Polikistik Over Sendromlu Adölesanlarda Trombosit İndeksleri, Hormonal Durum ve İnsülin Direnci Arasındaki İlişki: Retrospektif Bir Vaka-Kontrol Çalışması

Abstract

Amaç: Bu çalışmanın amacı, adölesanlarda metabolik bozukluklarla ilişkili, inflamasyon ve insülin direncinin neden olduğu bir hastalık olan polikistik over sendromu (PKOS) ile trombosit aktivitesi hakkında bilgi veren trombosit indeksleri arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Oligoovulasyon, hiperandrojenemi veya hiperandrojenizmin klinik bulguları (hirşutizm, akne vb.) ve yeni güncellenen Rotterdam kriterlerine göre ultrasonda her iki overde ≥ 20 küçük folikül ≥ 2∼ 9 mm çapında polikistik görünümü olan hastalar polikistik over sendromu tanısı ile çalışmaya dahil edildi ve PKOS grubunu oluşturdu. Kliniğe PKOS dışı nedenlerle (vajinit, dismenore, sistit) başvuran, hormon testi sırasında tam kan sayımına bakılan ve Rotterdam kriterlerini karşılamayan benzer yaş grupları ve vücut kitle indeksi (VKİ) değerlerine sahip hastalar kontrol grubu olarak seçildi. Rutin kan sayımı parametrelerinde bulunan trombosit indeksleri (trombosit büyük hücre oranı (P-LCR), trombosit dağılım genişliği (PDW) ve ortalama trombosit hacmi (MPV)) iki grup arasında analiz edilmiştir. Ayrıca, PKOS hastalarında bu indeksler ile hormonal durum ve insülin direnci arasındaki ilişki analiz edilmiştir. Diabetes mellitus, hipertansiyon, malign hastalıklar, kardiyovasküler hastalıklar, esansiyel trombositopeni veya diğer kan hastalıkları olan hastalar ve ilaç kullanan hastalar çalışma dışı bırakıldı. Bulgular: Çalışmaya dahil edilmiş olan 123 hastadan 67 tanesi polikistik over sendromu tanısı alarak vaka grubunu, geri kalan 56 hasta kontrol grubunu oluşturmuştur. Gruplar arası yaş ve vücut kitle indeksi açısından istatistiksel anlamlı fark bulunmamaktadır (p: >0,05). Gruplar arasında tam kan sayımı parametreleri karşılaştırıldığında, trombosit aktivitesini gösteren trombosit büyük hücre oranı (p: 0,002), trombosit dağılım genişliği (p: 0,011) ve ortalama trombosit hacmi (p: 0,007) polikistik over sendromu grubunda istatistiksel anlamlı olarak daha fazla bulunmuştur. Polikistik over sendromu hastalarının verileri incelendiğinde insulin direnci yüksek olan grupta trombosit indeksleri daha yüksek bulunmuştur (p: <0,005). Hormonal durumu analiz ettiğimizde, sadece kandaki prolaktin seviyesi P-LCR (r:0.223, p: 0.017), PDW (r:0.214, p:0.022) ve MPV (r: 0.213, p:0.023) değerleri ile pozitif korelasyon göstermektedir. Sonuç: Polikistik over sendromu hastalarının rutin kan sayımlarında mevcut olan trombosit indekslerini inceleyip hastalara metabolik hastalıklara yatkınlık konusunda bilgi vermek ve gerekli yönlendirmeleri yapmak hastalığının tedavisi ve takibine katkı sağlayacaktır. Her merkezde bakılması kolay olan bu tetkikler güncel pratikte kullanım alanı almalıdır.

Keywords

• Kan Trombositleri
• Metabolik Sendrom
• Polikistik Over Sendromu

The Relationship Between Platelet Indices, Hormonal Status, and Insulin Resistance in Adolescents with Polycystic Ovary Syndrome: A Retrospective Case-Control Study

Abstract

Aim: This study aimed to investigate the relationship between polycystic ovary syndrome in adolescents, a disease caused by inflammation and insulin resistance that is associated with metabolic disorders, and platelet indices, which provide information about platelet activity. Materials and methods: Patients with oligoovulation, hyperandrogenemia, or clinical signs of hyperandrogenism (hirsutism, acne, etc.) and polycystic appearance with ≥ 20 small follicles ≥ 2∼ 9 mm in diameter in both ovaries on ultrasound according to the newly updated Rotterdam criteria were included in the study with a diagnosis of polycystic ovary syndrome and formed PCOS group. Patients with similar age groups and body mass index (BMI) values who presented to the clinic for non-PCOS symptoms (vaginitis, dysmenorrhea, cystitis), whose complete blood count was checked during hormone testing, and who did not meet the Rotterdam criteria were selected as the control group. Platelet indices found in routine blood count parameters (platelet large cell ratio (P-LCR), platelet distribution width (PDW) and mean platelet volume (MPV)) were analyzed between the two groups. In addition, the relationship between these indices and hormone status and insulin resistance in PCOS patients was analyzed. Patients with diabetes mellitus, hypertension, malignant diseases, cardiovascular diseases, essential thrombocytopenia or other blood diseases and patients taking medication were excluded. Results: In the study of 123 patients, there was no statistically significant difference between the groups in terms of age and body mass index (p:>0.05). When hemogram parameters were compared between the groups, hemogram parameters such as P-LCR (p: 0.002), PDW (p: 0.011) and MPV (p: 0.007), which indicate platelet activity, were statistically significantly higher in the PCOS group. When the data of PCOS patients were analyzed, platelet indices were found to be higher in the group with high insulin resistance (p: <0.005). When analyzing the hormonal status, only the prolactin level in the blood correlates positively with the values of P-LCR (r:0.223, p: 0.017), PDW (r:0.214, p:0.022), and MPV (r: 0.213, p:0.023). Conclusion: Analyzing platelet indices in routine blood counts of patients with polycystic ovary syndrome, informing patients about their predisposition to metabolic diseases and making the necessary referrals will contribute to the treatment and follow-up of polycystic ovary syndrome. These tests, which can be easily performed in any center, should be used in common practice.

Keywords

• Blood Platelets
• Metabolic Syndrome
• Polycystic Ovary Syndrome

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