EVALUATION OF CLINICAL, METABOLIC AND ULTRASONOGRAPHIC PARAMETERS OF PATIENTS WITH POLYCYSTIC OVARY SYNDROME RECEIVING VITAMIN D TREATMENT

Yıl 2023, Cilt: 9 Sayı: 3, 165 - 184, 24.12.2023

Ufuk Atlıhan , Ömer Erbil Doğan

Öz

Objective: The aim of the study is the evaluation of clinical, metabolic and ultrasonographic parameters of patients with polycystic ovary syndrome, who are receiving treatment because of with vitamin D deficiency.
Materials & Method: This study was conducted after the permission was granted from the Ethics Committee for Clinical Studies of Dokuz Eylul University School of Medicine. 95 patients, who visited the reproductive endocrinology and infertility outpatient clinic of Dokuz Eylül University School of Medicine Department of Obstetrics and Gynaecology between December 1, 2013 and December 1, 2014 and were diagnosed with polycystic ovary syndrome according to Rotterdam Criteria. The clinical, metabolic and ultrasonographic parameters of the patients with polycystic ovary syndrome ,who received treatment due to vitamin D deficiency, were evaluated retrospectively.
Results: Between the weight, waist circumference, waist to hip ratio, LH, FSH, estradiol, total testosterone, prolactin, thyroid stimulating hormone, oral glucose tolerance test, insulin, 17-OH progesterone, HDL, LDL, triglyceride, total cholesterol, fasting blood glucose level, mean arterial blood pressure, androstenedione, SHBG, VKİ, HOMA-IR, total ovarian volume values of the patients in the 0th and 3rd months, the difference was insignificant. A statistically significant decrease was found in the mean Ferriman-Gallwey score, menstrual period, 25-OH vitamin D level, DHEAS level, free testosterone concentration, LH/FSH ratio, total number of antral follicles and free androgen index level. The correlation among the increase in the concentration of 25 - OH Vitamin D, the level of LH/FSH ratio, total antral follicle count, level of free androgen index and the decrease in DHEAS levels was evaluated with Pearson Correlation Analysis and no statistically significant difference was detected [(p<0,05),(r: ±1)]. The increase in 25-OH vitamin D level and the decrease Ferriman-Gallwey scores were evaluated with Pearson Correlation Analysis and the correlation was found statistically significant (p<0.024, r:-0,232).
Conclusion: After treatment with vitamin D3; no statistically significant difference was found between the lipid parameters and insulin resistance in patients with PCOS. The biochemical parameters of hyperandrogenism showed statistically significant difference after treatment. The clinical findings of the patients showed improvement after treatment; the difference in menstrual periods between before and after treatment was significant. The post-treatment ultrasonography of patients revealed significant decrease in total number of antral follicles when compared to the pre-treatment examination.

Anahtar Kelimeler

Polycystic ovary syndrome, 25-OH D vitamin

D VİTAMİNİ EKSİKLİĞİ NEDENİYLE TEDAVİ ALAN POLİKİSTİK OVER SENDROMLU HASTALARIN KLİNİK, METABOLİK VE ULTRASONOGRAFİK PARAMETRELERİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışmada, D vitamini eksikliği nedeniyle tedavi alan polikistik over sendromlu hastaların klinik, metabolik, ultrasonografik parametrelerinin değerlendirilmesi amaçlanmıştır.
Materyal-Metod: Dokuz Eylül Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı, Üreme Endokrinolojisi ve İnfertilite Bilim Dalı Polikliniği’ne 01/12/2013-01/12/2014 tarihleri arasında başvuran polikistik over sendromu tanısı konulan toplam 95 hasta çalışmaya alınmıştır. D vitamini eksikliği nedeniyle tedavi alan polikistik over sendromlu hastaların 3 aylık tedavi sonrasındaki klinik, metabolik, ultrasonografik parametreleri retrospektif olarak değerlendirilmiştir.
Bulgular: Vitamin D3 kullanımı sonrasında 0.ay ve 3.ay arasında kilo,bel çevresi,kalça çevresi,bel/kalça oranı, LH, FSH, estradiol, total testosteron, PRL, TSH, OGTT düzeyi, insülin, 17-OH progesteron, HDL, LDL, trigliserit, total kolesterol, açlık kan şekeri düzeyi, ortalama arteriyal kan basıncı, androstenedion, SHBG, VKİ, HOMA-IR, total over volümü değerleri arasında anlamlı farklılık izlenmedi. Ferriman gallwey skoru, adet düzeni, 25-OH D vitamini düzeyi, DHEAS düzeyi, free testosteron, LH/FSH oranı, total antral folikül sayısı, free androjen indeks düzeyinde istatistiksel olarak anlamlı azalma saptandı. 25-OH D vitamin düzeyi artışı ile LH/FSH oranı düzeyi, total antral folikül sayısı, serbest androjen indeksi düzeyi, DHEAS düzeyi azalması korelasyonu, pearson korelasyon analizi ile değerlendirildi ve istatistiksel olarak anlamlı farklılık saptanmadı[(p<0,05),(r: ±1)]. 25-OH D vitamin düzeyi artışı ile Ferriman Gallwey skoru azalması arasında anlamlı korelasyon saptandı (p<0.024, r:-0,232).
Sonuç: Polikistik over sendromlu hastalarda vitamin D3 kullanımı sonrasında lipid parametreleri ve insülin rezistansında anlamlı bir azalma saptanmamıştır. Hiperandrojenizmin biyokimyasal parametrelerinde tedavi sonrası dönemde anlamlı azalma saptanmıştır. Hastaların menstrual sikluslarında tedavi sonrası anlamlı düzelme saptanmıştır. Hastaların tedavi sonrası yapılan ultrasonografisinde, tedavi öncesi döneme göre total antral folikül sayısında anlamlı azalma saptanmıştır.

Anahtar Kelimeler

Polikistik over sendromu, 25-OH D vitamini, ultrasonografik parametre

Kaynakça

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