Mustafa HARI, Ramazan GEN, Mahmut Bakır KOYUNCU, Hüseyin DURUKAN, Mehmet Burak ÇİMEN

Adölesan Dönemde Polikistik Over Sendromu: Fiziksel, Metabolik ve Hormonal Özellikler

Amaç: Polikistik over sendromu (PKOS) tanısı için Rotterdam kriterleri kullanılmaktadır. Bununla birlikte, adolesanlarda adet düzensizlikleri ve sivilceler daha sık görüldüğünden teorik olarak Rotterdam kriterlerini kullanmak zordur. Bu çalışmanın amacı ergenlik çağındaki PKOS tanısı için Rotterdam kriterlerinin yeterli olup olmadığını incelemektir. Gereç ve Yöntemler: Çalışmaya 16 ve 18 yaş arası 30 hasta ve 30 sağlıklı birey dahil edildi. Çalışmaya dahil edilenlerin antropometrik ölçümleri, Ferriman Gallwey skoru (FGS), ultrasonografik over hacimleri, androjenler ve diğer hormon seviyeleri kaydedildi. Bulgular: Hasta grubunda insülin direncinin homeostatik model değerlendirmesi (HOMA-IR) ile bel çevresi/kalça çevresi oranı arasında istatistiksel olarak anlamlı pozitif bir korelasyon vardı (r=0,656; p<0,001). Hasta grubunun ortalama luteinizing hormone (LH) düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı derecede daha yüksek olarak bulundu (p=0,048). Hasta grubunda medyan FGS kontrol grubundan istatistiksel olarak anlamlı derecede daha yüksekti (p<0,001). Polikistik overi olan adolesan kızların serum total testosteron düzeyleri polikistik overi olmayanlara göre istatistiksel olarak anlamlı derecede daha yüksekti (p=0,001). Ultrasonografide polikistik over görünümü olanların ortanca FGS'si polikistik over görünümü olmayanlara göre istatistiksel olarak anlamlı derecede daha yüksek olarak bulundu (p=0,034). Sonuç: Rotterdam tanı kriterlerinden oligoanovulasyon, akne ve ultrasonografide polikistik over görünümü, PKOS olmayan sağlıklı adolesanlarda da görülebilir. Bu çalışmada PKOS tanısını en çok destekleyen bulgu, orta derecede hirsutizme eşlik eden polikistik over görünümü idi.

Anahtar Kelimeler:

Polikistik Over Sendromu, adölesan kızlar, serbest androjen indeksi, HOMA-IR

Polycystic Ovary Syndrome in Adolescent Period: Physical, Metabolic, and Hormonal Features

Aim: The Rotterdam criteria are used in the diagnosis of polycystic ovary syndrome (PCOS). However, since menstrual irregularities and acne are seen more frequently in adolescents, it is theoretically difficult to use the Rotterdam criteria. The aim of this study was to investigate whether the Rotterdam criteria are sufficient for the diagnosis of PCOS in adolescence. Material and Methods: Thirty patients and thirty healthy individuals between the ages of 16 and 18 years were included in the study. Anthropometric measurements, Ferriman Gallwey score (FGS), ultrasonographic ovarian volumes, androgens, and other hormone levels of the participants were recorded. Results: There was a statistically significant positive correlation between the homeostatic model assessment of insulin resistance (HOMA-IR) and waist circumference/hip circumference ratio in the patient group (r=0.656, p<0.001). The mean luteinizing hormone (LH) levels of the patient group were found to be statistically significantly higher than the control group (p=0.048). The median FGS of the patient group was statistically significantly higher than the control group (p<0.001). Serum total testosterone levels of adolescent girls who have polycystic ovaries were statistically significantly higher than the ones who have not (p=0.001). The median FGS of those with polycystic ovarian appearance on ultrasonography was found to be statistically significantly higher than those without (p=0.034). Conclusion: Among the Rotterdam diagnostic criteria, oligoanovulation, acne, and polycystic ovarian appearance on ultrasonography can be seen in healthy adolescents without PCOS. In this study, the most supportive finding for the diagnosis of PCOS was the appearance of polycystic ovaries accompanying moderate hirsutism.

Keywords:

Polycystic Ovary Syndrome, adolescent girls, free androgen index, HOMA-IR,

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