Kübra HAMZAOĞLU CANBOLAT, Koray GÖK, Nevin TÜTEN, Osman KÖSE, Mine KUCUR, Özlem EKMEKCİ, Abdullah Serdar AÇIKGÖZ, Mahmut ONCUL, Abdullah TÜTEN

Polikistik Over Sendromlu Kadınlarda İnsülin Direnci ile Serum Copeptin Düzeyi Arasındaki İlişki

ÖZET Amaç: Polikistik over sendromlu (PKOS) kadınlardaki insülin direnci ile serum copeptin düzeyi arasındaki olası ilişkiyi ortaya koymaktır. Yöntem: Benzer yaş ve vücut kitle indeksine (VKİ) sahip 44 PKOS’lu ve 44 sağlıklı kadın çalışmaya dahil edildi. Kadınların demografik, klinik ve laboratuvar bilgileri dosyalarından elde edildi. Adetin 2-4. günleri arası alınan örnekte serum copeptin düzeyi ölçüldü. PKOS ve sağlıklı kadınların verileri karşılaştırıldı. Serum copeptin düzeyinin anlamlı çıkan değişkenlerle korelasyonu değerlendirildi. Bulgular: PKOS’lu kadınlarda, klinik açıdan infertilite, hirşutizm, akne, ciltte yağlanma ve saç dökülmesi daha fazla, Ferriman-Gallwey Skoru (FGS) daha yüksek, adetler arası süre daha uzundu (bütün değişkenlerde p

Anahtar Kelimeler:

PKOS, Hiperandrojenizm, copeptin, insülin direnci

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1. Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83: 3078–82.
2. Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19: 41– 7.
3. Azziz R. Polycystic Ovary Syndrome. Obstet Gynecol. 2018 Aug;132(2):321-36.
4. Amato MC, Vesco R, Vigneri E, Ciresi A, Giordano C. Hyperinsulinism and polycystic ovary syndrome (PCOS): role of insulin clearance. J Endocrinol Invest. 2015;38(12):1319–26.
5. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989; 38(9):1165–74.
6. Zore T, Joshi NV, Lizneva D, Azziz R. PCOS: long term health consequences. Semin Reprod Med. 2017;35: 271–81.
7. Polak K, Czyzyk A, Simoncini T, Meczekalski B. New markers of insulin resistance in polycystic ovary syndrome. J Endocrinol Invest. 2017 Jan;40(1):1-8.
8. Solà E, Kerbert AJ, Verspaget HW, Moreira R, Pose E, Ruiz P, et al. Plasma copeptin as biomarker of disease progression and prognosis in cirrhosis. J Hepatol. 2016;65(5):914–20.
9. Barchetta I, Enhörning S, Cimini FA, Capoccia D, Chiappetta C, Di Cristofano C, et al. Elevated plasma copeptin levels identify the presence and severity of non-alcoholic fatty liver disease in obesity. BMC Med. 2019;17(1):85.
10. Karbek B, Ozbek M, Karakose M, Topaloglu O, Bozkurt NC, Cakır E, et al. Copeptin, a surrogate marker for arginine vasopressin, is associated with cardiovascular risk in patients with polycystic ovary syndrome. J Ovarian Res. 2014; 7:31.
11. Taskin MI, Bulbul E, Adali E, Hismiogulları AA, Inceboz U. Circulating levels of obestatin and copeptin in obese and nonobese women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2015 Jun;189: 19-23.
12. Deveer M, Deveer R, Basaran O, Turkcu UO, Akbaba E, Cullu N, et al. Serum Copeptin, Pentraxin 3, Anti-Mullerian Hormone Levels With Echocardiography and Carotid Artery Intima-Media Thickness in Adolescents With Polycystic Ovary Syndrome. J Clin Med Res. 2015;7(12):989-94.
13. Frøssing S, Nylander M, Aziz M, Skouby SO, Kistorp C, Faber J. Atrial natriuretic peptide, copeptin and adrenomedullin levels in polycystic ovary syndrome: a case-control study. Gynecol Endocrinol. 2017 Jan;33(1):30-3.
14. Widecka J, Ozegowska K, Banaszewska B, Kazienko A, Safranow K, Branecka-Wozniak D, et al. Is copeptin a new potential biomarker of insulin resistance in polycystic ovary syndrome ?. Ginekol Pol. 2019;90(3):115-21.
15. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21: 1440–7.
16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28:412–9
17. Azziz R, Carmina E, Chen ZJ, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers 2016 Aug 11;2: 16057.
18. Nestler JE, Powers LP, Matt DW, Steingold KA, Plymate SR, Rittmaster RS, et al. A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome. J Clin Endocrinol Metab.1991;72:83–9.
19. Nestler JE, Jakubowicz DJ, de Vargas AF, Brik C, Quintero N, Medina F. Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. J Clin Endocrinol Metab. 1998; 83:2001–5.
20. Yildiz BO, Bolour S, Woods K, Moore A, Azziz R. Visually scoring hirsutism. Hum Reprod Update. 2010; 16:51–64.
21. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012; 33(6): 981- 1030.
22. Randeva HS, Tan BK, Weickert MO, Lois K, Nestler JE, Sattar N, et al. Cardiometabolic aspects of the polycystic ovary syndrome. Endocr Rev. 2012;33(5):812-841.
23. S. Cassar, M.L. Misso, W.G. Hopkins, C.S. Shaw, H.J. Teede, N.K. Stepto. Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic-hyperinsulinaemic clamp studies. Hum Reprod, 2016; 31: 2619-31
24. Moghetti P. Insulin Resistance and Polycystic Ovary Syndrome. Curr Pharm Des. 2016;22(36):5526-34.
25. Polak K, Czyzyk A, Simoncini T, Meczekalski B. New markers of insulin resistance in polycystic ovary syndrome. J Endocrinol Invest. 2017 Jan;40(1):1-8.
26. Wang J, Wu D, Guo H, Li M. Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life Sci. 2019 Nov 1; 236:116940.
27. Baranowska B, Kochanowski J. Copeptin -a new diagnostic and prognostic biomarker in neurological and cardiovascular diseases. Neuro Endocrinol Lett. 2019 Dec;40(5):207-14.