Naciye Sinem GEZER, Cüneyt Eftal TANER, Atalay EKİN, Emre MAT, Ulaş SOLMAZ, Cenk GEZER, Mehmet ÖZEREN

Polikistik Over Sendromunda Over Hacminin İnsülin Direncini Öngörmedeki Rolü

Amaç: Bu çalışmada amacımız, PKOS tanısı alan hastaları değişik klinik ve laboratuvar bulgularına göre alt gruplara ayırarak, PKOS tanı kriterlerinden biri olan artmış overyan hacmin, insülin direnci ile ilişkisini araştırmak ve insülin direncini öngörmedeki değerini saptamaktı.Gereç ve Yöntemler: Çalışmamıza PKOS olan 47 hasta ve menstrüel düzensizliği veya klinik ve biyokimyasal olarak hiperandrojenizmi olmayan 25 kontrol olgusu dahil edildi. Tüm olgularda insülin direnci, açlık insülini ve “Homeostatik Model Assessment” indeksine göre, androjen düzeyi ise serbest androjen indeksine göre değerlendirildi. Hastaların over hacimleri ultrasonografi ile her iki overin üç boyutta ölçümleri alınarak hesaplandı. Hastalar ortalama over hacmi 10 ml altında olanlar ve 10 ml ve üstü olanlar olmak üzere iki gruba ayırıldı. Toplanan verilerin istatistiksel değerlendirilmesinde Student’s t test ve Pearson korelasyon testleri kullanıldı.Bulgular: PKOS tanısı konulmuş hastalar ve kontrol grubu arasında HOMA indeksi, ortalama over hacmi, açlık kan şekeri, FAI açısından anlamlı derecede fark saptandı. PKOS grubunda over hacmi artmış hastaların %96’sında hiperandrojenemi ve %100’ünde insülin direnci saptanırken, over hacmi normal olanların %46’sında hiperandrojenemi ve %10’unda insülin direnci saptandı. İki grup arasındaki fark istatistiksel olarak anlamlı bulundu.Sonuç: Bu çalışma, uzun vadeli metabolik hastalıklara predispozisyon oluşturan insülin direncinin öngörülebilmesi için, obez olsun veya olmasın her PKOS hastasında, over hacminin değerlendirilmesi ve over hacmi artmış olan tüm PKOS hastalarının insülin direnci yönünden araştırılması gerektiğini göstermektedir.

Anahtar Kelimeler:

PKOS, insülin direnci, HOMA, over hacmi

The Role Of Ovarian Volume in The Prediction Of Insulin Resistance in Polycystic Ovarian Syndrome

Aim: The aim of this study was to divide the patients with polycystic ovarian syndrome in to subgroups to according to various clinical and laboratory findings and to demonstrate the correlation between ovarian volume and insulin resistance and to determine the value of ovarian volume in predicting insulin resistance.Material and Methods: In our study, 47 patients with PCOS and 25 control subjects without any menstrual disorders or clinical and biochemical hyperandrogenism were included. In all subjects, insulin resistance was determined by measurement of fasting insulin and “Homeostatik Model Assessment” index. Androgenic status was assessed with free androgen index . Ovarian volume measurement was also performed for each participant by ultrasound. Patients were divided into two groups of ovarian volume, including those above and below the 10 ml. Collected data were analyzed by using Student’s t-test and Spearman’s correlation analysis.Results: The difference in mean ovarian volume, fasting glucose, FAI and HOMA index between PCOS and control group was statistically significant. When high and low ovarian volume patients were compared, the rate of insulin resistance was 100% and10%, the rate of hyperandrogenemia was 96% and 46% respectively. Both rates between two groups were found to be statistically significant.Conclusion: The results of this study demonstrated that, volumetric assessment of the ovaries in all PCOS patients whether or not obese, would be the appropriate approach to predict the long-term metabolic disease predisposition caused by insulin resistance. Also, all PCOS patients with increased ovarian volume need to be studied for insulin resistance.

Keywords:

PCOS, insulin resistance, HOMA, ovarian volume,

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