Obezite ve Tipinin Endometrial Kalınlık ve Endometrial Patolojiler ile İlişkisinin Değerlendirilmesi

Amaç: Obezite jinekolojik hastalıklar da dâhil olmak üzere birçok sorun ile ilişkilidir. Çeşitli metabolik yolakları etkileyerek ve hormonal dengeyi bozarak anovulasyon, anormal uterin kanama, endometrial polip, endometrial hiperplazi ve kansere sebep olabilir. Postmenopozal dönemde ana östrojen kaynağı, yağ dokusunda androjenlerin periferik aromatizasyonudur. Obezite ile artmış yağ dokusu ile birlikte artan östrojen düzeyi ultrasonografi ile ölçülen endometrial kalınlığa etki edebilir. Obezitenin değerlendirilmesinde Beden Kitle İndeksi (BKİ), bel/kalça oranı, bel çevresi, bel/boy oranı, boyun çevresi gibi ölçümler kullanılabilir. Çalışmada BKİ ve bel/kalça oranının endometrial patolojiler ve postmenopozal dönemdeki hastalarda ultrasonografi ile ölçülen endometrial kalınlık ile ilişkisi incelenmesi amaçlandı. Gereç ve Yöntemler: Şubat 2020-Nisan 2020 tarihleri arasında Zonguldak Kadın-Doğum ve Çocuk Hastalıkları Hastanesi jinekoloji polikliniğine anormal uterin kanama nedeni ile başvuran ve endometrial biyopsi planlanan hastaların boy, kilo, bel ve kalça ölçüleri alındı. Hastaların BKİ’leri ve bel/kalça oranları elde edilen ölçümlerden hesaplandı. Endometrial biyopsi patoloji tanıları ve postmenopozal dönemdeki hastaların rutin muayene sırasında ultrasonografi ile ölçülen endometrial kalınlıkları kayıt altına alındı. Bulgular: Hastaların endometrial patoloji tanıları ile bel/kalça oranı (p=0,091), BKİ değerleri (p=0,094) ve BKİ grupları (p=0,194, p=0,121) arasında fark saptanmadı. Postmenopozal dönemdeki hastaların ultrasonografide ölçülen endometrial kalınlıkları arasında BKİ grupları ve bel/kalça oranı açısından fark saptanmadı (sırasıyla p=0,879 ve p=0,935). Sonuç: Çalışmamızda BKİ grupları ve bel/kalça oranları açısından endometrial patolojiler ve postmenopozal dönemdeki endometrial kalınlık ölçümleri arasında fark bulunamamıştır. Obezitenin değerlendirilmesinde farklı yöntemlerin de kullanılması, biyokimyasal parametrelerin eklenmesi ve hasta sayısının artırılması ile farklı sonuçlar elde edilebilir.

Anahtar Kelimeler:

Obezite, beden kitle indeksi, uterus kanaması, endometriyal hastalıklar

Evaluation of the Relationship between Obesity and Obesity Type and Endometrial Thickness-Endometrial Pathologies

Aim: Obesity is associated with many problems, including gynecological diseases. It can cause anovulation, abnormal uterine bleeding, endometrial polyp, endometrial hyperplasia and cancer by affecting various metabolic pathways and disrupting hormonal balance. The main source of estrogen in the postmenopausal period is the peripheral aromatization of androgens in adipose tissue. Increasing estrogen level with increased adipose tissue with obesity may affect the endometrial thickness measured by ultrasonography. In the evaluation of obesity, measurements such as Body Mass Index (BMI), waist / hip ratio, waist circumference, waist / height ratio, neck circumference can be used. The aim of this study was to investigate the relationship between BMI and waist / hip ratio with endometrial pathologies and endometrial thickness measured by ultrasonography in postmenopausal patients. Material and Methods: Patients who were admitted to the gynecology outpatient clinic of Zonguldak Maternity and Children Hospital between February 2020 and April 2020 due to abnormal uterine bleeding and planned for endometrial biopsy were included in the study. Patient’s height, weight, waist and hip measurements were taken. BMI and waist / hip ratios of the patients were calculated from the measurements obtained. Endometrial biopsy pathology results and endometrial thicknesses measured by ultrasonography during the routine examination of patients in the postmenopausal period were recorded. Results: There was no statistical difference between endometrial sampling results and waist / hip ratio (p = 0.091), BMI averages (p = 0.094) and BMI groups (p = 0.194, p = 0.121). No statistical difference was found between the endometrial thicknesses measured by ultrasonography in the postmenopausal period and BMI groups and waist / hip ratio (p = 0.879 and p = 0.935). Conclusion: In our study, no relation was found between BMI groups and waist / hip ratios, endometrial pathologies and endometrial thickness measurements in the postmenopausal period. Different results can be obtained by using different methods in the evaluation of obesity, adding biochemical parameters and increasing the number of patients.

Keywords:

Obesity , Body mass index, Uterine bleeding, Endometrial diseases,

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