Sanem ÇİMEN, ÖZER ÖZTEKİN, Mehmet GENCER, Erhan MULUK, Hakan SABIRLI, Servet KIZILDAĞ, Gündüz DEMİR, Lütfi ÇAMLI

Kadın üreme hormonları ve leptin düzeylerinin polikistik over sendromu etiopatogenezindeki yeri

Bu çalışmamızda polikistik over sendromunda (PKOS) serum leptin seviyelerindeki değişiklikleri ve bu değişikliklerin PKOS ile bağlantılı diğer hormonlarla olan ilişkilerini araştırmayı amaçladık. Bu çalışmamız 01.10.2001-01.06.2002 tarihleri arasında İzmir Atatürk Eğitim ve Araştırma Hastanesi, II. Kadın Hastalıkları ve Doğum Kliniği Polikliniği'ne başvuran 32 PKOS hastası ve kontrol grubunu oluşturan 32 sağlıklı kadını içermektedir.Hastaların serum hormon düzeyleri RiA (Radioimmune assay) yöntemi ile saptandı. Reproduktif yaş grubundaki kadınlarda immunoreaktif leptin konsantrasyonları ölçüldü. BMI (Vücud Kitle lndeksi)'si 25 kg/m2'nin altında olanlar zayıf, üstünde olanlar obez olarak kabul edildi. Kontrol grubunda obezlerde, zayıflara oranla anlamlı ölçüde artmış leptin seviyeleri tespit edildi (P < 0,05). PKOS'lu zayıf hastalarda kontrol grubundaki zayıflara oranla leptin seviyeleri daha yüksekti (P < 0,05),ancak obez kontrol grubundakilere benzer ölçülerdeydi. PKOS'lu obez kadınlarda PKOS'lu zayıflara ve kontrol grubundaki tüm hastalara oranla dolaşımdaki leptin seviyeleri anlamlı ölçüde yüksek bulundu (P < 0,05). PKOS'lu hastaların yüksek bir bölümü hiperandrojenikti. Beklendiği gibi, PKOS'lu hastalarda serbest testosteron seviyeleri (3.7 $pm$0,2 pg/ml) anlamlı ölçüde yüksekti (P = 0,008). PKOS'lu gruptaki hastaların çoğunluğundaki leptin seviyeleri kontrol grubu için olan %99'luk tahmini aralıkta idi. Bu çalışmanın sonuçları serum leptin seviyeleri ile BMI arasında daha önce gösterilmiş olan pozitif korelasyonu desteklemektedir. Ayrıca PKOS'lu hastalarda artmış leptinin yüksek serbest testesteron seviyeleri ile bağlantılı olabileceği düşünüldü. Kontrol grubunda serum leptin seviyeleri ile insulin sensitivitesi arasında pozitif korelasyon saptandı.

Anahtar Kelimeler:

Polikistik yumurtalık sendromu, Leptin, Vücut kitle indeksi, Testosteron

Effects of female sex hormones and leptin levels on etiopathogenesis of polycystic ovary syndrome

Our objective was to determine the levels of serum leptin in polycystic ovarian syndrome (PCOS) and to compare this with other PCOS related hormones, 32 PCOS patients and 32 healthy women who admitted to Obstetrics and Gynecology Clinics of Izmir Atatürk Education and Research Hospital during 01.10.2001-01,06.2002 were included in this study.Serum hormone levels were measured by RIA method. In control group obese women had significantly higher leptin levels than non-obese controls (p<0.05) Immunoreactive serum leptin levels were measured in reproductive women.Women with BMI (Body Mass index) levels below 25 kg/m2 were accepted as lean while those above this level were regarded as obese.Significantly higher leptin levels were measured in obese group (p<0.05). Lean PCOS patients had higher leptin levels than those of control group (p<0.05) but similar to obese controls.Obese PCOS patients had the highest leptin levels among all groups (p<0.05).Most of PCOS patients had hyperandrogenism.Free testosteron levels were higher in PCOS patients as we expected (3.7$pm$ 0,2 pg/ml).Most of PCOS patients had leptin levels in the range of 99% prediction interval for control group. Non-obese PCOS patients had higher leptin levels than non-obese controls (p<0.05) but similar with obese controls.There were no relation between high leptin levels and LH, FSH or LH/FSH.Higher leptin levels were found to be related to with high free testosteron levels in PCOS patients.

Keywords:

Polycystic Ovary Syndrome, Leptin, Body Mass Index, Testosterone,

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