Pınar KIRICI, Seval Müzeyyen ECİN, Nihal MAVRAL, Sevil ÇİÇEK, Ebru CELİK

Rotterdam, Androgen Excess Society ve National Institutes of Health Kriterlerine Göre Tanı Alan Polikistik Over Sendromlu Hastaların Biyokimyasal Değerleri ve İnsülin Direncinin Karşılaştırılması

Amaç: Polikistik over sendromu (PKOS) tanısında Rotterdam Consensus, Androjen Excess Society (AES), ve National Institutes of Health (NIH) gibi cemiyetlerin farklı kriterleri kullanılmaktadır. Biz bu çalışmada PKOS ön tanısıyla kliniğe başvuran hastaların farklı PKOS tanı kriterlerine göre biyokimyasal değerlerini ve insülin direncini karşılaştırmayı amaçladık. Gereç ve yöntemler: Kliniğimize PKOS ön tanısıyla başvuran 1299 hasta retrospektif olarak incelendi. Dahil edilme ve dışlama kriterlerinin uygulanmasını takiben Rotterdam kriterleri ile (Grup 1) 200, AES kriterleri ile (Grup 2) 182, ve NIH kriterleri ile (Grup 3) 180 hasta PKOS tanısı konularak çalışmaya dahil edildi. Bulgular: Bel/kalça oranında tüm gruplar arasında (p1=0,002; p2=0,0001; p3=0,0001), LH/FSH oranında Grup 1 ve Grup 3 arasında (p2=0,017), AST Grup 2 ve Grup 3 arasında (p3=0,012), DHEA-S ve modifiye Ferriman–Gallwey skoru Grup 1 ve Grup 2 (sırasıyla p1=0,041; p1= 0.013,) ile Grup 1 ve Grup 3 (sırasıyla p2= 0,003; p2=0,04) arasında istatistiksel olarak anlamlı farklı bulundu. Vücut kütle indeksi≥ 25 (kg/m2) olan hasta yüzdesi Grup 1 ile Grup 3 arasında istatistiksel olarak anlamlı farklı bulundu (p=0,006). Bel çevresi ≥ 88 cm olan hasta yüzdesinde tüm gruplar arasında istatistiksel olarak anlamlı fark saptandı (Grup 1 ve Grup 2 için p1=0,0001, Grup 1 ve Grup 3 için p2=0,0012, Grup 2 ve Grup 3 için p3=0,004). Tartışma: Metabolik sendrom görülme sıklığı Rotterdam tanı kriterleri ile, insulin direnci görülme sıklığı NIH tanı kriterleri ile, dislipidemi görülme sıklığı ise AES tanı kriterleri ile PKOS tanısı alan kadınlarda istatistiksel anlama ulaşmasa da daha yüksek saptanmıştır.

Anahtar Kelimeler:

Polikistik over sendromu, Metabolik sendrom, dislipidemi, Rotterdam, AES, NIH, polycystic ovary syndrome, metabolic syndrome, dyslipidemia

Comparison Of Biochemical Markers and Insulin Resistance of Polycystic Ovary Syndrome Patients Diagnosed with the Criteria of Rotterdam, Androgen Excess Society and National Institutes of Health

Objective: There are different criteria to diagnose polycystic ovary syndrome (PCOS) such as Rotterdam Consensus, Androgen Excess Society (AES), and National Institutes of Health (NIH). We aimed to investigate the biochemical and insulin resistance-related markers of PCOS patients according to different diagnostic criteria. Material and methods: 1299 patients admitted to our clinic retrospectively analyzed. Following the inclusion and exclusion criteria, 200 patients with Rotterdam (Group 1), 182 patients with AES (Group 2), and 180 patients with NIH (Group 3) criteria were included in the study. Results: Waist/hip ratio among all groups (p1 = 0.002; p2 = 0.0001; p3 = 0.0001), LH/FSH ratio between Group 1 and 3 (p2=0.017), AST between Group 2 and 3 (p3 =0.012), DHEA-S and modified Ferriman–Gallwey score between Group 1 and 2 (p1 = 0.041; p1 = 0.013, respectively) and Group 1 and 3 (p2= 0.003; p2 = 0.04, respectively) were significantly different. A significant difference was detected between Group 1 and 3 in body mass index ≥ 25 (kg/m2) (p = 0.006). A significant difference was detected among all groups in waist circumference ≥ 88 cm (p1 = 0.0001, p2 = 0.0012, p3 = 0.004). Conclusion: The rate of metabolic syndrome was found to be higher in patients diagnosed with Rotterdam criteria, the rate of insulin resistance with NIH criteria, and the rate of dyslipidemia with AES criteria. However, these differences were not statistically significant.

Keywords:

AES, NIH, polycystic ovary syndrome, metabolic syndrome, dyslipidemia,

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