Obezitenin üreme sistemi üzerine etkisi

Obezite dünya çapında yaygın görülen, mortalite ve morbite üzerine ciddi etkileri olduğu bilinen bir durum olarak tanımlanabilir. Obezite vücutta yağ dokusunun aşırı birikmesi sonucu ortaya çıkan klinik bir durumdur. Obezite ile ilişkili üreme sorunları infertilite problemleri, düşüklere ve gebelik komplikasyonlarına kadar geniş bir yelpazeyi kapsamaktadır. Bu derleme ile obezitenin kadın üreme sistemindeki etkilerinin klinik yönlerine odaklanarak obez kadınlarda fertilite problemlerini tartışmayı hedefledik.

The effect of the obesity on reproductive system

Obesity may be described as the new worldwide epidemic, and its serious impact on morbidity and mortality are well known. Obesity is the excessive accumulation of fat in the body, the result is a clinical condition. The reproductive problems associated with obesity encompasses a wide range of disorders including infertility problems, miscarriage and pregnancy complications. In this review, we aim to discuss the impact of obesity on the various aspects of female reproductive function with focus on the clinical aspects of fertility problems in obese women.

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1 Pasquali R, Pelusi C, Genghini S, Cacciari M, Gambineri A. Obesity and reproductive disorders in women. Hum Reprod Update. 2003; 9: 359-372.
2 Yılmaz C. Obezite. İstanbul. Nobel Tıp Kitabevleri Ltd, 1995, s. 95-105.
3 Kaltila-Heino R, Kosunen E, Rimpela M. Pubertal timing, sexual behavior and self-reported depression in middle adolescence. J Adolesc. 2003; 26: 531-545.
4 Lash MM, Armstrong A. Impact of obesity on women’s health. Fertil Steril. 2009; 91: 1712-1715.
5 Ahemed ML, Ong K, Morrel D, Cox L, Drayer N, Perry L. Longitudinal study of leptin concentrations during puberty: sex differences and relationship to changes in body composition. J Clin Endocrinol Metab. 1999; 84: 899–905.
6 Ahima RS, Dushay J, Flier SN, Prabakaran D, Flier JS. Leptin accelerates the onset of puberty in normal female mice. J Clin Invest. 1997; 99: 391-395.
7 Tang T, Glanville J, Hayden CJ, White D, Barth JH, Balen AH. Combined lifestyle modification and metformin in obese patients with polycystic ovary syndrome. A randomized, placebo-controlled, double-blind multicentre study. Hum Reprod. 2006; 21: 80-89.
8 Essah PA, Apridonidze T, Iuorno MJ, Nestler JE. Effects of short-term and long-term metformin treatment on menstrual cyclicity in women with polycystic ovary syndrome. Fertil Steril. 2006; 86: 230-232.
9 Eisenhardt S, Schwarzmann N, Henschel V, et all. Early effects of metformin in women with polycystic ovary syndrome: a prospective randomized, double-blind, placebocontrolled trial. J Clin Endocrinol Metab. 2006; 91: 946-952.
10 The ESHRE Capri Work Group. Nutrition and reproduction in women. Hum Reprod Update. 2006; 12: 193-207.
11 Smallwood GH, Meador ML, Lenihan JP, Shangold GA, Fisher AC, Creasy GW, Efficacy and safety of a transdermal contraceptive system. Obstet Gynecol. 2001; 98: 799-805.
12 Koetsawang S, Ji G, Krishna U, Cuadros A, Dhall G, Wyss R. Microdose intravaginal levonorgestrel contraception: a multicentre clinical trial: III. The relationship between pregnancy and body weight. Contraception. 1990; 41: 143-150.
