The Role Of Plasma Interleukin-18 Levels And Carotid Intima-Media Thickness Measurement In Patients With Polycstic Ovary Syndrome to Predict the Risk For Development Of Cardiovascular Disease

Öz

Aim: In this study, we aimed to investigate the utility of plasma IL-18 levels and carotis intima media thickness for prediction of cardiovascular disease development in patients with polycystic ovary syndrome.Material and Methods: The study was conducted between September 2011 and May 2012 and included 44 women that applied to our department with complaints of irregular menstruation and hirsutism, who were diagnosed with polycystic ovary syndrome PCOS and met the inclusion criteria. A control group of 44 healthy volunteer women were included as controls. We compared these two groups in terms of plasma fasting glucose levels, lipid and hormone profiles, C- reactive protein CRP , insulin, homocysteine, interleukin-18 levels and of carotid artery intima-media thickness. P values less than 0.05 were considered statistically significant.Results: There were no statistically significant differences between the groups in terms of demographic features such as age, height, weight, body mass index, waist to hip circumference ratio p>0.05 . Plasma IL-18 levels were higher in the study group. In addition, carotid artery intima-media thickness measurements were significantly higher in the study group p0.05 .Conclusion: In this study, we demonstrated that both increased plasma IL-18 levels and increased carotid artery intima-media thickness measurements may be useful parameters for prediction of cardiovascular disease development in patients with PCOS. If future studies with larger sample sizes also report similar findings, we believe that these parameters could be routinely used to determine the cardiovascular risk in these patients.

Anahtar Kelimeler

• PCOS,interleukin-18,carotid artery intima-media thickness

Polikistik Over Sendromlu Hastalarda Plazma İnterlökin-18 Düzeyi ve Karotis İntima- Media Kalınlığı Ölçümünün Kardiyovasküler Hastalık Gelişim Riskini Öngörmedeki Rolü

Öz

Amaç: Bu çalışmadaki amacımız; polikistik over sendromlu PKOS olgularda plazma interlökin-18 düzeyi ve karotisintima-media kalınlığının İMK , kardiyovasküler hastalık gelişimini öngörmedeki yerinin belirlenmesini araştırmaktır.Gereç ve Yöntemler: Bu çalışma Eylül 2011– Mayıs 2012 tarihleri arasında adet düzensizliği ve tüylenme şikayetleriyle başvuran hastalardan, çalışma kriterlerine uygun olduğu saptanan,44 PKOS tanısı alan hasta ve 44 sağlıklı gönüllü dahil edilerek yapılmıştır. Bu iki grupta da serum açlık kan şekeri, lipid ve hormon profili, C-Reaktif protein CRP , insülin, homosistein Hcy ve interlökin-18 düzeyleri ile karotis İMK ölçülerek karşılaştırılmıştır. %95 güven aralığında, p0.05 . Plazma interlökin-18 düzeyi çalışma grubunda daha yüksek seviyelerdeydi. Ayrıca karotis İMK’lığı çalışma grubunda artmış olarak bulundu ve bu farklar istatistiksel olarak anlamlıydı p0.05 .Sonuç: Çalışmamızda hem interlökin-18 plasma seviyelerinin hem de karotis İMK’lığı ölçümlerindeki artışın, PKOS’lu olgularda kardiyovasküler hastalık gelişimini öngörmede faydalı parametreler olabileceği saptanmıştır. Bu parametrelerin hastalarda riskin belirlenmesinde, daha fazla hastayla yapılacak çalışmalar neticesinde, rutin uygulamaya girebileceği görüşündeyiz.

Anahtar Kelimeler

• PKOS,interlökin-18,karotis intima-media kalınlığı

Kaynakça

1. Çelik C. Ovarian Volume in Turkish Women with Normal and Polycystic Ovaries. J Clin Anal Med. 2014 1;5:8–10.
2. Çakır E, Çakal E, Özbek M, Şahin M, Delibaşı T. Polycystic Ovary Sy- ndrome and the Relationship of Cardiovascular Disease Risk. Turkish J Endocrinol Metab. 2013;17:33–7.
3. Escobar-Morreale HF, Luque-Ramírez M, González F. Circulating inflam- matory markers in polycystic ovary syndrome: a systematic review and metaanalysis. Fertil Steril. 2011 1;95:1048–58, 1–2.
4. Blankenberg S, Luc G, Ducimetière P, Arveiler D, Ferrières J, Amouyel P, et al. Interleukin-18 and the risk of coronary heart disease in Europe- an men: the Prospective Epidemiological Study of Myocardial Infarction (PRIME). Circulation. 2003 18;108:2453–9.
5. Escobar-Morreale HF, Botella-Carretero JI, Villuendas G, Sancho J, San Millán JL. Serum interleukin-18 concentrations are increased in the poly- cystic ovary syndrome: relationship to insulin resistance and to obesity. J Clin Endocrinol Metab. 2004;89:806–11.
6. De la Calle M, Gallardo T, Diestro MD, Hernanz A, Pérez E, Fernández-Mi- randa C. [Increased homocysteine levels in polycystic ovary syndrome]. Med Clin (Barc). 2007 8;129:292–4.
7. Yilmaz N, Pektas M, Tonguc E, Kilic S, Gulerman C, Gungor T, et al. The correlation of plasma homocysteine with insulin resistance in polycystic ovary syndrome. J Obstet Gynaecol Res. 2008;34:384–91.
8. Kilic-Okman T, Guldiken S, Kucuk M. Relationship between homocys- teine and insulin resistance in women with polycystic ovary syndrome. Endocr J. 2004 ;51:505–8.

9. Revised 2003 consensus on diagnostic criteria and long-term health ris- ks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25.
10. FERRIMAN D, GALLWEY JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440–7.
11. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–9.
12. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thick- ness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986;74:1399–406.
13. Wofford JL, Kahl FR, Howard GR, McKinney WM, Toole JF, Crouse JR. Relation of extent of extracranial carotid artery atherosclerosis as mea- sured by B-mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb. 11:1786–94.
14. Kaya C, Pabuccu R, Berker B, Satiroglu H. Plasma interleukin-18 levels are increased in the polycystic ovary syndrome: relationship of carotid intima-media wall thickness and cardiovascular risk factors. Fertil Steril. 2010 1;93:1200–7.
15. Zhang Y, Yang Y, Hong J, Gu W, Shen C, Xu M, et al. Elevated serum levels of interleukin-18 are associated with insulin resistance in women with polycystic ovary syndrome. Endocrine. 2006;29:419–23.
16. Luque-Ramírez M, Mendieta-Azcona C, Alvarez-Blasco F, Escobar-Mor- reale HF. Androgen excess is associated with the increased carotid inti- ma-media thickness observed in young women with polycystic ovary syndrome. Hum Reprod. 2007;22:3197–203.
17. Loverro G, Lorusso F, Mei L, Depalo R, Cormio G, Selvaggi L. The plasma homocysteine levels are increased in polycystic ovary syndrome. Gyne- col Obstet Invest. 2002;53:157–62.
18. Wu Y, Zhang J, Wen Y, Wang H, Zhang M, Cianflone K. Increased acy- lation-stimulating protein, C-reactive protein, and lipid levels in young women with polycystic ovary syndrome. Fertil Steril. 2009;91:213–9.
19. Hu W, Qiao J, Yang Y, Wang L, Li R. Elevated C-reactive protein and monocyte chemoattractant protein-1 in patients with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2011;157:53–6.