Öz
Polikistik over sendromunun (PKOS) hangi fenotipinin daha yüksek metabolik riske sahip olduğu tartışmalıdır. Bu çalışma üçüncü basamak bir hastanede metabolik sendrom (MetS) insidansını ve farklı fenotipler için metabolik riski karşılaştırmayı amaçladı. Endokrinoloji ve Metabolizma Hastalıkları Kliniği'ne klinik hiperandrojenizm ve/veya düzensiz menstrüasyon şikayetleri ile başvuran ve Rotterdam kriterlerine göre tanı konulan PKOS olguları retrospektif olarak incelendi. Hastalar Rotterdam kriterlerine göre dört fenotipe ayrıldı ve gruplar MetS prevalansı ve metabolik risk açısından karşılaştırıldı. Toplam 100 hasta çalışmaya alındı. MetS prevalansı fenotip A'da %30.3, fenotip B'de %24.1, fenotip C'de %15.4 ve fenotip D'de %36 idi. Fenotip A'da obezite (BKİ> 30 kg/m2) ve HOMA-IR> 2.5 insidansı daha yüksek olmasına rağmen, gruplar arasındaki fark anlamlı değildi. Tüm hastalar obez ve obez olmayan hastalar olarak gruplandırıldığında, metabolik sendrom varlığı obez hastalarda anlamlı oranda fazla görüldü (p <0.001) ve LH/FSH oranı obez hastalarda anlamlı olarak yüksek bulundu (p=0.011). Sonuç olarak metabolik sendrom varlığı obez hastalarda ve LH/FSH oranı obezite varlığında anlamlı olarak yüksekti ancak dört fenotip arasında fark görülmedi.
Anahtar Kelimeler
Fenotip Metabolik sendrom Polikistik over sendromu Risk faktörü
Kaynakça
- Anagnostis, P, Tarlatzis, B. C. ve Kauffman, R. P. (2018). Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism, 86, 33–43.
- Barber, Thomas M., John, A. H. Wass, Mark I. McCarthy ve Stephen Franks. (2007). Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: Implications for the management of polycystic ovary syndrome. Clinical Endocrinology, 66 (4), 513–517. https://doi.org/10.1111/J.1365-2265.2007.02764.X.
- Blouin Karine, Mélanie Nadeau, Martin Perreault, Alain Veilleux, Renée Drolet, Picard Marceau, …André Tchernof. (2010). Effects of Androgens on adipocyte differentiation and adipose tissue explant metabolism in men and women. Clinical Endocrinology ,72 (2), 176–188. https://doi.org/10.1111/J.1365-2265.2009.03645.X.
- Dewailly Didier, Marla E Lujan, Enrico Carmina, Marcelle I Cedars, Joop Laven, Robert J Norman, …F Escobar-Morreale. (2014). Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society pcom in the general population pcom in particular situations polycystic ovaries as an ındicator of ıll health ıs there any evidence in healthy women that pcom confers risk of ıll health? Does PCOM in PCOS confer any extra health risk? Defining PCOM in 2013: Which guidelines? Guidelines for clinical practice guidelines for research conclusions. Human Reproduction Update, 20 (3), 334–352. https://doi.org/10.1093/humupd/dmt061.
- Diamanti-Kandarakis, E. ve Andrea D. (2012). Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications. Endoc Rev., 33 (6), 981–1030. https://doi.org/10.1210/er.2011-1034.
- Dumesic, Daniel A., Alin L. Akopians, Vanessa K. Madrigal, Emmanuel Ramirez, Daniel J. Margolis, Manoj K. Sarma, …Chazenbalk GD. (2016). Hyperandrogenism Accompanies increased intra-abdominal fat storage in normal weight polycystic ovary syndrome women. The Journal of Clinical Endocrinology & Metabolism, 101 (11), 4178–4188. https://doi.org/10.1210/JC.2016-2586.
