Evaluation of the Effect of Visceral / Truncal Fat Rate and Insulin Resistance on Myoma Uteri Formation Among Premenopausal Women

Abstract

Objectives:  Within the scope of this study, we aimed to analyze the effect of visceral and truncal fat rate and insulin resistance on myoma uteri progression in premenopausal women.

Materials and Methods: 100 patients, who have been applied to the gynecology department with myoma diagnosis and 50 control patients who had no myomas and had similar properties with the patient group were included in the study. Anthropometric measures, pre-prandial serum glucose, HbA1c, insulin, LDL-cholesterol, triglyceride, HDL-cholesterol and total cholesterol levels were studied. All statistical analyses were performed with SPSS 16.0 statistical soft-ware and a level of p < 0.05 is accepted statistically significant.

Results: Truncal fat rate of the patient group is found higher than the control group (p=0.014). Mean HbA1c was higher and statistically significant (p< 0.001) in the patient group. Mean HDL-C was found significantly lower in the patient group (p= 0.001).

Conclusion: In our study, higher levels of truncal fat rate in the patient group can be inferred to the production of estrogen in truncal fat tissue due to increased aromatase activity and thus myoma frequency was increased. We have also determined in this study that higher HbA1c levels in patient group caused an increase in the risk of myoma up to 3.5 times. Normal values of HOMA-IR suggest that insulin resistance is not a risk factor for the development of myoma. It is believed that there is a negative correlation between hyperlipidemia and myoma. 

Keywords

• Myoma Uteri,visceral / truncal obesity,insulin resistance

Premenapozal Kadınlarda Myoma Uteri Gelişimi Üzerine Visseral/Trunkal Yağ Oranının ve İnsülin Direncinin Etkisinin Değerlendirilmesi

Öz

Amaç: Biz bu kesitsel çalışmada premenapozal kadınlarda myoma uteri gelişimi üzerinde visseral- trunkal yağ oranı ve insülin direncinin etkisini araştırmayı amaçladık.

Materyal ve Metot: Bu çalışmada, Ankara Atatürk Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği’ne Ocak-Mayıs 2012 tarihleri arasında başvuran, myoma uteri tanısı almış 100 hasta, kontrol grubu olarak hasta grubu ile benzer klinik özelliklere sahip myomu olmayan 50 kadın çalışmaya alındı. Hastaların antropometrik ölçümleri, açlık plazma glukozu, HbA1c, insulin, LDL-kolesterol, trigliserit, HDL-kolesterol ve total kolesterol seviyesi bakıldı. Tüm istatistiksel analizler için SPSS 16.0 programı kullanıldı ve anlamlılık düzeyi  p < 0,05 olarak kabul edildi.

Bulgular: Hasta grubunun trunkal yağ oranı, kontrol grubundan istatistiksel olarak anlamlı derecede daha yüksek bulundu (p= 0,014). HbA1c ortalaması hasta grubunda istatistiksel olarak anlamlı derecede yüksek idi (p < 0,001). HDL-K ortalaması hasta grubunda istatistiksel olarak anlamlı düzeyde düşük bulundu (p= 0,001).

Sonuç: Çalışmamızda hasta grubunda trunkal yağ doku oranının yüksek bulunması trunkal yerleşimli yağ dokuda artmış aromataz aktivitesi nedeni ile östrojen üretiminin daha fazla olduğunu bu nedenle myoma sıklığının arttığını düşündürmüştür. Myoma uteri gelişimi üzerinde etkili metabolik parametrelerin değerlendirildiği ileri çalışmalara ihtiyaç vardır. Yine çalışmamızda hasta grubunda ki HbA₁c yüksekliğinin myom olma olasılığını 3,5 kat arttırdığını tespit ettik. HOMA-IR değerinin normal saptanması üzerine insülin direncinin myom gelişimi için muhtemel bir risk faktörü olamayacağı sonucuna varılmıştır.

Anahtar Kelimeler

• Myoma uteri,visseral / trunkal obezite,insülin direnci

Kaynakça

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