Polikistik Over Sendromlu Adölesanlarda Serum Ürokortin 2, Ürokortin 3 ve Antimüllerian Hormon Düzeyleri

Yıl 2018, Cilt: 3 Sayı: 2, 21 - 26, 31.05.2018

Selin Öztürk Bumin Nuri Dündar , Cemil Koçyiğit Gönül Çatlı

Öz

Amaç: Polikistik over sendromu (PKOS) kronik anovulasyon ve hiperandrojenizm ile karakterize, üreme çağındaki kadınların %5-10’unu etkileyen yaygın bir endokrin bozukluktur. PKOS’lu adölesanlarda serum ürokortin 2 ve ürokortin 3 ve Antimüllerian Hormon (AMH) düzeylerinin araştırılması ve sağlıklı kontroller ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Rotterdam kriterlerine göre PKOS tanısı alan (ortalama yaş: 16.1±0.98 yıl) 37 adölesan ve 39 sağlıklı (ortalama yaş: 16.1±1.08) kontrol olmak üzere 76 adölesan alındı. Tüm hastaların antropometrik ölçümleri ve pubertal gelişim evreleri kaydedildi. Modifiye Ferriman- Gallwey skorlama sistemine göre hirsutizm skorlaması yapıldı. Homa-IR >4 değeri insülin direnci olarak kabul edildi. Biyoelektriksel impedans analizi ile olguların vücut yağ-kas oranı değerlendirildi. Açlık serum glukoz, insülin, lipit, Follikül Stimüle Edici Hormon, Lüteinleştiren Hormon, Seks Hormonu Bağlayıcı Globulin, Serbest Testosteron, Total Testosteron düzeyleri ölçüldü. USG ile PKOS tanısı alan olguların over morfolojileri değerlendirildi. Bulgular: Her iki grup arasında yaş ortalaması açısından fark saptanmadı (p>.05). PKOS’lu grupta VKİ SDS, boy SDS ve bel çevresi SDS kontrol grubundan daha yüksek bulundu (p<.05). Obezite, akne, alopesi, akantozis, stria, oligo-amonere ve hirsutizm skoru PKOS grubunda istatiksel olarak anlamlı yüksek saptandı (p<.01). AMH ve ürokortin 2-3 düzeyleri açısından iki grup arasında farklılık yoktu (p>.05). Hirsutizm şiddeti ile AMH, ürokortin 2 ve 3 düzeyleri arasında ilişki saptanmadı (p>.05). AMH, ürokortin 2 ve ürokortin 3 arasında anlamlı pozitif korelasyon tespit edilirken, LH, FSH, serbest testosteron, total testosteron ve SHBG düzeyleri ile AMH, ürokortin 2 ve ürokortin 3 düzeyleri arasında korelasyon gösterilemedi. Sonuç: Bu çalışmada ürokortin 2 ve ürokortin 3 ve AMH düzeyleri ile PKOS arasında ilişki saptanamamıştır. Bu konuda daha ileri çalışmalara ihtiyaç vardır.

Objective: Polycystic ovary syndrome (PCOS) is a frequent endocrine disorder characterized by chronic anovulation and hyperandrogenism, affecting 5 to 10 percent of women in reproductive age. It was aimed in this study to examine serum urocortin 2, urocortin 3 and AMH levels in adolescents with PCOS and to compare the results with those of healthy adolescents. Material and Methods: 37 adolescent girls (16.1±0.98 years) with PCOS diagnosed according to Rotterdam criteria and 39 healthy adolescent girls (16.1±1.08 years) were recruited to the study. All patients’ anthropometric measurements and pubertal development stages were recorded. Hirsutism was scored according to Ferriman-Gallwey scoring system. Insulin resistance was diagnosed when HOMA-IR was >4. Bioelectrical impedance analysis was used to measure body fat percentage and fat free mass. Levels of fasting glucose, insulin, lipids, follicle stimulating hormone, luteinizing hormone, sex hormone binding globulin, free and total testosterone, urocortin 2 and 3, and AMH were measured. Suprapubic pelvic USG was also performed in the PCOS group. Findings: The mean age of the two groups was similar (p>.05). In the PCOS group, body mass index SDS, height SDS and waist circumference SDS was significantly higher than the control group (p<.05). Obesity, acne, alopecia, acanthosis, stria, oligomenorrhea and hirsutism score were significantly higher in the PCOS group (p<.01). AMH, urocortin 2 and urocortin 3 levels showed no significant difference between the two groups (p>.05). There was no significant correlation between hirsutism score and AMH, urocortin 2 and urocortin 3 levels (p>.05). There was a significant positive correlation between AMH, urocortin 2 and urocortin 3, but no correlation was found between LH, FSH, free testosteron, total testosterone, SHBG levels and AMH, urocortin 2 and urocortin 3. Conclusion: This study did not find any relationship between urocortin 2, urocortin 3 and AMH levels and PCOS. Further studies are needed to search about this topic.

Anahtar Kelimeler

Polikistik Over Sendromu, adölesan, ürokortin 2, ürokortin 3, Antimüllerian Hormone

Kaynakça

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