- Echiburú Bárbara, Francisco Pérez-Bravo, José E. Galgani, Daniel Sandoval, Carolina Saldías, Nicolás Crisosto, …Teresa Sir-Petermann. (2018). Enlarged adipocytes in subcutaneous adipose tissue associated to hyperandrogenism and visceral adipose tissue volume in women with polycystic ovary syndrome. Steroids, 130 (February), 15–21. https://doi.org/10.1016/J.STEROIDS.2017.12.009.
- Fauser, Bart C.J.M., Tarlatzis, Fauser, Chang, Aziz, …Lobo (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction (Oxford, England), 19 (1), 41–47. https://doi.org/10.1093/HUMREP/DEH098.
- Hernández‐Mijares, A., Bañuls, C., Gómez‐Balaguer, M., Bergoglio, M., Víctor, V. M. ve Rocha, M. (2013). Influence of obesity on atherogenic dyslipidemia in women with polycystic ovary syndrome. European Journal of Clinical Investigation, 43 (6), 549–556. https://doi.org/10.1111/ECI.12080.
- Jena, D., Choudhury, A. K., Mangaraj, S., Singh, M., Mohanty, B. K. ve Baliar_sinha, A. K. (2018). Study of Visceral and subcutaneous abdominal fat thick_ness and its correlation with cardiometabolic risk factors and hormonal parameters in polycystic ovary syndrome. Indian J Endo_crinol Metab., 22 (3), 321–327. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063187/pdf/IJEM-22-321.pdf.
- Krentowska, A. ve Kowalska, I.. (2022). Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome. Diabetes/Metabolism Research and Reviews, 38 (1). https://doi.org/10.1002/DMRR.3464.
- Lookingbill, D. P., Egan, N., Santen, R. J. ve Demers, L. M. (1988). Correlation of serum 3α-androstanediol glucuronide with acne and chest hair density in men. The Journal of Clinical Endocrinology & Metabolism, 67 (5), 986–991. https://doi.org/10.1210/JCEM-67-5-986.
- Ludwig, E. (1977). Classification of the Types of androgenetic alopecia (common baldness) occurring in the female sex. British Journal of Dermatology, 97 (3), 247–54. https://doi.org/10.1111/J.1365-2133.1977.TB15179.X.
- Phelan, N., A. O’Connor, T. Kyaw-Tun, N. Correia, G. Boran, H. M. Roche ve James Gibney. (2010). Lipoprotein subclass patterns in women with polycystic ovary syndrome (PCOS) compared with equally ınsulin-resistant women without PCOS. The Journal of Clinical Endocrinology & Metabolism, 95 (8), 3933–39. https://doi.org/10.1210/JC.2009-2444.
- Rosenfield, Robert L. ve David A. Ehrmann. (2016). The pathogenesis of polycystic ovary syndrome (pcos): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev., 37 (5), 467–520. https://doi.org/10.1210/er.2015-1104.
- Stepto Nigel, K., Samantha Cassar, Anju E. Joham, Samantha K. Hutchison, Cheryce L. Harrison, Rebecca F. Goldstein ve Helena J. Teede. (2013). Women with polycystic ovary syndrome have ıntrinsic ınsulin resistance on euglycaemic–hyperinsulaemic clamp. Human Reproduction, 28 (3), 777–784. https://doi.org/10.1093/HUMREP/DES463.
- Teede Helena J, Marie L Misso, Michael F Costello, Anuja Dokras, Joop Laven, Lisa Moran, …Robert J Norman. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33 (9), 1602–1618. https://doi.org/10.1093/humrep/dey256.
- Wang, J, D., Wu, H. Guo ve Li, M. (2019). Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sci, 236, 116940.
- Zawadzki, J. K. (1992). Diagnostic Criteria for polycystic ovary syndrome (a Rational Approach). Polycystic Ovary Syndrome, 377–384. https://ci.nii.ac.jp/naid/10025339338/.
- Zeng X, Xie Y-J, Liu Y-T, Long S-L ve Mo Z‐C. (2020). Polycystic ovarian syndrome: Correlation between hyperandrogenism, ınsulin resistance and obesity. Clinica Chimica Acta | 10.1016/j.Cca.2019.11.003.” Clin Chim Acta, 502, 214–221.