13 Burkman R, Schlesselman JJ, Zieman M. Safety concerns and health benefits associated with oral contraception. Am J Obstet Gynecol. 2004; 190: 5-22.
14 Law G, Maclehose R.F, Longnecker M.P. Obesity and time to pregnancy. Hum Reprod. 2007; 22: 414-420.
15 Lord JM, Flight IH, Norman RJ. Insulin-sensitizing drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome. Cochrane Database Syst Rev. 2003; 3: CD003053.
16 Zhang Y, Proenca R, Maffei M, Barone M, Leopold L, Friedman JM. Positional cloning of the mouse obese gene and its human homologue. Nature. 1994; 372: 425-432.
17 Barash IA, Cheung CC, Weigle DS, Ren H, Kabigting EB, Kuijper JL. Leptin is a metabolic signal to the reproductive system. Endocrinology. 1996; 137: 3144-3147.
18 Chehab FF, Lim ME, Lu R. Correction of the sterility defect in homozygous obese female mice by treatment with the human recombinant leptin. Nat Genet. 1996; 12: 318-320.
19 Fedorcsak P, Storeng R, Dale PO, Tanbo T, Abyholm T. Impaired insulin action on granulosa-lutein cells in women with polycystic ovary syndrome and insulin resistance. Gynecol Endocrinol. 2000; 14: 327-336.
20 Kawamura K, Sato N, Fukuda J, Kodama H, Kumagai J, Tanikawa H. The role of leptin during the development of mouse preimplantation embryos. Mol Cell Endocrinol. 2003; 202: 185-189.
21 Bellver J, Melo M, Bosch E, Serra V, Remohi J, Pellicer A. Obesity and poor reproductive outcome: the potential role of the endometrium. Fertil Stertil. 2007; 88: 446-451.
22 Ramlau-Hansen CH, Thulstrup AM, Nohr EA, Bonde JP, Sorensen TIA, Olsen J. Subfecundity in overweight and obese couples. Hum Reprod. 2007; 22: 1634-1637.
23 Norman RJ, Noakes M, Wu R, Davies MJ, Mora L, Wang JX. Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update. 2004; 10: 267-280.
24 Jauniaux E, Farquharson RG, Christiansen OB, Exalto N. Evidence based guidelines for investigation and medical management of recurrent miscarriage. Hum Reprod. 2006; 21: 2216-2222.
25 Apay SE, Pasinlioğlu T. Obezite ve gebelik. TAF Preventive Medicine Bulletin. 2009; 8(4): 345-350.
26 Apay SE, Kılıç M, Pasinlioğlu T. Obez gebelerde doğum eylemi ve doğum sonu dönem. TAF Preventive Medicine Bulletin. 2010; 9(2): 151-156.
27 Galtier-Dereure F, Mantpeyroux F, Bringer J, Jaffol C. Weight excess before pregnancy: complication and cost. Int J Obesity. 1995; 26: 883-896.
28 Güler Y, Gönener HD, Altay B, Gönener A. Adölesanlarda Obezite ve Hemşirelik Bakımı. Fırat Sağlık Hizmetleri Dergisi. 2009; 4: 165-180.
29 Finnish Medical Society Duodecim. Treatment of obesity, National Guideline Clearinghouse, http://www.guideline.gov/summary/summary.aspx? doc_id=12802&nbr=006604&string=obesity
30 Institute for Clinical Systems Improvement (ICSI). Prevetion and management of obesity (mature adolescents and adults), National Guideline_Clearinghouse_http://www.guideline.gov/summary/summary.aspx?doc_id=14178&nbr=007085&string=obesity.
31 Esterbauer E, Anders I, Ladurner G, Huemer M, Wranek U. Stres management in hearth diseases, obesity, nicotine and alcohol use. Wein Klin Wochenschr. 2001; 17: 947-953.
32 Ryden A, Karlsson J, Sullivan M, Torgerson JS, Taft C. Coping and distress: What happens after interventions? A 2-year follow-up from the Swedish obese subjects study. Psychosomatic Medicine. 2003; 65: 435-442.
33 Bal Ö, Özgür G, Gümüş AB. Obez bireylerin stresle başa çıkma yolları. C.Ü Hemşirelik Yüksekokulu Dergisi. 2006; 10: 20-27.