Eda Ülkü ULUDAĞ, İlay GÖZÜKARA, Suna KUCUR KABİL, Havva KESKİN, Halime KILIÇ, Zeynep KAMALAK, Ayşe KARGILI, Şenay DURMAZ ARIKAN

Polikistik over sendromunda kardiyovasküler hastalık risk faktörü olarak C-reaktif protein düzeyi ve obezite

Amaç: Bu çalışmada PKOS lu hastalarda kardiyovaskü- ler hastalık risk faktörü olarak obesite ve C-reaktif protein (CRP) seviyesinin artışını değerlendirmeyi amaçladık. Yöntemler: Çalışmamıza 109 PKOSlu ve kontrol grubu olarak benzer yaş grubundan 30 sağlıklı düzenli menstrüel siklusu olan Vücut Kitle İndeksi (VKI) 18,5-25 kg/m2 arası kadın hasta dahil edildi. PKOSlu 109 hasta VKIne göre 3 alt gruba ayrıldı. VKI 30 de olan 33 hasta çalışmada yer aldı. Hastaların 12 saat açlık sonrası sabah kan glikoz, insülin, ürik asit ve CRP düzeyleri bakıldı. HOMA-IR (Homeostatic model assesment-insulin resistance) indeksi hesaplandı. Bulgular: Açlık kan şekeri, insülin ve HOMA-IR değerleri PKOS grubunda anlamlı şekilde yüksek bulundu (p=0.02, p=0.01 ve p=0.02). VKI> 30 olanlarda CRP düzeyleri anlamlı olarak yüksek bulundu. CRP deki bu anlamlı yükseklik VKİ den bağımsız olarak saptandı (p30 olan PKOSlu grupta HOMA-IR indeksi ve insü- lin düzeyleri diğer gruplara göre daha yüksek bulundu. Kontrol grubu ile karşılaştırıldığında insulin yüksekliği sadece obez grupta istatistiksel olarak anlamlı bulundu (p=0,005). VKİ >30 olan PKOSlu grupta kontrol ve VKİ

C-reactive protein level and obesity as cardiovascular risk factors in polycystic ovary syndrome

Objective: To investigate the role of C-reactive protein (CRP) level elevation and obesity for the increased cardiovascular disease risk in polycystic ovary syndrome (PCOS). Methods: A hundred and nine patients with PCOS and 30 age matched healthy volunteers with regular menstrual cycle are involved in the study. PCOS group is further subdivided into three subgroups according to the body mass index (BMI). Subgroups included 54 with BMI<25, 22 with BMI 25-30, and 33 with BMI>30. Blood samples for glucose, insulin, uric acid, and CRP were collected in the morning after overnight fasting (12 hours). Homeostasis model assessment-insulin resistance (HOMA-IR) was calculated. Results: Fasting blood glucose, insulin, and HOMA-IR was significantly higher in PCOS group (p=0.02, p=0.01 and p=0.02). CRP level was higher in subgroup with BMI>30. High CRP level in PCOS was found to be independent from BMI (p<0.001). HOMA-IR and insulin level was higher in the subgroup with BMI>30. When compared with the control group high insulin level was the only to be statistically significant in obese PCOS patients (p=0.005). HOMA-IR was higher in PCOS subgroup with BMI>30 when compared with controls and the PCOS subgroup with BMI<25 (p<0.001, p= 0.003). Conclusion: Obesity, hyperinsulinemia, and high CRP levels are seemed to be related and potentiating each other in PCOS. Struggling with obesity is one of the most important issues for preventive medicine.

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