Abstract
Amaç: Polikistik over sendromunda (PCOS) görülen hipertansiyon ve insülin direnci gibi bozukluklardan sempatik aktivitedeki değişiklikler sorumludur. Sempatik deri cevabı (SDC), sempatik sinirler tarafından uyarılan sudomotor bezlerin aktivitesini yansıtır. Bu çalışmada, PKOS hastalarında insülin direnci ile SSR arasındaki ilişkiyi araştırmayı amaçladık. Ayrıca antidiyabetik ajan metformin ile insülin direnci tedavisinin SSR üzerindeki etkisi araştırıldı.
Gereç ve Yöntemler: Çalışmaya metformin tedavisi almayan insülin direnci olan 30 PKOS hastası ve 20 sağlıklı kadın dahil edildi. Tüm katılımcılara hormon, oral glukoz tolerans testi ve HOMA skoru (Homeostasis Model Assessment) ölçümleri yapıldı. SSR'nin bir parametresi olan ve sempatik aktiviteyi yansıtan deri iletkenlik seviyesi (DİS), anksiyete-depresyon olmayan tüm katılımcılardan kaydedildi. PKOS hastalarında 6 ay süreyle 1500-2000 mg/gün metformin tedavisi sonrasında tüm ölçümler tekrarlandı.
Bulgular: Testosteron ve androstenedion düzeyleri ile HOMA-insülin direnci değerleri PKOS'lu hastalarda sağlıklı kontrollere göre anlamlı derecede yüksekti (p<0.00). DİS, PKOS'lu hastalarda metformin tedavisi öncesinde sağlıklı gruba göre daha yüksekti (p<0,05), ancak metformin tedavisi sonrasında anlamlı düzeyde azalarak kontrol grubuna yaklaştı (p<0,05).
Sonuç: PKOS hastalarında gözlenen yüksek DİS, bu hastalarda sempatik aktivitenin arttığını göstermektedir. PKOS hastalarının metformin ile tedavisi sonrasında DİS'deki azalma, metforminin sempatik aktiviteyi azaltarak bazı PKOS semptomları üzerinde iyileştirici etkisi olabileceğini göstermektedir.
Project Number
TSY-10-3284
References
- 1. Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): ar guably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab. 1999; 84:1897-1899.
- 2. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1985; 61:946-51.
- 3. Azziz R, Ehrmann D, Legro RS, et al. PCOS/Troglitazone Study Group. Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2001; 86:1626-1632.
The Relation Between Insulin Resistance and Sympathetic Skin Response in Patients with Polycystic Ovary Syndrome
Abstract
Aim: Changes in sympathetic activity are responsible for disorders such as hypertension and insulin resistance observed in polycystic ovary syndrome (PCOS). The Sympathetic skin response (SSR) reflects the activity of the sudomotor glands stimulated by the sympathetic nerves. In this study, we aimed to investigate the relationship between insulin resistance and SSR in PCOS patients. In addition, the effect of insulin resistance treatment with the antidiabetic agent metformin on SSR was explored.
Material and Methods: Thirty PCOS patients with insulin resistance who did not receive metformin therapy and twenty healthy women were included in the study. Hormone, oral glucose tolerance test, and HOMA score (Homeostasis Model Assessment) measurements were performed on all participants. Skin conductance level (SCL) which is a parameter of SSR and reflects sympathetic activity was recorded from the all participants without anxiety-depression. All measurements were repeated after treatment with 1500-2000 mg/day metformin for 6 months in PCOS patients.
Results: Testosterone, and androstenedione levels, HOMA-insulin resistance values were significantly higher in PCOS patients than healthy controls (p <0.00). SCL was higher in PCOS patients than in the healthy group before metformin treatment (p<0.05), but significantly decreased after metformin treatment and approached the value of the control group (p<0.05).
Conclusion: The high SCL observed in PCOS patients indicates increased sympathetic activity in these patients. The decrease in SCL after treatment of PCOS patients with metformin indicates that metformin may have an ameliorative effect on some PCOS symptoms by reducing sympathetic activity.
Keywords
Polycystic Ovary Syndrome sympathetic skin response insulin resistance sympathetic activity HOMA
Ethical Statement
The study was approved by the Ethics Committee of Erciyes University Faculty of Medicine (2010/57). Written informed consent was obtained from the patients who agreed to participate in the study.
Supporting Institution
This study was supported by Erciyes University Research Fund (TSY-10-3284).
Project Number
TSY-10-3284
References
- 1. Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): ar guably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab. 1999; 84:1897-1899.
- 2. Wild RA, Painter PC, Coulson PB, Carruth KB, Ranney GB. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1985; 61:946-51.
- 3. Azziz R, Ehrmann D, Legro RS, et al. PCOS/Troglitazone Study Group. Troglitazone improves ovulation and hirsutism in the polycystic ovary syndrome: a multicenter, double-blind, placebo-controlled trial. J Clin Endocrinol Metab. 2001; 86:1626-1632.
Details
| Primary Language | English |
|---|---|
| Subjects | Endocrinology, Physiopathology, Medical Physiology (Other) |
| Journal Section | Research Article |
| Authors | |
| Project Number | TSY-10-3284 |
| Publication Date | April 30, 2025 |
| Submission Date | November 11, 2024 |
| Acceptance Date | April 13, 2025 |
| Published in Issue | Year 2025 Volume: 9 Issue: 1 |
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