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Polikistik over sendromu ve moleküler yaklaşımlar

Year 2016, Volume: 73 Issue: 1, 81 - 88, 01.03.2016

Abstract

Polikistik over sendromu PKOS , üreme çağındaki kadınları etkileyen bir endokrin hastalığıdır. Sendrom polikistik over morfolojisi, kronik yumurtlama bozukluğu karakterizedir ve başta infertilite olmak üzere insülin direnci ve tip 2 diyabet gibi hastalıklarla da doğrudan ilişkilidir. PKOS’un görülme sıklığı kullanılan tanı kriterlerine göre değişiklik göstermektedir. ESHRE / ASRM İnsan Üremesi ve Embriyolojisi Avrupa Topluluğu / Amerika Üreme Tıbbi Derneği kriterlerine göre her 100 kadından yaklaşık 15-20’sine PKOS teşhisi konmaktadır. Tip 1-2 diyabet hastası yetişkin kadınlar PKOS açısından risk altındadırlar. PKOS hastası kadınların %50-70’inde insülin direnci ve bu duruma bağlı olarak gelişebilen hipertansiyon, dislipidemi, glikoz intoleransı, diyabet gibi hastalıklar gelişmektedir. Kıllanma hirsutism ve adet döngüsü düzensizlikleri de yine PKOS ile birlikte görülebilmektedir. Yapılan çalışmalarda, PKOS’un kardiyovasküler hastalıklar ve kanser gibi hastalıklarla ilişkisi de gösterilmiştir. Yine mental düzensizliklerin de depresyon, kaygı bozukluğu, bipolar bozukluk ve tıkanırcasına yeme bozukluğu PKOS hastası kadınlarda daha sık görüldüğü tespit edilmiştir. PKOS’ta hormonal duruma ve hasta profiline göre değişen klomifen sitrat-metformin terapisi, üremeye yardımcı tedaviler, laparoskopik ovaryum cerrahisi veya dışarıdan gonadotropin verilmesi gibi tedavi yöntemleri uygulanmaktadır. Polikistik over sendromu metabolik, endokrinolojik, psikiyatrik ve kardiyovasküler etkileri ile kompleks bir hastalıktır. Etkileri hastaların hayatı boyunca sürebilmekte ve yaşam kalitesini düşürebilmektedir. Bu nedenle daha etkili tanı ve tedavi yöntemleri geliştirilmesi hastada görülebilecek diyabet, kanser ve kardiyovasküler hastalıklar gibi hastanın yaşam süresini kısaltabilecek durumlardan korunmak için önemlidir. PKOS’un etiyolojisi açık olmamakla birlikte; genetik temele dayanan ailesel geçişlere ait bağlantılar bulunmaktadır. Yapılan çalışmalar PKOS hastası kadınlarda birçok moleküler sinyal yolağına ait genlerin Wnt sinyal yolağı gibi ifadesinin değişerek yumurtalıklarda fonksiyonel bozuklukların oluştuğunu göstermiştir. Bu nedenle, PKOS’un moleküler temelinin aydınlatılması ve bu yolaklarda hangi genlerin etkilendiğinin bulunması, PKOS’un mekanizmalarının daha iyi anlaşılması ve tanıtedavi yöntemlerinin geliştirilmesi açısından önemlidir

