OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU

Hasan Süt; Cem Terece; Sevcan Arzu Arinkan; Murat Muhcu

doi:10.16948/zktipb.468810

Araştırma Makalesi

OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU

Yıl 2019, , 1 - 4, 15.06.2019

Hasan Süt Cem Terece , Sevcan Arzu Arinkan , Murat Muhcu

https://doi.org/10.16948/zktipb.468810

Öz

Amaç: Obez olan ve olmayan polikistik over sendromlu
(PKOS) kadınlarda insulin rezistansı ve insulin rezistansının hormonel
parametrelerle korelasyonunu araştırmayı amaçladık.

Materyal Metod: Polikliniğe başvuran, 21 ile 40 yaşları arasında klinik ve endokrinolojik özelliklerine
dayanılarak PKOS tanısı konulan ve çalışma şartlarını sağlayan 78 hasta çalışmaya
dahil edildi. PKOS tanısı Rotterdam yeniden gözden geçirilmiş tanı
kriterlerine göre konuldu. Hastalar, obez olanlar (Vücut Kitle İndeksi 25 üzerinde
olanlar) ve Obez olmayanlar (Vücut Kitle İndeksi 25 altında olanlar) olarak iki
grupta incelendi

Bulgular: Obez olan grupta bakılan QUİCKİ ve
Açlık glukoz / Açlık insulin düzeyleri anlamlı düsük, HOMA-İR anlamlı olarak yüksek
saptandı. Obez olan grupta LH düzeyi ve LH / FSH oranının HOMA-IR ve QUİCKİ ile
korele olduğu saptandı. Obez olmayan grupta LH / FSH oranının HOMA-IR ve QUİCKİ
ile korele olduğu ve yine obez olmayan grupta total testosteron düzeyinin
QUİCKİ ile korele olduğu saptandı. FSH düzeyinin insulin rezistansı ile korele
olmadığı görüldü.

Sonuç: PKOS lu tüm hastaların insülin
rezistansı açısından taranmasını önermekteyiz. Obez olan PKOS lu hastalarda LH
düzeyinin insulin rezistansını öngörmede önemli olabileceğini düşünmekteyiz.

Anahtar Kelimeler

Polikistik over sendromu, insulin direnci, FSH, LH, vucut kitle indeksi

Kaynakça

1. Orio Jr F, Palomba S, Cascella T, De Simone B, Di Biase S, Russo T, Labella D, Zullo F, Lombardi G, Colao A. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2004;89(9):4588-93.
2. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility: Lippincott Williams & Wilkins; 2005.
3. Ovesen P, Moller JE, Ingerslev HJ, Jørgensen JO, Mengel A, Schmitz O, Alberti KG, Moller N. Normal basal and insulin-stimulated fuel metabolism in lean women with the polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 1993;77(6):1636-40.
4. Kirschner MA, Samojlik E, Drejka M, Szmal E, Schneider G, Ertel N. Androgen-estrogen metabolism in women with upper body versus lower body obesity. The Journal of Clinical Endocrinology & Metabolism. 1990;70(2):473-9.
5. Adams J, Polson DW, Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J (Clin Res Ed). 1986;293(6543):355-9.
6. Kidson W. Polycystic ovary syndrome: a new direction in treatment. The Medical Journal of Australia. 1998;169(10):537-40.
7. Legro RS, Finegood D, Dunaif A. A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 1998;83(8):2694-8.
8. Hatun Ş. Cocukluk çağında obezite ve insülin rezistansı. Turkjem 2003;7(2):23-6.
9. Georgopoulos NA, Saltamavros AD, Vervita V, Karkoulias K, Adonakis G, Decavalas G, Kourounis G, Markou KB, Kyriazopoulou V. Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance. Fertility and sterility. 2009;92(1):250-5.
10. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes care. 1999;22(1):141-6.
11. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. The journal of clinical endocrinology & metabolism. 1999;84(1):165-9.
12. Peppard HR, Marfori J, Iuorno MJ, Nestler JE. Prevalence of polycystic ovary syndrome among premenopausal women with type 2 diabetes. Diabetes care. 2001;24(6):1050-2.
13. Gokcel A, Baltali M, Tarim E, Bagis T, Gumurdulu Y, Karakose H, Yalcin F, Akbaba M, Guvener N. Detection of insulin resistance in Turkish adults: a hospital‐based study. Diabetes, Obesity and Metabolism. 2003;5(2):126-30. 14. Stenchever MA, Macintyre MN, Jarvis JA, Hempel JM. Cytogenetic evaluation of 41 patients with Stein-Leventhal syndrome. Obstetrics & Gynecology. 1968;32 (6):794-801.
15. Şimşir C, Koçak M, Çalişkan E, Yalvaç S, Turan H, Haberal A. Polikistik Over Sendromu Olgularında Metformin Tedavisinin Hiperandrojenizm veİnsülin Rezistansına Etkisi. Turkiye Klinikleri Journal of Gynecology and Obstetrics. 2002;12(2):134-8.
16. Alkan N. Polikistik Over Sendromlu Kadınlarda Kan CRP, Homosistein Düzeyleri, Obezite ve insülin Rezitansı Arasındaki ilişkinin Araştırılması. Uzmanlık Tezi, Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi. 2006;2:5-45.
17. Hřebíček J, Janout V, Malinčíková J, Horáková D, Čížek L. Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. The Journal of Clinical Endocrinology & Metabolism. 2002 Jan 1;87(1):144-.
18. Bagis HT, Hacıvelioğlu S, Haydardedeoğlu B, Şimşek E, Çok T, Parlakgümüş A, Poçan G. Prevalance Of Insulın Resıstance, Impaired Glucose Tolerans Test And Diabetes Mellitus In Women With Polcystic Ovary Syndrome; Analysis Of 235 Patients.
19. Shoupe D, Lobo RA. The influence of androgens on insulin resistance. Fertility and sterility. 1984;41(3):385-8.
20. Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. The Journal of Clinical Endocrinology & Metabolism. 1980;50(1):113-6.

