TY  - JOUR
T1  - Ergen kızlarda polikistik over sendromu: klinik, endokrin ve metabolik bulgular
TT  - Polycystic ovary syndrome in adolescent girls: Clinical, endocrinological and metabolic findings
AU  - Özcabı, Bahar
AU  - Tahmiscioğlu Bucak, Feride
AU  - Şengenç, Esma
AU  - Sunamak, Evrim
AU  - Adaletli, İbrahim
AU  - Kuruğoğlu, Sebuh
AU  - Ercan, Oya
AU  - Evliyaoğlu, Olcay
PY  - 2019
DA  - December
DO  - 10.16948/zktipb.499708
JF  - Zeynep Kamil Tıp Bülteni
PB  - Zeynep Kamil Kadın ve Çocuk Hastalıkları EAH
WT  - DergiPark
SN  - 1300-7971
SP  - 194
EP  - 197
VL  - 50
IS  - 4
LA  - tr
AB  - Amaç:Polikistik over sendromu tanısı alan ergen kızların başvurudaki klinik, metabolikve endokrin bulgularını değerlendirmeyi amaçladık.Gereç-Yöntemler: Ocak 2008-Aralık 2012 tarihleri arasında Rotterdam tanı ölçütlerine göre tanılandırılan53 olgunun yakınmaları, adet düzenleri, fizik bakı bulguları (antropometrikölçümler, Ferriman Gallwey skoru, akantozis nigrikans varlığı), bazal/uyarılmışadrenal androjen, açlık glukoz/insülin değerleri, kan yağ ve lipoproteindüzeyleri, pelvik ultrasonografi bulguları kaydedildi. Yaşa göre vücut kitleindeksi (VKİ) %95 ve üzeri olgular şişman olarak tanımlandı. Oligo/amenore,hiperandrojenizm ve ultrasonografide polikistik over bulgularının hepsinin bulunduğuhastalar klasik grup olarak adlandırıldı. Kan trigliserit düzeyi yaşa göre %97değerinden fazla ise yüksek olarak nitelendirildi; HOMA-IR değeri ≥ 3,82 olgulardainsülin direnci var kabul edildi.Bulgular:Ortalama başvuru yaşı 15±1,5 yıldı. En sık yakınma adet düzensizliğiydi(%49,1). Adet düzeni ayrıntılı sorgulandığındaysa olguların %60,4’ünde oligo/amenoreolduğu görüldü. Olguların %43,4’üşişmandı. Akantozis nigrikans (%37,7) olan olgularda şişmanlık daha sıktı(p=0.010). Hirsutizm %41,5 olguda orta-ağır (Ferriman Gallwey skoru≥16) olarakbelirlendi: orta-ağır olgularda oligo/amenore daha sıktı (p=0,007).İnsülin direnci %39,6 olguda (%81 obez) vardı ve akantozis nigrikanssaptananlarda daha sıktı (p=0,001). Trigliserityüksekliği 49 olgudan 7’sinde saptandı; bu olguların hepsinde insülin direnci demevcuttu (p=0,033). Serum trigliserit düzeyi ile HOMA-IR değeri arasındakorelasyon saptandı (r:0,415). Polikistik over bulgusu olguların % 96,2’sindebelirlendi. Klasik grupta diğer gruba göre oligo/amenore, hirsutizm, akantozisnigrikans, trigliserit yüksekliği anlamlı (p<0.005), total testosterondüzeyi anlamlılığa yakın yüksekti (p=0.056). Sonuç: Polikistikover sendromu tanısında adet düzeni ayrıntılı olarak sorgulanmalıdır. Akantozisnigrikans saptanan olgular insülin direnci açısından irdelenmeli, insülindirenci varlığında trigliserit yüksekliği araştırılmalıdır.
KW  - akantozis nigrikans
KW  - hiperandrojenizm
KW  - hirsutizm
KW  - insülin direnci
KW  - polikistik over sendromu
N2  - Aim:We aimed to evaluate the clinical, metabolic, and endocrinological findings ofadolescent girls with polycystic ovary syndrome. Material-Methods: The dataabout menstrual patterns, physical examination (anthropometric measurements,Ferriman Gallwey score, acanthosis nigricans), basal/stimulated adrenalandrogens, fasting glucose/insulin, lipid/lipoprotein levels, andultrasonography findings wereobtained from the medical records of53 cases diagnosed according to Rotterdam criteria between January2008-December 2012. Patients with body mass index (BMI) percentile ≥95%according to age were defined as obese. Patients meeting all of the 3 criteria(menstrual irregularity, hyperandrogenism and polycystic ovaries on ultrasound)were defined as the classical group and the rest as the other group. Blood triglyceridelevel more than %97 percentile level according to age is considered high;insulin resistance was considered to be present in patients with HOMA-IR ≥3.82.Results:The mean age was 15±1.5 years. The most common complaint was menstrual irregularity(49,1%);oligo/amenorrhea was present in 60.4% of cases when questioned in detail.Acanthosis nigricans was more frequent in obese cases (p=0.010). Moderate-severehirsutism (Ferriman Gallwey score ≥16) was present in 41.5% of patients in whomoligo/amenorrhea was more frequent (p=0.007). Insulin resistance was detected in 39.6% of the patients(81% obese) and more frequent in patients with acanthosis nigricans (p=0.001). Hypertriglyceridemiawas determined in seven of 49 cases in which insulin resistance wassignificantly more frequent (p=0.033). A positive correlation was detectedbetween triglyceride and HOMA-IR levels (r:0,415). Polycystic ovary on ultrasound was detected in 96.2% of patients. Inclassical group; oligo/amenorrhea, hirsutism, acanthosis nigricans, andhypertriglyceridemia were more frequent than the other group (p<0.005).Total testosterone level was higher in the classical group but the differencewas not significant (p=0.056). Conclusion: The menstrual cycle of patientswith polycystic ovary syndrome should be questioned in detail. In patients withacanthosis nigricans, insulin resistance must be considered and in the presenceof insulin resistance hypertriglyceridemia should be investigated.
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UR  - https://doi.org/10.16948/zktipb.499708
L1  - https://dergipark.org.tr/tr/download/article-file/959704
ER  -