References

  • Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol, 2013; 6: 1–13. doi:10.2147/CLEP. S37559.
  • Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab, 2004; 89(6): –9. doi:10.1210/jc.2003-032046.
  • Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev, 2012; 33(6): 981–1030. doi:10.1210/er.2011
  • Atiomo WU, El-Mahdi E, Hardiman P. Familial associations in women with polycystic ovary syndrome. Fertil Steril, 2003; 80(1): 143–145. doi:10.1016/S0015-0282(03)00502-8.
  • Amato P, Simpson JL. The genetics of polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol, 2004; 18(5): 707–18. doi:10.1016/j. bpobgyn.2004.05.002.
  • Huang A, Brennan K, Azziz R. Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria. Fertil Steril, 2010; 93(6): –41. doi:10.1016/j.fertnstert.2008.12.138.
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
  • Fertil Steril, 2004; 81(1): 19–25. doi:10.1016/j. fertnstert.2003.10.004.
  • Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W,et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril, 2009; 91(2): 456–88. doi:10.1016/j.fertnstert.2008.06.035.
  • Goodarzi MO, Azziz R. Diagnosis, epidemiology, and genetics of the polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab, 2006; 20(2): –205. doi:10.1016/j.beem.2006.02.005.
  • Trivax B, Azziz R. Diagnosis of polycystic ovary syndrome. Clin Obstet Gynecol, 2007; 50(1): –77. doi:10.1097/GRF.0b013e31802f351b.
  • Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia, 2009; 13(2): 90–2.
  • Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord, 2002; (7): 883–96. doi:10.1038/sj.ijo.0801994.
  • Setji TL, Brown AJ. Polycystic ovary syndrome: update on diagnosis and treatment. Am J Med, 2014; 127(10): 912–9. doi:10.1016/j. amjmed.2014.04.017.
  • Costello MF, Misso ML, Wong J, Hart R, Rombauts L, Melder A, et al. The treatment of infertility in polycystic ovary syndrome: a brief update. Aust N Z J Obstet Gynaecol, 2012; 52(4): 400–3. doi:10.1111/j.1479-828X.2012.01448.x.
  • Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab, 2010; 95(5): 2038–49. Doi:10.1210/jc.2009
  • Navaratnarajah R, Pillay OC, Hardiman P. Polycystic ovary syndrome and endometrial cancer. Semin Reprod Med, 2008; 26(1): 62–71. doi:10.1055/s-2007-992926.
  • Pierpoint T, McKeigue PM, Isaacs a J, Wild SH, Jacobs HS. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol, 1998; 51(7): 581–6.
  • Jakimiuk AJ, Issat T. PCOS and cancer risk. Folia Histochem Cytobiol, 2009; 47(5): S101–5. doi:10.2478/v10042-009-0092-1.
  • Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update, ; 20(5): 748–58. doi:10.1093/humupd/ dmu012. McFarland C. Treating syndrome and infertility. MCN Am J Matern
  • Child Nurs, 2012; 37(2): 116–21. doi:10.1097/ NMC.0b013e31824239ce. polycystic ovary
  • Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane database Syst Rev, 2012; (5): CD003053. doi:10.1002/14651858.CD003053. pub5.
  • Moll E, van der Veen F, van Wely M. The role of metformin in polycystic ovary syndrome: a systematic review. Hum Reprod Update, 2007; (6): 527–37. doi:10.1093/humupd/dmm026.
  • Kobayashi H, Sun GW, Hirashima Y, Terao T. Identification of link protein during follicle development and cumulus cell cultures in rats. Endocrinology, 1999; 140(8): 3835–42. doi:10.1210/ endo.140.8.6917.
  • Kenigsberg S, Bentov Y, Chalifa-Caspi V, Potashnik G, Ofir R, Birk OS. Gene expression microarray profiles of cumulus cells in lean and overweight- obese polycystic ovary syndrome patients. Mol Hum Reprod, 2009; 15(2): 89–103. doi:10.1093/ molehr/gan082.
  • Wood JR, Ho CKM, Nelson-Degrave VL, McAllister JM, Strauss JF. The molecular signature of polycystic ovary syndrome (PCOS) theca cells defined by gene expression profiling. J Reprod Immunol, 2004; (1): 51–60. doi:10.1016/j.jri.2004.01.010.
  • Wood JR, Nelson VL, Ho C, Janson E, Wong CY, Urbanek M, et al. The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new Candidate PCOS genes defined by microarray analysis. J Biol Chem, 2003; 278(29): 26380–90. doi:10.1074/jbc.M300688200.
  • Chin K, Seifer DB, Feng B, Lin Y, Shin WC, et al. DNA microarray analysis of the expression profiles of luteinized granulosa cells as a function of a varran reserve. Fertil Steril, 2002; 77(6): 1214–8.
  • Kaur S, Archer KJ, Devi MG, Kriplani A, Strauss JF, Singh R. Differential gene expression in granulosa cells from polycystic ovary syndrome patients with and without insulin resistance: identification of susceptibility gene sets through network analysis. J Clin Endocrinol Metab, 2012; 97(10): E2016–21. doi:10.1210/jc.2011-3441.

