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KARDİYOVASKÜLER SİSTEM HASTALIKLARINDA RİSK FAKTÖRÜ OLAN HİPERHOMOSİSTEİNEMİ’NİN POLİKİSTİK OVER SENDROMUNDAKİ YERİ

Yıl 2021, Cilt: 18 Sayı: 1, 684 - 690, 01.04.2021
https://doi.org/10.38136/jgon.787451

Öz

Amaç: Polikistik Over Sendromu (PKOS) olan hastalar, hiperhomosisteinemiye bağlı kardiyovasküler sistem ile ilişkili hastalıklar için uzun vadede risk grubundadır. Çalışmamız, hiperhomosisteineminin PKOS tanılı hastalarda önemi ve kardiyovasküler hastalıkların ön tanısında kullanılabilecek bir belirteç olup olmadığını araştırmayı amaçlamaktadır. Bu çalışmada, PKOS tanısı almış hastalar ile sağlıklı bireyler arasında serum homosistein düzeyleri karşılaştırılmıştır.
Materyal ve Metod: Çalışmamız hastanemizin polikliniğine başvuran 20-49 yaş arası Rotterdam kriterlerine göre PKOS tanısı almış 24 hasta ve kontrol grubu olarak 26 sağlıklı gönüllü kadın ile yapılmış prospektif kesitsel bir çalışmadır. Çalışmaya dahil edilen tüm katılımcıların antropometrik ölçümleri kaydedildi. Çalışmaya katılan bireylerin kan örnekleri 12 saatlik açlığı takiben adetin 2. veya 3. gününde -80 derecede santrifüj edilerek serum homosistein düzeyleri ELISA (Enzyme-Linked ImmunoSorbent Assay) ile ölçüldü. Katılımcıların serum homosistein düzeyleri 30 μmol / L'nin altında ve 30 μmol / L'nin üzerinde olmak üzere iki gruba ayrıldı. Serum homosistein düzeylerine bakılmaksızın katılımcılar vücut kitle indeksi (VKİ) 25 kg (kilogram) / m2 (metrekare) üstü ve altı, bel çevresi 80 cm (santimetre) üstü ve altı olmak üzere gruplara ayrıldı. Oluşturulan yeni grupların serum homosistein seviyeleri karşılaştırıldı.
Bulgular: PKOS'lu kadınların serum homosistein düzeyleri, PKOS olmayan kadınlara göre daha yüksek bulundu (p = 0,001). PKOS hastaları, kontrol grubuna göre anlamlı derecede daha gençti (p = 0,017). VKİ, bel çevresi ve serum homosistein düzeyleri arasında istatistiksel olarak anlamlı bir fark bulunmadı (p> 0.5).
Sonuç: VKİ ve bel çevresi ne olursa olsun, fenotip A PKOS'lu gençlerde rutin serum homosistein düzeylerinin taranması ve hiperhomosisteinemili hastaların tedavi edilmesi, uzun vadede gelişebilecek kardiyovasküler sistem ilişki hastalıklarının öngörülmesinde ve önlenmesinde faydalı olabilir.