Yıl 2019, , 1 - 4, 15.06.2019

Hasan Süt Cem Terece , Sevcan Arzu Arinkan , Murat Muhcu

https://doi.org/10.16948/zktipb.468810

Öz

Aim: The aim of our study was to investigate the correlation
between insulin resistance and hormonal parameters of insulin resistance on the
non-obese and obese patients with polycystic ovary syndrome (PCOS).

Method: 78 women patient with age range 21 to 40 diagnosed with PCOS
based on the clinical and endocrine features were included to our study. PCOS was diagnosed according to the reviewed
Rotterdam criteria. PCOS patients were studied in two groups: Obese patients
(the patients that body mass indexes over 25) non-obese patients (the patients
that body mass indexes under 25)

Results: It has been detected,
fasting insulin, total testosterone and HbA1c levels were significantly higher
and also HDL level was significantly lower in the obese group. Besides, QUİCKİ
and fasting glucose / fasting insulin level have been detected significantly
low, HOMA-IR was significantly higher in the obese group. In the non-obese
group LH / FSH ratio is correlated with HOMA-IR and QUİCKİ and also total
testosterone levels are correlated with QUİCKİ. Besides, it has been noted that
the insulin resistance is not correlated with FSH level. PCOS patients Impaired
glucose tolerance and the prevalence of DM are 5 times greater than the general
population. PCOS is seen more frequently in type 2 DM patients.

Conclusion: We suggest insulin
resistance screening in all PCOS patients.
However, if this is not possible, at least all patients that VKI levels
over 25, should be screened. We think that, LH level in obese patients with
PCOS is important to predict the insulin resistance.