Öz
Which phenotype of polycystic ovary syndrome (PCOS) has a greater metabolic risk is controversial. This study aimed to compare the incidence of metabolic syndrome (MetS) and metabolic risk for different phenotypes in a tertiary hospital. Women who applied to the Endocrinology and Metabolic Diseases Clinic with complaints of clinical hyperandrogenism and/or irregular menstruation and were diagnosed as PCOS according to the Rotterdam criteria were retrospectively analyzed. Patients were classified into four phenotypes according to the Rotterdam criteria, and the groups were compared in terms of MetS prevalence and metabolic risk. A total of one hundred patients were included in the study. Prevalence of MetS was 30.3% in phenotype A, 24.1% in phenotype B, 15.4% in phenotype C, and 36% in phenotype D. Although the incidence of obesity (BMI> 30 kg/m2) and HOMA-IR> 2.5 were higher in phenotype A, differences were not statistically significant. In the overall collective the presence of metabolic syndrome was significantly higher in obese patients (p <0.001), and LH/FSH ratio was found to be significantly higher in the presence of obesity (p=0.011). In summary, the presence of metabolic syndrome was significantly higher in obese patients and the LH/FSH ratio was significantly higher in the presence of obesity, but no difference was found between the four phenotypes.
Anahtar Kelimeler
Metabolic syndrome Phenotype Polycystic ovary syndrome Risk factor
Kaynakça
- Anagnostis, P, Tarlatzis, B. C. ve Kauffman, R. P. (2018). Polycystic ovarian syndrome (PCOS): Long-term metabolic consequences. Metabolism, 86, 33–43.
- Barber, Thomas M., John, A. H. Wass, Mark I. McCarthy ve Stephen Franks. (2007). Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: Implications for the management of polycystic ovary syndrome. Clinical Endocrinology, 66 (4), 513–517. https://doi.org/10.1111/J.1365-2265.2007.02764.X.
- Blouin Karine, Mélanie Nadeau, Martin Perreault, Alain Veilleux, Renée Drolet, Picard Marceau, …André Tchernof. (2010). Effects of Androgens on adipocyte differentiation and adipose tissue explant metabolism in men and women. Clinical Endocrinology ,72 (2), 176–188. https://doi.org/10.1111/J.1365-2265.2009.03645.X.
- Dewailly Didier, Marla E Lujan, Enrico Carmina, Marcelle I Cedars, Joop Laven, Robert J Norman, …F Escobar-Morreale. (2014). Definition and significance of polycystic ovarian morphology: a task force report from the androgen excess and polycystic ovary syndrome society pcom in the general population pcom in particular situations polycystic ovaries as an ındicator of ıll health ıs there any evidence in healthy women that pcom confers risk of ıll health? Does PCOM in PCOS confer any extra health risk? Defining PCOM in 2013: Which guidelines? Guidelines for clinical practice guidelines for research conclusions. Human Reproduction Update, 20 (3), 334–352. https://doi.org/10.1093/humupd/dmt061.
- Diamanti-Kandarakis, E. ve Andrea D. (2012). Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications. Endoc Rev., 33 (6), 981–1030. https://doi.org/10.1210/er.2011-1034.
- Dumesic, Daniel A., Alin L. Akopians, Vanessa K. Madrigal, Emmanuel Ramirez, Daniel J. Margolis, Manoj K. Sarma, …Chazenbalk GD. (2016). Hyperandrogenism Accompanies increased intra-abdominal fat storage in normal weight polycystic ovary syndrome women. The Journal of Clinical Endocrinology & Metabolism, 101 (11), 4178–4188. https://doi.org/10.1210/JC.2016-2586.
- Echiburú Bárbara, Francisco Pérez-Bravo, José E. Galgani, Daniel Sandoval, Carolina Saldías, Nicolás Crisosto, …Teresa Sir-Petermann. (2018). Enlarged adipocytes in subcutaneous adipose tissue associated to hyperandrogenism and visceral adipose tissue volume in women with polycystic ovary syndrome. Steroids, 130 (February), 15–21. https://doi.org/10.1016/J.STEROIDS.2017.12.009.
