Perimenopozal Polikistik Over Sendromlu Kadınlarda Monosit/HDL Oranının, Lipid Birikim Ürünleri, Karotis İntima Media Kalınlığı ve SCORE2 Kardiyovasküler Risk Hesaplama Sistemi Skoru ile Karşılaştırılması

Öz

ÖZ Amaç: Polikistik over sendromu (PCOS), reprodüktif çağdaki kadınların en sık görülen endokrin hastalığıdır ve ilerleyen yaşlarda kardiyovasküler hastalık riskinde artış ile ilişkilendirilmiş bir çok komorbiditeye yol açmaktadır. Bu çalışma, kardiyovasküler risk faktörleri ile daha önceden ilişkilendirilmiş belirteçlerle monosit/HDL oranı (MHR) arasındaki potansiyel ilişkiyi belirlemeyi amaçlamaktadır. Gereç ve Yöntem: Kesitsel olarak tasarlanan bu çalışma, 40 tane menopozal geçiş dönemindeki PCOS tanısı almış hasta ile yaş ve beden kitle indeksi (BMI) açısından eşleşmiş 40 PCOS olmayan hasta üzerinde yürütülmüştür. Demografik ve antropometrik ölçümler, lipid profilleri, karotis intima-media kalınlığı (CIMT), serbest androjen indeksi (FAI), lipid birikim ürünleri (LAP) indeksi, homeostasis model assessment-insulin resistance (HOMA-IR), MHR ve SCORE2 risk skorları iki grup arasında karşılaştırılmıştır. Bulgular: Yapılan istatistik analizde; yaş, BMI, sigara içiciliği, lipid profilleri, açlık glukozu ve insülin seviyeleri, MHR, LAP indeksi, HOMA-IR değerleri ve SCORE2 skorları açısından anlamlı fark bulunamamıştır. Ancak, seks hormon bağlayıcı globulin ve total testosteron seviyeleri PCOS grubunda istatistiki anlamlı yüksek bulunmuştur (p<0,001). Metabolik sendrom oranları, FAI ve CIMT ölçümleri PCOS grubunda istatistiki anlamlı olacak şekilde yüksek bulunmuştur (sırasıyla p= 0,045; 0,003; 0,022). MHR; LAP indeksi, HOMA-IR, FAI değerleri ve CIMT ölçümleri ile pozitif korele bulunmuştur (sırasıyla r= 0,235; 0,297; 0,28; 0,215). Sonuç: PCOS hastası kadınlar, BMI açısından eşleştirilmiş PCOS olmayan yaşıtlarına göre artmış metabolik sendrom ve ortalama CIMT ölçümlerine sahiptir. Kardiyovasküler riskle ilişkisi daha önceden bilinen parametrelerle MHR arasındaki pozitif korelasyon değerleri, bu popülasyondaki kardiyovasküler risk faktörlerini değerlendirme konusunda dikkat çekmektedir ve perimenopozal PCOS hastalarında MHR’nin diğer kardiyovasküler risk prediktörlerine oranla çok daha ucuz bir prediktör olarak kullanılabilirliğini göstermektedir.

Anahtar Kelimeler

• polikistik over sendromu
• monosit/HDL oranı
• lipid birikim ürünleri indeksi
• HOMA-IR
• karotis intima-media kalınlığı

Carotis Intima-Media Thickness, Lipid Accumulation Product Index, Cardiovascular Risk Calculation Score and Their Relationship with Monocyte to HDL Ratio in Middle-Aged Women with Polycystic Ovary Syndrome

Öz

ABSTRACT Objectives: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women in the reproductive age and also associated with many comorbidities that increase the risk of cardiovascular disease in later ages. This study explores the potential correlation between the monocyte to HDL ratio (MHR) and established cardiovascular risk factors in women with PCOS. Material and method: This cross-sectional analysis includes PCOS-diagnosed women (n=40) in menopausal transition over 40 years old, and a control group of non-PCOS healthy women (n=40) matched for age and body-mass index (BMI). Various parameters, including demographic and anthropometric measurements, lipid profiles, carotis intima-media thickness (CIMT), free androgen index (FAI), lipid accumulation product (LAP) index, homeostasis model assessment-insulin resistance (HOMA-IR), MHR, and SCORE2 risk scores were compared between the groups. Results: Results indicate no significant differences in age, BMI, smoking, lipid profiles, fasting glucose, insulin levels, MHR, LAP index, HOMA-IR, and SCORE2 scores. However, sex-hormone binding globulin and total testosterone were higher in the PCOS group (p<0.001). Metabolic syndrome rates, FAI, and average CIMT were notably higher in the PCOS group (p=0.045, p=0.003, p=0.022). MHR was positively correlated with LAP index, HOMA-IR, FAI, and left CIMT (r=0.235; r=0.297; r=0.28; r=0.215; respectively). Conclusion: In conclusion, PCOS women exhibit higher metabolic syndrome rates and average CIMT measurements compared to healthy age and BMI matched counterparts. Positive correlations of the MHR with various risk factors emphasize the importance of assessing cardiovascular risk in this population and shows that MHR can be used as a much cheaper predictor of cardiovascular risk compared to other predictors in perimenopausal PCOS patients.

Anahtar Kelimeler

• polycystic ovary syndrome
• monocyte to hdl ratio
• lipid accumulation product index
• homa-ir
• carotid intima-media thickness

Kaynakça

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