Polycystic ovary syndrome and molecular approaches

Year 2016, Volume: 73 Issue: 1, 81 - 88, 01.03.2016

Abstract

Polycystic ovary syndrome PCOS is an endocrine disorder, which affects women at reproductive age. Syndrome is characterized by hyperandrogenism, polycystic ovarian morphology and ovulatory dysfunction. PCOS is associated with reproductive and metabolic abnormalities including infertility, insulin resistance and type 2 diabetes. Prevalence of PCOS changes by the used diagnostic criteria for PCOS. According to ESHRE / ASRM European Society of Human Reproduction and Embryology / American Society for Reproductive Medicine criteria PCOS is diagnosed at nearly 15%-20% of women. Adult women, who have type 1-2 diabetes, are under high risk of PCOS. 50%-70% of PCOS patients have insulin resistance. Diseases like hypertension, dyslipidemia, glucose intolerance, diabetes are highly associated with insulin resistance and PCOS. In addition, hirsutism and menstrual irregularities could occur with PCOS. Studies show that there is a relation between PCOS and cardiovascular diseases and cancer as well. Studies identified that mental disorders depression, anxiety, bipolar disorder and binge eating disorder are frequently seen at PCOS patients. The treatment strategies applied to PCOS patients vary according to the hormonal status and profile of the patient. Clomiphene citrate-metformin therapy, fertility treatments, laparoscopic ovarian surgery or gonadotrophin hormone therapy are the most frequent therapies used for treatment of PCOS. PCOS is a complex disorder, which includes metabolic, endocrinologic, psychiatric and cardiovascular effects. These effects could be lifetime long and yaşam kalitesini düşürebilmektedir. Bu nedenle daha etkili tanı ve tedavi yöntemleri geliştirilmesi hastada görülebilecek diyabet, kanser ve kardiyovasküler hastalıklar gibi hastanın yaşam süresini kısaltabilecek durumlardan korunmak için önemlidir. PKOS’un etiyolojisi açık olmamakla birlikte; genetik temele dayanan ailesel geçişlere ait bağlantılar bulunmaktadır. Yapılan çalışmalar PKOS hastası kadınlarda birçok moleküler sinyal yolağına ait genlerin Wnt sinyal yolağı gibi ifadesinin değişerek yumurtalıklarda fonksiyonel bozuklukların oluştuğunu göstermiştir. Bu nedenle, PKOS’un moleküler temelinin aydınlatılması ve bu yolaklarda hangi genlerin etkilendiğinin bulunması, PKOS’un mekanizmalarının daha iyi anlaşılması ve tanı

References

  • Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol, 2013; 6: 1–13. doi:10.2147/CLEP. S37559.
  • Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab, 2004; 89(6): –9. doi:10.1210/jc.2003-032046.
  • Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev, 2012; 33(6): 981–1030. doi:10.1210/er.2011
  • Atiomo WU, El-Mahdi E, Hardiman P. Familial associations in women with polycystic ovary syndrome. Fertil Steril, 2003; 80(1): 143–145. doi:10.1016/S0015-0282(03)00502-8.
  • Amato P, Simpson JL. The genetics of polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol, 2004; 18(5): 707–18. doi:10.1016/j. bpobgyn.2004.05.002.
  • Huang A, Brennan K, Azziz R. Prevalence of hyperandrogenemia in the polycystic ovary syndrome diagnosed by the National Institutes of Health 1990 criteria. Fertil Steril, 2010; 93(6): –41. doi:10.1016/j.fertnstert.2008.12.138.
  • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
  • Fertil Steril, 2004; 81(1): 19–25. doi:10.1016/j. fertnstert.2003.10.004.
  • Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W,et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril, 2009; 91(2): 456–88. doi:10.1016/j.fertnstert.2008.06.035.
  • Goodarzi MO, Azziz R. Diagnosis, epidemiology, and genetics of the polycystic ovary syndrome. Best Pract Res Clin Endocrinol Metab, 2006; 20(2): –205. doi:10.1016/j.beem.2006.02.005.
  • Trivax B, Azziz R. Diagnosis of polycystic ovary syndrome. Clin Obstet Gynecol, 2007; 50(1): –77. doi:10.1097/GRF.0b013e31802f351b.
  • Daniilidis A, Dinas K. Long term health consequences of polycystic ovarian syndrome: a review analysis. Hippokratia, 2009; 13(2): 90–2.
  • Gambineri A, Pelusi C, Vicennati V, Pagotto U, Pasquali R. Obesity and the polycystic ovary syndrome. Int J Obes Relat Metab Disord, 2002; (7): 883–96. doi:10.1038/sj.ijo.0801994.
  • Setji TL, Brown AJ. Polycystic ovary syndrome: update on diagnosis and treatment. Am J Med, 2014; 127(10): 912–9. doi:10.1016/j. amjmed.2014.04.017.
  • Costello MF, Misso ML, Wong J, Hart R, Rombauts L, Melder A, et al. The treatment of infertility in polycystic ovary syndrome: a brief update. Aust N Z J Obstet Gynaecol, 2012; 52(4): 400–3. doi:10.1111/j.1479-828X.2012.01448.x.
  • Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab, 2010; 95(5): 2038–49. Doi:10.1210/jc.2009
  • Navaratnarajah R, Pillay OC, Hardiman P. Polycystic ovary syndrome and endometrial cancer. Semin Reprod Med, 2008; 26(1): 62–71. doi:10.1055/s-2007-992926.
  • Pierpoint T, McKeigue PM, Isaacs a J, Wild SH, Jacobs HS. Mortality of women with polycystic ovary syndrome at long-term follow-up. J Clin Epidemiol, 1998; 51(7): 581–6.
  • Jakimiuk AJ, Issat T. PCOS and cancer risk. Folia Histochem Cytobiol, 2009; 47(5): S101–5. doi:10.2478/v10042-009-0092-1.
  • Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update, ; 20(5): 748–58. doi:10.1093/humupd/ dmu012. McFarland C. Treating syndrome and infertility. MCN Am J Matern
  • Child Nurs, 2012; 37(2): 116–21. doi:10.1097/ NMC.0b013e31824239ce. polycystic ovary
  • Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane database Syst Rev, 2012; (5): CD003053. doi:10.1002/14651858.CD003053. pub5.
  • Moll E, van der Veen F, van Wely M. The role of metformin in polycystic ovary syndrome: a systematic review. Hum Reprod Update, 2007; (6): 527–37. doi:10.1093/humupd/dmm026.
  • Kobayashi H, Sun GW, Hirashima Y, Terao T. Identification of link protein during follicle development and cumulus cell cultures in rats. Endocrinology, 1999; 140(8): 3835–42. doi:10.1210/ endo.140.8.6917.
  • Kenigsberg S, Bentov Y, Chalifa-Caspi V, Potashnik G, Ofir R, Birk OS. Gene expression microarray profiles of cumulus cells in lean and overweight- obese polycystic ovary syndrome patients. Mol Hum Reprod, 2009; 15(2): 89–103. doi:10.1093/ molehr/gan082.
  • Wood JR, Ho CKM, Nelson-Degrave VL, McAllister JM, Strauss JF. The molecular signature of polycystic ovary syndrome (PCOS) theca cells defined by gene expression profiling. J Reprod Immunol, 2004; (1): 51–60. doi:10.1016/j.jri.2004.01.010.
  • Wood JR, Nelson VL, Ho C, Janson E, Wong CY, Urbanek M, et al. The molecular phenotype of polycystic ovary syndrome (PCOS) theca cells and new Candidate PCOS genes defined by microarray analysis. J Biol Chem, 2003; 278(29): 26380–90. doi:10.1074/jbc.M300688200.
  • Chin K, Seifer DB, Feng B, Lin Y, Shin WC, et al. DNA microarray analysis of the expression profiles of luteinized granulosa cells as a function of a varran reserve. Fertil Steril, 2002; 77(6): 1214–8.
  • Kaur S, Archer KJ, Devi MG, Kriplani A, Strauss JF, Singh R. Differential gene expression in granulosa cells from polycystic ovary syndrome patients with and without insulin resistance: identification of susceptibility gene sets through network analysis. J Clin Endocrinol Metab, 2012; 97(10): E2016–21. doi:10.1210/jc.2011-3441.
There are 29 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

