Davut SAKIZ, Murat ÇALAPKULU, Muhammed Erkam SENCAR, Bekir UCAN, İlknur ÖZTÜRK ÜNSAL, Mustafa ÖZBEK, Erman ÇAKAL

Polikistik over sendromu hastalarında subklinik ateroskleroz, proinflamatuvar durum ve insülin direncinin antropometrik ölçümlerle korelasyonu

Amaç: Polikistik over sendromu (PKOS) doğurganlık çağındaki kadınlarda sık görülen bir endokrinopatidir. PKOS hastalarında visseral obezite, kardiyovasküler bozukluklar, insülin direnci, proinflamatuvar durum sıklıkla görülebilmektedir. Visseral obezitenin değerlendirilmesi amacıyla bir çok antropometrik ölçüm kullanılmaktadır. Amacımız antropometrik ölçümlerinin kardiyovasküler risk, insülin direnci ve proinflamatuvar durum ile korelasyonlarını değerlendirmektir. Gereç ve Yöntem: Bu retrospektif çalışmaya 68 PKOS ve 83 kontrol katılımcı alındı. Tüm katılımcıların bel çevresi, kalça çevresi, bel/kalça oranı, vücut kitle indeksi (VKI), visseral yağlanma indeksi (VAI), lipid birikim ürünü (LAP), vücut yağlanma indeksi (BAI), abdominal hacim indeksi (AVI), vücut yuvarlaklık indeksi (BRI) ve vücut şekli indeksi (ABSI) gibi antropometrik ölçümleri yapıldı. Ana sonuç ölçütü olarak kardiyovasküler risk ve subklinik ateroskleroz değerlendirmesi için karotis intima media kalınlığı (KIMK), insülin direnci değerlendirmesi için HOMA-IR, proinflamatuvar durum değerlendirmesi amaçlı hsCRP düzeyleri belirlendi. Antropometrik ölçümlerin birbirleri ve ana sonuç ölçütleri ile korelasyonları değerlendirildi. Bulgular: HOMA-IR ve KIMK, PCOS hastalarında anlamlı olarak daha yüksekti. PCOS grubunda bel çevresi, kalça çevresi, bel kalça oranı, LAP, BAI, BRI, AVI, VAI ve ABSI gibi abdominal obezite göstergeleri anlamlı olarak daha yüksekti. hsCRP düzeyleri arasında anlamlı farklılık yoktu (p=0,317). Antropometrik ölçümlerin PCOS olma durumu, KIMK, hsCRP ve HOMA ile korelasyonları değerlendirildiğinde tüm ölçümlerin korele olduğu görüldü. KIMK ile en yüksek korelasyon VKI ölçümü, HOMA ile en yüksek korelasyon BRI ölçümünde elde edildi. Antropometrik ölçümlerin PKOS hastalarında CRP ile korelasyon göstermediği tespit edildi. Sonuç: Antropometrik ölçümlerin PKOS ilişkili subklinik ateroskleroz ve insülin direncini öngörmede işlevsel olabileceği görülmüştür. PCOS hastalarında visseral adipozitenin subklinik ateroskleroz ve insülin direncini için prediktif olduğu görülmüştür.

Anahtar Kelimeler:

Adipozite, insülin direnci, karotis intima media kalınlığı, KIMK

Correlation of subclinic atherosclerosis, proinflammatory status, and insulin resistance with anthropometric measurements in polycystic ovary syndrome

Introduction: Polycystic ovary syndrome (PCOS) is the most frequently encountered endocrinopathy in women of reproductive age. Visceral obesity, cardiovascular complications, insulin resistance, and proinflammatory status are frequently seen in PCOS patients. Many anthropometric measurements are used to evaluate visceral obesity. The aim of this study was to evaluate the correlations of anthropometric measurements with cardiovascular risk, insulin resistance and proinflammatory status in PCOS patients. Material and Method: This retrospective study included 68 PCOS patients and 83 healthy females. Anthropometric measurements were evaluated of waist circumference, hip circumference, waist/hip ratio, body mass index (BMI), visceral adiposity index (VAI), lipid accumulation product (LAP), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and a body shape index (ABSI) of all the participants. Carotid intima media thickness (CIMT) for subclinical atherosclerosis cardiovascular risk evaluation, HOMA for insulin resistance assessment, and hsCRP levels for proinflammatory status assessment were determined as the main outcome measure. Correlations of anthropometric measurements with each other and with the main outcome measures were evaluated. Results: HOMA and CIMT were significantly higher in PCOS patients. Abdominal obesity indicators such as waist circumference, hip circumference, waist-to-hip ratio, BMI, LAP, BAI, BRI, AVI, VAI and ABSI were significantly higher in the PCOS group. There was no significant difference between the groups in respect of hsCRP levels (p=0.317). When the correlations of anthropometric measurements with PCOS status were evaluated, it was seen that all measurements were correlated. The highest correlation with CIMT was obtained in BMI measurement, and the highest correlation with HOMA was obtained in BRI measurement. The anthropometric measurements were not found to be correlated with proinflammatory status in PCOS patients. Conclusion: It was observed that anthropometric measurements may be functional in predicting PCOS-related subclinical atherosclerosis and insulin resistance. Visceral adiposity was found to be predictive for insulin resistance and subclinical atherosclerosis in PCOS patients.

Keywords:

Adiposity, insulin resistance, carotid intima media thickness, CIMT,

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