Destekleyen Kurum

University of Health Sciences Scientific Research Projects Coordinator

Proje Numarası

2019/086

Kaynakça

  • REFERENCES: 1. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and sterility 2009; 91(2):456-88.
  • 2. Aktaran Ş, Akarsu E, Çelik A, Altunören O. Polikistik over sendromunda obeziteden bağımsız olarak artmış plazma homosistein düzeylerinin insülin rezistansı ile korelasyonu. Turkiye Klinikleri Journal of Medical Sciences 2007; 27(4):508-12.
  • 3. ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and sterility 2004; 81(1):19-25.
  • 4. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction 2018; 33(9):1602-18.
  • 5. Sahmay S, Atakul N, Oncul M, Tuten A, Aydogan B, Seyisoglu H. Serum anti-Mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology 2013; 170(1):157-61.
  • 6. Mehrabian F, Khani B, Kelishadi R, Kermani N. The prevalence of metabolic syndrome and insulin resistance according to the phenotypic subgroups of polycystic ovary syndrome in a representative sample of Iranian females. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2011 ; 16(6):763.
  • 7. Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Human reproduction update 2009; 15(4):477-88.
  • 8. Sucu M, Karadere A, Toprak N. Homosistein ve kardiyovasküler hastalıkları. Türk Kardiyol Dern Arş 2001; 29(3):181-90.
  • 9. Zhao L, Zhu Z, Lou H, Zhu G, Huang W, Zhang S, et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget 2016; 7(23):33715.
  • 10. Ueland PM, Refsum H, Stabler SP, Malinow MR, Andersson A, Allen RH. Total homocysteine in plasma or serum: methods and clinical applications. Clinical chemistry 1993; 39(9):1764-79.
  • 11. Kang S-S, Wong PW, Malinow MR. Hyperhomocysteinemia as a risk factor for occlusive vascular disease. Annual review of nutrition 1992; 12(1):279-98.
  • 12. Anagnostis P, Tarlatzis BC, Kauffman RP. Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism 2018; 86:33-43.
  • 13. Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. Bmj 2002;325(7374):1202.
  • 14. Collaboration HS. Homocysteine and risk of ischemic heart disease and stroke. Jama 2002;288(16):2015-22.
  • 15. Naruszewicz M, Mirkiewicz E, Olszewski AJ, McCully KS. Thiolation of low-density lipoprotein by homocysteine thiolactone causes increased aggregation and altered interaction with cultured macrophages. Nutrition Metabolism and Cardiovascular Diseases 1994;4: 70-75.
  • 16. Eskandari Z, Sadrkhanlou R-A, Nejati V, Tizro G. PCOS women show significantly higher homocysteine level, independent to glucose and E2 level. International Journal of Reproductive BioMedicine 2016;14(8):495.
  • 17. Dunaif A, Book CB. Insulin resistance in the polycystic ovary syndrome. Clinical research in diabetes and obesity: Springer1997. p. 249-74.
  • 18. Wild RA, Painter P, Coulson PB, Csrruth KB, Ranney G. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 1985;61(5):946-51.
  • 19. Diwaker A, Kishore D. Evaluation of Plasma Homocysteine Levels in Patients of PCOS. Journal of The Association of Physicians of Indi 2018; 66:17.
  • 20. Maleedhu P, Vijayabhaskar M, Sharma S, Kodumuri PK. Status of homocysteine in polycystic ovary syndrome (PCOS). Journal of clinical and diagnostic research: JCDR 2014;8(2):31.
  • 21. Dikmen M. Metilentetrahidrofolat redüktaz (MTHFR) enziminin moleküler biyolojisi ve hastalıklarla ilişkisi. Kocatepe Tıp Dergisi 2004;5(2).
  • 22. Keşkek Udşö, Kırım Uds, Çapar Udh, Saler T. Metabolik Sendromlu Hastalarda Hiperhomosisteinemi Sıklığı.İç Hastalıkları dergisi 2013; 20:129-134.
  • 23. Berg K, Malinow MR, Kiarulf P, Upson B. Population variation and genetics of plasma homocyst (e) ine level. Clinical genetics 1992;41(6):315-21.
  • 24. Zhang G, Dai C. Gene polymorphisms of homocysteine metabolism-related enzymes in Chinese patients with occlusive coronary artery or cerebral vascular diseases. Thrombosis research 2001;104(3):187-95

IMPORTANT RISK FACTOR OF HYPERHOMOCYSTEINEMIA IN CARDIOVASCULAR SYSTEM DISEASES AND STATUS OF THE HOMOCYSTEINE LEVELS IN POLYCYSTIC OVARY SYNDROME

Yıl 2021, Cilt: 18 Sayı: 1, 684 - 690, 01.04.2021
https://doi.org/10.38136/jgon.787451

Öz

Aim: Patients with Polycystic Ovary Syndrome (PCOS) are in the risk group at long-term for Cardiovascular System (CVS) related diseases due to hyperhomocysteinemia. Our study aims to investigate whether hyperhomocysteinemia can be used to determine the value of PCOS and a marker that can be used in the preliminary diagnosis of cardiovascular diseases. This study compares serum homocysteine levels between patients diagnosed with PCOS and healthy individuals.
Material and Methods: Our study was a prospective cross-sectional study of 20-49 years old patients who applied to Reproductive Endocrinology Outpatient Clinics, 24 patients diagnosed with PCOS using Rotterdam criteria, and 26 healthy volunteer women as a control group. Anthropometric measurements of all participants included in the study were recorded. The blood samples of the individuals participating in the study were taken on the 2nd or 3rd day of menstruation following 12-hour fasting, centrifuged at -80 degrees, and serum homocysteine levels were measured by ELISA (Enzyme-Linked ImmunoSorbent Assay). Participants' serum homocysteine levels were divided into two groups as those below 30 μmol / L, and those above 30 μmol / L. Regardless of serum homocysteine levels, the participants were divided into groups that body mass index (BMIs) were higher, and lower than 25 kg (kilogram) / m2 (square meter), a waist circumference above, and below 80 cm (centimeter). Serum homocysteine levels of the created new groups were compared.
Results: Serum homocysteine levels of women with PCOS were found higher than women without PCOS (p = 0.001). PCOS patients were significantly younger than the control group (p=0.017). No statistically significant difference was found between BMI, waist circumference, and serum homocysteine levels (p > 0.5).
Conclusion: Regardless of the BMI, and waist circumference, screening routine serum homocysteine levels in young people with phenotype A PCOS, and treating patients with hyperhomocysteinemia may be useful in predicting, and preventing cardiovascular system relationship diseases that may develop in the long term.

