med j west black sea Medical Journal of Western Black Sea 2822-4302 2587-0602 Zonguldak Bulent Ecevit University Surgery (Other) Cerrahi (Diğer) Polikistik over sendromunda demodex enfestasyonu ile klinik parametreler arasındaki ilişki: Prospektif gözlemsel çalışma Relationship between demodex infestation and clinical parameters in polycystic ovary syndrome: A prospective observational study https://orcid.org/0000-0001-5695-2586 Bülbül Mehmet Department of Obstetrics and Gynecology, Zonguldak Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye https://orcid.org/0000-0002-4658-1336 Kaplanoğlu Mustafa Department of Obstetrics and Gynecology, Medical Park Hospital, Adana, Türkiye https://orcid.org/0000-0002-2197-0079 Çelik Tuncay Department of Parasitology, Adıyaman University Faculty of Medicine, Adıyaman, Türkiye https://orcid.org/0000-0002-8360-236X Çakılkaya İpek Department of Obstetrics and Gynecology, Private Öztan Hospital, Uşak, Türkiye https://orcid.org/0000-0002-7223-7950 Dündar Emel Family Health Center, Adıyaman Provincial Health Directorate, Adıyaman, Türkiye 04 29 2026 10 1 151 156 10 02 2025 03 23 2026 Copyright © 2017, Medical Journal of Western Black Sea 2017 Medical Journal of Western Black Sea

Amaç: Polikistik over sendromu (PKOS), ovulatuvar disfonksiyon, hiperandrojenizm ve polikistik over morfolojisi ile karakterize, sıklıkla metabolik bozukluklarla birlikte görülen yaygın bir endokrin hastalıktır. PKOS'ta akne ve sebore gibi cilt belirtileri sık görülür ve cildin yağ bakımından zengin bölgelerinde yaşayan Demodex türleri çeşitli dermatolojik ve metabolik rahatsızlıklarla ilişkilendirilmiştir. Bu çalışmanın amacı, PKOS'lu kadınlarda Demodex türleri enfestasyonu yaygınlığını belirlemek ve antropometrik, hormonal ve glisemik parametrelerle ilişkisini değerlendirmektir. Gereç ve Yöntemler: Bu prospektif gözlemsel çalışmaya, Rotterdam kriterlerine göre doğrulanmış PKOS tanısı almış 18-40 yaş arası 63 kadın dahil edildi. Demodex türlerinin varlığı, standart yüzeyel deri biyopsisi tekniği kullanılarak değerlendirildi. Sosyodemografik veriler, antropometrik ölçümler, over hacmi, oral glukoz tolerans testi sonuçları ve bir dizi hormonal parametre toplandı. Bulgular: Demodex pozitif hastaların vücut kütle indeksi (VKİ), bel ve abdominal çevresi, over hacmi ve açlık kan şekeri düzeyleri anlamlı derecede daha yüksekken, bel-abdominal oranları Demodex negatif hastalara kıyasla daha düşüktü (p0,05). Sonuç: Bulgular, PKOS'lu kadınlarda Demodex spp. enfestasyonunun hem dermatolojik hem de metabolik değişiklikleri yansıtabileceğini düşündürmektedir. Tek değişkenli analizler anlamlı ilişkiler gösterse de bunlar çok değişkenli modellerde kalıcı olmamıştır ve bu da daha büyük, prospektif çalışmalara duyulan ihtiyacı vurgulamaktadır. Demodex taraması, özellikle dermatolojik şikayetlerle başvuran hastalarda PKOS'un kapsamlı yönetimine ilişkin ek bilgi sağlayabilir.

Aim: Polycystic ovary syndrome (PCOS) is frequently accompanied by dermatologic findings and metabolic disturbances. Because Demodex mites thrive in sebaceous areas and have been linked to several inflammatory and metabolic conditions, we explored whether Demodex positivity is associated with clinical and laboratory features in women with PCOS.Material and Methods: In this prospective observational study, 63 women aged 18–40 years with a confirmed diagnosis of PCOS based on the Rotterdam criteria were enrolled. The presence of Demodex spp. was assessed using the standardized superficial skin biopsy technique. Sociodemographic data, anthropometric measurements, ovarian volume, oral glucose tolerance test results, and a panel of hormonal parameters were collected.Results: Demodex-positive patients had significantly higher body mass index, waist and abdominal circumference, ovarian volume, and fasting glucose levels, while their waist-to- abdominal ratio was lower compared to Demodex-negative patients (p < 0.05). In contrast, multivariate logistic regression analysis revealed that none of these parameters remained independently significant (p > 0.05).Conclusion: The findings suggest that Demodex spp. infestation in women with PCOS may reflect both dermatological and metabolic alterations. Although univariate analyses indicated significant associations, these did not persist in multivariate models, underscoring the need for larger, prospective studies. Screening for Demodex may provide additional insight into the comprehensive management of PCOS, particularly in patients presenting with dermatological complaints.

