Postmenopozal Kadınlarda Vü cüt Kitle İ ndeksi ile Trombosit, Lo kosit ve C-reaktif Protein Seviyesinin İ lişkisi

Postmenopozal dönemdeki kadınlarda inflamatuar belirteçler olan trombosit, lökosit ve C-reaktif protein değerlerinin vücut kitle indeksi ile ilişkisinin belirlenmesi. Araştırmamız retrospektif olarak Eskişehir Osmangazi Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Polikliniğine başvuran menopozal döneminde olan kadınların değerlendirilen klinik ve laboratuar bulgularının incelenmesi şeklinde planlanmıştır. Bu bulgular vücut kitle indeksi değerlerinin kategorizasyonu ile üç grup halinde karşılaştırılmıştır. Demografik veriler, klinik ve laboratuar bulguları parametrik ve non-parametrik testler ile analiz edilmiştir. Vücut kitle indeksi ile laboratuar ve kan basıncı değerlerinin korelasyon analizleri gerçekleştirilmiştir. Retrospektif analizde 1369 hasta değerlendirilmiş, dışlanma kriterleri sonrası ve verilerine ulaşılamayan hastalar çalışma dışı bırakıldıktan sonra toplamda 782 hasta çalışma grubu olarak belirlenerek analizler gerçekleştirilmiştir. Hastaların ortalama yaş ve menopoz yaşı sırasıyla 49.8±5.4 ve 46.0±4.9 olarak tespit edilmiştir. Vücut kitle indeksi(kg/m2) değerlerine göre üç ayrı grup olarak analizler gerçekleştirilmiştir(30). Kan basıncı ölçümlerinin vücut kitle indeksi artışı ile istatistiksel olarak anlamlı düzeyde artış gösterdiği tespit edilmiştir(p=0.001). Trombosit değerlerinde gruplar arası anlamlılık tespit edilemezken, lökosit ve C-reaktif protein düzeyleri vücut kitle indeksinin artışı ile yükseldiği gözlenmiştir. Menopozal dönem bir çok kronik hastalığın eşlik ettiği ve özellikle obezite gibi ciddi morbidite ile seyredebilecek bir dönemdir. Bu dönemde rutin ve kolay inceleme yöntemi olarak tam kan sayımı ile özellikle inflamatuar belirteçlerin değerlendirmesi yapılabilmektedir. Obezitenin inflamatuar bir süreci tetiklemesi ile ilişkili çalışmamızda da trombosit, lökosit ve C-reaktif protein gibi inflamatuar belirteçlerin vücut kitle indeksi artışı ile korele şekilde yükseldiği gözlenmiştir.

The Association of Body Mass İndex with Platelets, Leükocytes and C-reactive Protein Valües in Postmenopaüsal Women

To evaluate the association of body mass index with the inflammatory markers such as platelets, leukocytes and Creactive protein levels in postmenopausal women. The present retrospective study was performed among postmenopausal women who admitted to Eskisehir Osmangazi University. The clinical and laboratory findings were analyzed retrospectively. The body mass index values were categorized as three groups. Demographic characteristics, clinical and laboratory datas were analyzed with parametric or non-parametric tests according to the distribution of the datas. The correlation analysis was carried out to determine the relationship between body mass index and clinical findings. One thousand three hundred and sixty-nine patients were evaluated, women who did not met inclusion criterias were excluded. After exclusion criterias, totally 782 patients were analyzed. Mean age(years) and age of menopause(years) were 49.8±5.4 and 46.0±4.9 respectively. Women were divided into three groups according to the body mass index(kg/m2) as 30. The blood pressure values were increased with higher body mass index significantly(p=0.001). Although the platelet counts were not different between groups, we determined that leukocytes and Creactive protein levels were higher in obese subjects compared to normal body weight. Menopausal status is a period which is accompanied by many chronic diseases and can be seen with serious morbidity such as obesity. In the postmenopausal women, complete blood count and especially inflammatory markers can be evaluated as a routine and easy examination method. In the present study that was related with the triggering of an inflammatory process by obesity, it was observed that the inflammatory markers such as the platelet, leukocyte counts and C-reactive protein levels increased with the increase in body mass index.