- Fauser, Bart C.J.M., Tarlatzis, Fauser, Chang, Aziz, …Lobo (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction (Oxford, England), 19 (1), 41–47. https://doi.org/10.1093/HUMREP/DEH098.
- Hernández‐Mijares, A., Bañuls, C., Gómez‐Balaguer, M., Bergoglio, M., Víctor, V. M. ve Rocha, M. (2013). Influence of obesity on atherogenic dyslipidemia in women with polycystic ovary syndrome. European Journal of Clinical Investigation, 43 (6), 549–556. https://doi.org/10.1111/ECI.12080.
- Jena, D., Choudhury, A. K., Mangaraj, S., Singh, M., Mohanty, B. K. ve Baliar_sinha, A. K. (2018). Study of Visceral and subcutaneous abdominal fat thick_ness and its correlation with cardiometabolic risk factors and hormonal parameters in polycystic ovary syndrome. Indian J Endo_crinol Metab., 22 (3), 321–327. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6063187/pdf/IJEM-22-321.pdf.
- Krentowska, A. ve Kowalska, I.. (2022). Metabolic syndrome and its components in different phenotypes of polycystic ovary syndrome. Diabetes/Metabolism Research and Reviews, 38 (1). https://doi.org/10.1002/DMRR.3464.
- Lookingbill, D. P., Egan, N., Santen, R. J. ve Demers, L. M. (1988). Correlation of serum 3α-androstanediol glucuronide with acne and chest hair density in men. The Journal of Clinical Endocrinology & Metabolism, 67 (5), 986–991. https://doi.org/10.1210/JCEM-67-5-986.
- Ludwig, E. (1977). Classification of the Types of androgenetic alopecia (common baldness) occurring in the female sex. British Journal of Dermatology, 97 (3), 247–54. https://doi.org/10.1111/J.1365-2133.1977.TB15179.X.
- Phelan, N., A. O’Connor, T. Kyaw-Tun, N. Correia, G. Boran, H. M. Roche ve James Gibney. (2010). Lipoprotein subclass patterns in women with polycystic ovary syndrome (PCOS) compared with equally ınsulin-resistant women without PCOS. The Journal of Clinical Endocrinology & Metabolism, 95 (8), 3933–39. https://doi.org/10.1210/JC.2009-2444.
- Rosenfield, Robert L. ve David A. Ehrmann. (2016). The pathogenesis of polycystic ovary syndrome (pcos): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev., 37 (5), 467–520. https://doi.org/10.1210/er.2015-1104.
- Stepto Nigel, K., Samantha Cassar, Anju E. Joham, Samantha K. Hutchison, Cheryce L. Harrison, Rebecca F. Goldstein ve Helena J. Teede. (2013). Women with polycystic ovary syndrome have ıntrinsic ınsulin resistance on euglycaemic–hyperinsulaemic clamp. Human Reproduction, 28 (3), 777–784. https://doi.org/10.1093/HUMREP/DES463.
- Teede Helena J, Marie L Misso, Michael F Costello, Anuja Dokras, Joop Laven, Lisa Moran, …Robert J Norman. (2018). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human Reproduction, 33 (9), 1602–1618. https://doi.org/10.1093/humrep/dey256.
- Wang, J, D., Wu, H. Guo ve Li, M. (2019). Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sci, 236, 116940.
- Zawadzki, J. K. (1992). Diagnostic Criteria for polycystic ovary syndrome (a Rational Approach). Polycystic Ovary Syndrome, 377–384. https://ci.nii.ac.jp/naid/10025339338/.
- Zeng X, Xie Y-J, Liu Y-T, Long S-L ve Mo Z‐C. (2020). Polycystic ovarian syndrome: Correlation between hyperandrogenism, ınsulin resistance and obesity. Clinica Chimica Acta | 10.1016/j.Cca.2019.11.003.” Clin Chim Acta, 502, 214–221.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 17 Mart 2023 |
| Gönderilme Tarihi | 6 Aralık 2022 |
| Kabul Tarihi | 19 Ocak 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 11 Sayı: 1 |
