrisi analizi kullanıldı. Sonuçlar: Katılımcıların ortalama yaşı 24,09±5,53 yıldı ve ortalama BMI'si 28,12±6,38 kg/m² idi. Çalışmada ortalama HOMA-IR 3,46±1,82 ve ortalama TyG indeksi 4,51±0,26 olarak belirlendi. HOMA-IR ile TyG indeksi arasında anlamlı pozitif korelasyon bulundu (r=0,370, p<0,001). IR'yi tespit etmek için optimum TyG indeksi sınır değeri %70 duyarlılık ve %60 özgüllük ile 4,44 olarak bulundu (AUC=0,693, p=0,035). TyG indeksi farklı PCOS fenotiplerinde IR'yi etkili bir şekilde tespit etti, ancak HOMA-IR değeri için PCOS fenotipleri arasında anlamlı farklılıklar saptandı. Sonuç: Bu çalışma, PCOS'lu Türk kadınlarında IR'yi tahmin etmede TyG indeksinin etkinliğini gösteren ve fenotipler arasındaki değişkenliğini araştıran ilk çalışmadır. Açlık plazma glukoz ve trigliserid düzeyleri ile hesaplanan TyG indeksi, PCOS'da IR'yi değerlendirmek için geleneksel yöntemlere pratik ve uygun maliyetli bir alternatif sunmaktadır.

Keywords

• trigliserid glukoz indeksi
• insülin direnci
• polikistik over sendromu
• insülin direncinin homeostatik model değerlendirmesi

Evaluating the triglyceride glucose index as a novel method for assessing insulin resistance in Turkish women with polycystic ovary syndrome

Abstract

Aims: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, characterized by insulin resistance (IR), hyperandrogenism, and polycystic ovary morphology. IR is a significant contributor to the pathogenesis and long-term complications of PCOS, but current gold-standard methods for assessing IR are often impractical for routine clinical use. This study aimed to evaluate the performance of the triglyceride glucose (TyG) index in identifying IR among Turkish women with PCOS and to assess its variability across different PCOS phenotypes. Methods: This single-center, retrospective study included 247 patients diagnosed with PCOS according to the 2003 Rotterdam criteria. IR was assessed using both the TyG index and HOMA-IR. The study analyzed demographic and clinical data, including fasting plasma glucose, triglycerides, and various metabolic parameters. ROC curve analysis was used to determine the optimal TyG index cutoff for detecting IR. Results: The mean age of participants was 24.09±5.53 years, with a mean BMI of 28.12±6.38 kg/m². The study identified a mean HOMA-IR of 3.46±1.82 and a mean TyG index of 4.51±0.26. A significant positive correlation was found between HOMA-IR and the TyG index (r=0.370, p<0.001). The optimal TyG index cutoff for detecting IR was 4.44, with a sensitivity of 70% and a specificity of 60% (AUC=0.693, p=0.035). The TyG index effectively identified IR across different PCOS phenotypes, though HOMA-IR revealed significant differences between some phenotypes. Conclusion: This study is the first to demonstrate the effectiveness of the TyG index for predicting IR in Turkish women with PCOS and to explore its variability among phenotypes. The TyG index, based on fasting plasma glucose and triglyceride levels, offers a practical, cost-effective alternative to traditional methods for evaluating IR in PCOS.

Keywords

• Triglyceride glucose index
• insulin resistance
• polycystic ovary syndrome
• homeostatic model assessment of insulin resistance

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