Alp Aydos This is me

Yasemin Öztemur This is me

Bala Gür Dedeoğlu This is me

Publication Date March 1, 2016
Published in Issue Year 2016 Volume: 73 Issue: 1

Cite

APA Aydos, A., Öztemur, Y., & Dedeoğlu, B. G. (2016). Polikistik over sendromu ve moleküler yaklaşımlar. Türk Hijyen Ve Deneysel Biyoloji Dergisi, 73(1), 81-88.
AMA Aydos A, Öztemur Y, Dedeoğlu BG. Polikistik over sendromu ve moleküler yaklaşımlar. Turk Hij Den Biyol Derg. March 2016;73(1):81-88.
Chicago Aydos, Alp, Yasemin Öztemur, and Bala Gür Dedeoğlu. “Polikistik over Sendromu Ve moleküler yaklaşımlar”. Türk Hijyen Ve Deneysel Biyoloji Dergisi 73, no. 1 (March 2016): 81-88.
EndNote Aydos A, Öztemur Y, Dedeoğlu BG (March 1, 2016) Polikistik over sendromu ve moleküler yaklaşımlar. Türk Hijyen ve Deneysel Biyoloji Dergisi 73 1 81–88.
IEEE A. Aydos, Y. Öztemur, and B. G. Dedeoğlu, “Polikistik over sendromu ve moleküler yaklaşımlar”, Turk Hij Den Biyol Derg, vol. 73, no. 1, pp. 81–88, 2016.
ISNAD Aydos, Alp et al. “Polikistik over Sendromu Ve moleküler yaklaşımlar”. Türk Hijyen ve Deneysel Biyoloji Dergisi 73/1 (March 2016), 81-88.
JAMA Aydos A, Öztemur Y, Dedeoğlu BG. Polikistik over sendromu ve moleküler yaklaşımlar. Turk Hij Den Biyol Derg. 2016;73:81–88.
MLA Aydos, Alp et al. “Polikistik over Sendromu Ve moleküler yaklaşımlar”. Türk Hijyen Ve Deneysel Biyoloji Dergisi, vol. 73, no. 1, 2016, pp. 81-88.
Vancouver Aydos A, Öztemur Y, Dedeoğlu BG. Polikistik over sendromu ve moleküler yaklaşımlar. Turk Hij Den Biyol Derg. 2016;73(1):81-8.