PDF

___

1. Beaufrere B, Morio B. Fat and protein redistribution with aging: metabolic considerations. Eur J Clin Nutr. 2000;54:S48-53.
2. Sternfeld B, Wang H, Quesenberry CP, Jr Abrams B, Everson-Rose SA, Greendale GA, et al. Physical activity and changes in weight and waist circumference in midlife women: findings from the Study of Women's Health Across the Nation. Am J Epidemiol. 2004;160:912-22.
3. Messier V, Rabasa-Lhoret R, Barbat-Artigas S, Elisha B, Karelis AD, Aubertin-Leheudre M, et al. Menopause and sarcopenia: A potential role for sex hormones. Maturitas. 2011;68:331-6.
4. Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation. 1998;97:2099-100.
5. Yudkin JS, Kumari M, Humphries SE, MohamedAli V, et al. Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link? Atherosclerosis. 2000;148:209-14.
6. Furuncuoglu Y, Tulgar S, Dogan AN, Cakar S, Tulgar YK, Cakiroglu B, et al. How obesity affects the neutrophil/lymphocyte and platelet/lymphocyte ratio, systemic immuneinflammatory index and platelet indices: a retrospective study. Eur Rev Med Pharmacol Sci. 2016;20:1300-6.
7. Park WJ, Jung DH, Lee JW, Shim JY, Kwon YJ, et al. Association of platelet count with sarcopenic obesity in postmenopausal women: A nationwide population-based study. Clin Chim Acta. 2018;477:113-8.
8. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. Fertil Steril. 2012;97:843-51.
9. Samocha-Bonet D, Justo D, Rogowski O, Saar N, Abu-Abeid S, Shenkerman G, et al. Platelet counts and platelet activation markers in obese subjects. Mediators Inflamm. 2008;2008:834153.
10. Lovejoy JC, Champagne CM, de Jonge L, Xie H, Smith SR, et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32:949-58.
11. Ryder E, Diez-Ewald M, Mosquera J, Fernandez E, Pedreanez A, Vargas R, et al. Association of obesity with leukocyte count in obese individuals without metabolic syndrome. Diabetes Metab Syndr. 2014;8:197-204.
12. Subramanian V, Ferrante AW, Jr. Obesity, inflammation, and macrophages. Nestle Nutr Workshop Ser Pediatr Program. 2009;63:151-9; discussion 9-62, 259-68.
13. Virdis A. Endothelial Dysfunction in Obesity: Role of Inflammation. High Blood Press Cardiovasc Prev. 2016;23:83-5.
14. Tasoglu O, Boluk H, Sahin Onat S, Tasoglu I, Ozgirgin N, et al. Is blood neutrophil-lymphocyte ratio an independent predictor of knee osteoarthritis severity? Clin Rheumatol. 2016;35:1579-83.
15. Saskin H, Duzyol C, Ozcan KS, Aksoy R, Idiz M, et al. Preoperative Platelet to Lymphocyte Ratio Is Associated with Early Morbidity and Mortality after Coronary Artery Bypass Grafting. Heart Surg Forum. 2015;18:E255-62.
16. Nakata M, Yada T, Soejima N, Maruyama I, et al. Leptin promotes aggregation of human platelets via the long form of its receptor. Diabetes. 1999;48:426-9.
17. Chen YL, Hung YJ, He CT, Lee CH, Hsiao FC, Pei D, et al. Platelet count can predict metabolic syndrome in older women. Platelets. 2015;26:31- 7.
18. Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost. 2015;114:449- 58.
19. Koca TT. Does obesity cause chronic inflammation? The association between complete blood parameters with body mass index and fasting glucose. Pak J Med Sci. 2017;33:65-9.
20. Furman-Niedziejko A, Rostoff P, Rychlak R, Golinska-Grzybala K, Wilczynska-Golonka M, Golonka M, et al. Relationship between abdominal obesity, platelet blood count and mean platelet volume in patients with metabolic syndrome. Folia Med Cracov. 2014;54:55-64.
21. Nieman DC, Henson DA, Nehlsen-Cannarella SL, Ekkens M, Utter AC, Butterworth DE, et al. Influence of obesity on immune function. J Am Diet Assoc. 1999;99:294-9.
22. Nieto FJ, Szklo M, Folsom AR, Rock R, Mercuri M, et al. Leukocyte count correlates in middleaged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol. 1992;136:525-37.