Proje Numarası

2019/086

Kaynakça

  • REFERENCES: 1. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and sterility 2009; 91(2):456-88.
  • 2. Aktaran Ş, Akarsu E, Çelik A, Altunören O. Polikistik over sendromunda obeziteden bağımsız olarak artmış plazma homosistein düzeylerinin insülin rezistansı ile korelasyonu. Turkiye Klinikleri Journal of Medical Sciences 2007; 27(4):508-12.
  • 3. ESHRE TR, Group A-SPCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and sterility 2004; 81(1):19-25.
  • 4. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction 2018; 33(9):1602-18.
  • 5. Sahmay S, Atakul N, Oncul M, Tuten A, Aydogan B, Seyisoglu H. Serum anti-Mullerian hormone levels in the main phenotypes of polycystic ovary syndrome. European Journal of Obstetrics & Gynecology and Reproductive Biology 2013; 170(1):157-61.
  • 6. Mehrabian F, Khani B, Kelishadi R, Kermani N. The prevalence of metabolic syndrome and insulin resistance according to the phenotypic subgroups of polycystic ovary syndrome in a representative sample of Iranian females. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences 2011 ; 16(6):763.
  • 7. Moran L, Teede H. Metabolic features of the reproductive phenotypes of polycystic ovary syndrome. Human reproduction update 2009; 15(4):477-88.
  • 8. Sucu M, Karadere A, Toprak N. Homosistein ve kardiyovasküler hastalıkları. Türk Kardiyol Dern Arş 2001; 29(3):181-90.
  • 9. Zhao L, Zhu Z, Lou H, Zhu G, Huang W, Zhang S, et al. Polycystic ovary syndrome (PCOS) and the risk of coronary heart disease (CHD): a meta-analysis. Oncotarget 2016; 7(23):33715.
  • 10. Ueland PM, Refsum H, Stabler SP, Malinow MR, Andersson A, Allen RH. Total homocysteine in plasma or serum: methods and clinical applications. Clinical chemistry 1993; 39(9):1764-79.
  • 11. Kang S-S, Wong PW, Malinow MR. Hyperhomocysteinemia as a risk factor for occlusive vascular disease. Annual review of nutrition 1992; 12(1):279-98.
  • 12. Anagnostis P, Tarlatzis BC, Kauffman RP. Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism 2018; 86:33-43.
  • 13. Wald DS, Law M, Morris JK. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. Bmj 2002;325(7374):1202.
  • 14. Collaboration HS. Homocysteine and risk of ischemic heart disease and stroke. Jama 2002;288(16):2015-22.
  • 15. Naruszewicz M, Mirkiewicz E, Olszewski AJ, McCully KS. Thiolation of low-density lipoprotein by homocysteine thiolactone causes increased aggregation and altered interaction with cultured macrophages. Nutrition Metabolism and Cardiovascular Diseases 1994;4: 70-75.
  • 16. Eskandari Z, Sadrkhanlou R-A, Nejati V, Tizro G. PCOS women show significantly higher homocysteine level, independent to glucose and E2 level. International Journal of Reproductive BioMedicine 2016;14(8):495.
  • 17. Dunaif A, Book CB. Insulin resistance in the polycystic ovary syndrome. Clinical research in diabetes and obesity: Springer1997. p. 249-74.
  • 18. Wild RA, Painter P, Coulson PB, Csrruth KB, Ranney G. Lipoprotein lipid concentrations and cardiovascular risk in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 1985;61(5):946-51.
  • 19. Diwaker A, Kishore D. Evaluation of Plasma Homocysteine Levels in Patients of PCOS. Journal of The Association of Physicians of Indi 2018; 66:17.
  • 20. Maleedhu P, Vijayabhaskar M, Sharma S, Kodumuri PK. Status of homocysteine in polycystic ovary syndrome (PCOS). Journal of clinical and diagnostic research: JCDR 2014;8(2):31.
  • 21. Dikmen M. Metilentetrahidrofolat redüktaz (MTHFR) enziminin moleküler biyolojisi ve hastalıklarla ilişkisi. Kocatepe Tıp Dergisi 2004;5(2).
  • 22. Keşkek Udşö, Kırım Uds, Çapar Udh, Saler T. Metabolik Sendromlu Hastalarda Hiperhomosisteinemi Sıklığı.İç Hastalıkları dergisi 2013; 20:129-134.
  • 23. Berg K, Malinow MR, Kiarulf P, Upson B. Population variation and genetics of plasma homocyst (e) ine level. Clinical genetics 1992;41(6):315-21.
  • 24. Zhang G, Dai C. Gene polymorphisms of homocysteine metabolism-related enzymes in Chinese patients with occlusive coronary artery or cerebral vascular diseases. Thrombosis research 2001;104(3):187-95
Toplam 24 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kadın Hastalıkları ve Doğum
Bölüm Araştırma Makaleleri
Yazarlar

Burcu İmre Bu kişi benim 0000-0003-0875-5208

Duygu İmre Yetkin 0000-0002-4988-4738

Cavidan Gülerman 0000-0003-4960-991X

Proje Numarası 2019/086
Yayımlanma Tarihi 1 Nisan 2021
Gönderilme Tarihi 28 Ağustos 2020
Kabul Tarihi 10 Ocak 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 18 Sayı: 1

Kaynak Göster

Vancouver İmre B, İmre Yetkin D, Gülerman C. KARDİYOVASKÜLER SİSTEM HASTALIKLARINDA RİSK FAKTÖRÜ OLAN HİPERHOMOSİSTEİNEMİ’NİN POLİKİSTİK OVER SENDROMUNDAKİ YERİ. JGON. 2021;18(1):684-90.