Kaynakça

1. Orio Jr F, Palomba S, Cascella T, De Simone B, Di Biase S, Russo T, Labella D, Zullo F, Lombardi G, Colao A. Early impairment of endothelial structure and function in young normal-weight women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2004;89(9):4588-93.
2. Speroff L, Fritz MA. Clinical gynecologic endocrinology and infertility: Lippincott Williams & Wilkins; 2005.
3. Ovesen P, Moller JE, Ingerslev HJ, Jørgensen JO, Mengel A, Schmitz O, Alberti KG, Moller N. Normal basal and insulin-stimulated fuel metabolism in lean women with the polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 1993;77(6):1636-40.
4. Kirschner MA, Samojlik E, Drejka M, Szmal E, Schneider G, Ertel N. Androgen-estrogen metabolism in women with upper body versus lower body obesity. The Journal of Clinical Endocrinology & Metabolism. 1990;70(2):473-9.
5. Adams J, Polson DW, Franks S. Prevalence of polycystic ovaries in women with anovulation and idiopathic hirsutism. Br Med J (Clin Res Ed). 1986;293(6543):355-9.
6. Kidson W. Polycystic ovary syndrome: a new direction in treatment. The Medical Journal of Australia. 1998;169(10):537-40.
7. Legro RS, Finegood D, Dunaif A. A fasting glucose to insulin ratio is a useful measure of insulin sensitivity in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 1998;83(8):2694-8.
8. Hatun Ş. Cocukluk çağında obezite ve insülin rezistansı. Turkjem 2003;7(2):23-6.
9. Georgopoulos NA, Saltamavros AD, Vervita V, Karkoulias K, Adonakis G, Decavalas G, Kourounis G, Markou KB, Kyriazopoulou V. Basal metabolic rate is decreased in women with polycystic ovary syndrome and biochemical hyperandrogenemia and is associated with insulin resistance. Fertility and sterility. 2009;92(1):250-5.
10. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes care. 1999;22(1):141-6.
11. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. The journal of clinical endocrinology & metabolism. 1999;84(1):165-9.
12. Peppard HR, Marfori J, Iuorno MJ, Nestler JE. Prevalence of polycystic ovary syndrome among premenopausal women with type 2 diabetes. Diabetes care. 2001;24(6):1050-2.
13. Gokcel A, Baltali M, Tarim E, Bagis T, Gumurdulu Y, Karakose H, Yalcin F, Akbaba M, Guvener N. Detection of insulin resistance in Turkish adults: a hospital‐based study. Diabetes, Obesity and Metabolism. 2003;5(2):126-30. 14. Stenchever MA, Macintyre MN, Jarvis JA, Hempel JM. Cytogenetic evaluation of 41 patients with Stein-Leventhal syndrome. Obstetrics & Gynecology. 1968;32 (6):794-801.
15. Şimşir C, Koçak M, Çalişkan E, Yalvaç S, Turan H, Haberal A. Polikistik Over Sendromu Olgularında Metformin Tedavisinin Hiperandrojenizm veİnsülin Rezistansına Etkisi. Turkiye Klinikleri Journal of Gynecology and Obstetrics. 2002;12(2):134-8.
16. Alkan N. Polikistik Over Sendromlu Kadınlarda Kan CRP, Homosistein Düzeyleri, Obezite ve insülin Rezitansı Arasındaki ilişkinin Araştırılması. Uzmanlık Tezi, Dr. Lütfi Kırdar Kartal Eğitim ve Araştırma Hastanesi. 2006;2:5-45.
17. Hřebíček J, Janout V, Malinčíková J, Horáková D, Čížek L. Detection of insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. The Journal of Clinical Endocrinology & Metabolism. 2002 Jan 1;87(1):144-.
18. Bagis HT, Hacıvelioğlu S, Haydardedeoğlu B, Şimşek E, Çok T, Parlakgümüş A, Poçan G. Prevalance Of Insulın Resıstance, Impaired Glucose Tolerans Test And Diabetes Mellitus In Women With Polcystic Ovary Syndrome; Analysis Of 235 Patients.
19. Shoupe D, Lobo RA. The influence of androgens on insulin resistance. Fertility and sterility. 1984;41(3):385-8.
20. Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. The Journal of Clinical Endocrinology & Metabolism. 1980;50(1):113-6.

Toplam 19 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Bölüm	Orjinal Araştırma
Yazarlar	Hasan Süt Bu kişi benim Cem Terece Sevcan Arzu Arinkan Murat Muhcu Bu kişi benim
Yayımlanma Tarihi	15 Haziran 2019
Yayımlandığı Sayı	Yıl 2019

Kaynak Göster

APA	Süt, H., Terece, C., Arinkan, S. A., Muhcu, M. (2019). OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU. Zeynep Kamil Tıp Bülteni, 50(2), 1-4. https://doi.org/10.16948/zktipb.468810
AMA	Süt H, Terece C, Arinkan SA, Muhcu M. OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU. Zeynep Kamil Tıp Bülteni. Haziran 2019;50(2):1-4. doi:10.16948/zktipb.468810
Chicago	Süt, Hasan, Cem Terece, Sevcan Arzu Arinkan, ve Murat Muhcu. “OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU”. Zeynep Kamil Tıp Bülteni 50, sy. 2 (Haziran 2019): 1-4. https://doi.org/10.16948/zktipb.468810.
EndNote	Süt H, Terece C, Arinkan SA, Muhcu M (01 Haziran 2019) OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU. Zeynep Kamil Tıp Bülteni 50 2 1–4.
IEEE	H. Süt, C. Terece, S. A. Arinkan, ve M. Muhcu, “OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU”, Zeynep Kamil Tıp Bülteni, c. 50, sy. 2, ss. 1–4, 2019, doi: 10.16948/zktipb.468810.
ISNAD	Süt, Hasan vd. “OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU”. Zeynep Kamil Tıp Bülteni 50/2 (Haziran 2019), 1-4. https://doi.org/10.16948/zktipb.468810.
JAMA	Süt H, Terece C, Arinkan SA, Muhcu M. OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU. Zeynep Kamil Tıp Bülteni. 2019;50:1–4.
MLA	Süt, Hasan vd. “OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU”. Zeynep Kamil Tıp Bülteni, c. 50, sy. 2, 2019, ss. 1-4, doi:10.16948/zktipb.468810.
Vancouver	Süt H, Terece C, Arinkan SA, Muhcu M. OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU. Zeynep Kamil Tıp Bülteni. 2019;50(2):1-4.

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