 Polycystic ovary syndrome demodex spp. fasting glucose insulin resistance hormonal profile ovarian volume Polikistik over sendromu demodex türleri açlık glikozu insülin direnci hormonal profil over hacmi Siddiqui S, Mateen S, Ahmad R, Moin S. A brief insight into the etiology, genetics, and immunology of polycystic ovarian syndrome (PCOS). J Assist Reprod Genet. 2022;39(11):2439-2473. https://doi.org/10.1007/s10815-022-02625-7 Gleicher N, Darmon S, Patrizio P, Barad DH. Reconsidering the polycystic ovary syndrome (PCOS). Biomedicines. 2022;10(7):1505. https://doi.org/10.3390/biomedicines10071505 Yang J, Chen C. Hormonal changes in PCOS. J Endocrinol. 2024;261(1):e230342. https://doi.org/10.1530/JOE-23-0342 Helvaci N, Yildiz BO. Polycystic ovary syndrome as a metabolic disease. Nat Rev Endocrinol. 2025;21(4):230-244. https://doi.org/10.1038/s41574-024-01057-w Lie Fong S, Douma A, Verhaeghe J. Implementing the international evidence-based guideline of assessment and management of polycystic ovary syndrome (PCOS): how to achieve weight loss in overweight and obese women with PCOS? J Gynecol Obstet Hum Reprod. 2021;50(6):101894. https://doi.org/10.1016/j.jogoh.2020.101894 Chang YS, Huang YC. Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis. J Am Acad Dermatol. 2017;77(3):441-447.e6. https://doi.org/10.1016/j.jaad.2017.03.040 Trave I, Salvi I, Canepa P, Parodi A, Cozzani E. Detection of demodex mites in papulopustular rosacea using microscopic examination and polymerase chain reaction: a comparative case-control study. Arch Dermatol Res. 2024;316(7):485. https://doi.org/10.1007/s00403-024-03228-1 Kim J, Choi S, Choi S, Lee YI, Kim J, Lee JH, et al. Contact hypersensitivity and Demodex mite infestation in patients with rosacea: a retrospective cohort analysis. Eur J Dermatol. 2022;32(6):716-723. https://doi.org/10.1684/ejd.2022.4358 Bakacak Z, Kaplanoğlu M, Bakacak M, Çelik T. Demodex folliculorum mite infestation in gynecological cancers: A case control study. Eur J Gynaecol Oncol. 2020;41(4):583-586. https://doi.org/10.31083/j.ejgo.2020.04.3687 Kaplanoğlu M, Bulbul M, Çelik T. High incidence of Demodex Folliculorum in women treated for gestational diabetes mellitus persists after treatment. Acta Med Eur. 2025;7(1):1-4. https://doi.org/10.5281/zenodo.14546805 Eroglu S, Cakmakliogullari M, Kal Cakmakliogullari E. Is the presence of Demodex folliculorum increased with impaired glucose regulation in polycystic ovary syndrome? J Obstet Gynaecol. 2020;40(4):546-550. https://doi.org/10.1080/01443615.2019.1634026 Toka Özer T, Akyürek Ö, Durmaz S. Association between Demodex folliculorum and Metabolic Syndrome. J Cosmet Dermatol. 2020;19(11):3145-3149. https://doi.org/10.1111/jocd.13721 Enginyurt O, Karaman U, Cetin F, Ozer A. The Prevalence of Demodex Species and Its Relationship With the Metabolic Syndrome in Women of Malatya Province, Turkey. Jundishapur J Microbiol. 2015;8(10):e24322. https://doi.org/10.5812/jjm.24322 Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related microbial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157(3).474-481. https://doi.org/10.1111/j.1365-2133.2007.08056.x Forton F, De Maertelaer V. Rosacea, skin immunity and Demodex: Pityriasis folliculorum as a missing link. J Eur Acad Dermatol Venereol. 2017;31(11):1907-1916. https://doi.org/10.1111/jdv.14406 Eser A, Erpolat S, Kaygusuz I, Balci H, Kosus A. Investigation of Demodex folliculorum frequency in patients with polycystic ovary syndrome. An Bras Dermatol. 2017;92(6):807-810. https://doi.org/10.1590/abd1806-4841.20176043