Polikistik Over Sendromlu Hastalarda Yeni Antropometrik Ölçümlerin Kardiyometabolik Risk ve İnsülin Rezistansını Belirlemedeki Önemi
Amaç: Polikistik Over Sendromunda (PKOS) abdominal obezite sıklıkla görülmektedir. Abdominal obezitenin değerlendirilmesi PKOS’lu hastalarda metabolik ve kardiyovasküler disfonksiyon açısından önemlidir. Bu çalışmada PKOS’lu hastalarda yeni antropometrik ölçümleri ve kardiyovasküler risk ve insülin rezistansı ile ilişkisini araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmaya 62 PKOS’lu hasta ve 38 sağlıklı kontrol dahil edildi. Hastaların klinik bulguları, serum hormon düzeyleri ve overlerin ultrasonik bulguları değerlendirildi. Antropometrik ölçümler, HOMA-IR düzeyleri ve karotis intima media kalınlıkları (KIMK) değerlendirildi.
Bulgular: Abdominal obezite belirteci olan bel çevresi, LAP, BAI, BRI, VAI, AVI ve WHtR PKOS’lu hastalarda anlamlı olarak yüksekti (p
The Importance of New Anthropometric Measurements in Detecting Cardio Metabolic Risk and Insulin Resistance in Patients with Polycystic Ovary Syndrome: Single Center Experience
Objective: Abdominal obesity is frequently seen in Polycystic Ovary Syndrome (PCOS). The evaluation of abdominal obesity might be important according to metabolic and cardiovascular dysfunctions in patients with PCOS. We aimed to evaluate the new anthropometric measurements in patients with polycystic ovary syndrome (PCOS) and their relationship with cardiovascular risk and insulin resistance.
Methods: We included 62 patients with PCOS and 38 healthy individuals as control. The clinical examinations, serum hormone levels and ultrasonographic findings of overs were evaluated. Anthropometric Measurements, HOMA-IR values and Carotid intima-media thickness (CIMT) measurements were evaluated.
Results: The predictors of abdominal obesity as waist circumference, LAP, BAI, BRI, VAI, AVI, WHtR were significantly higher in patient with PCOS (p
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- 1. Salehi M, Bravo-Vera R, Sheikh A, Gouller A, Poretsky L.
Obesity in polycystic ovary syndrome: Two disease or one?
Turk JEM. 2003;4:149-157.
- 2. Legro RS. Polycystic ovary syndrome and cardiovascular
disease: A premature association? Endocr Rev. 2003;24:302-
312.
- 3. Lemieux S, Prud’homme D, Nadeau A, Tremblay A, Bouchard
C, Despres JP. Seven-year changes in body fat and visceral
adipose tissue in women. Association with indexes of plasma
glucose-insulin homeostasis. Diabetes Care. 1996;19:983-991.
- 4. Dos Santos RE, Aldrighi JM, Lanz JR, Ferezin PC, Marone MMS.
Relationship of body fat distribution by waist circumference,
dual- energy X-ray absorptiometry and ultrasonography
to insulin resistance by homeostasis model assessment and
lipid profile in obese and nonobese postmenopausal women.
Gynecol Endocrinol. 2005;21:295-301.
- 5. Uruska A, Zozulinska-Ziolkiewicz D, Niedzwiecki P, Pietrzak
M, Wierusz-Wysocka B. TG/HDL-C ratio and visceral
adiposity index may be useful in assessment of insulin
resistance in adults with type I diabetes in clinical practice. J
Clin Lipidol. 2018;12:734-740.
- 6. Feng J, He S, Chen X. Body adiposity indexand body roundness
index in identifying insulin resistance among adults without
diabetes. Am J Med Sci. 2019;357:116-123.
- 7. Chen S, Chen Y, Liu X, Li M, Wu B, Li Y, Liang Y, Shao X,
Holthöfer H, Zou H. Insulin resistance and metabolic syndrome
in normal-weight individuals. Endocrine. 2014;46:496-504.
- 8. Kahn HS. The lipid accumulation product is better than BMI
for identifying diabetes: A population-based comparison.
Diabetes Care. 2006;29:151-153.
- 9. Kahn HS. The lipid accumulation product performs better
than the body mass index for recognizing cardiovascular risk:
A population-based comparison. BMC Cardiovasc Disord.
2005;5:26.
- 10. Rotterdam ESHRE/ASRM Sponsored PCOS Consensus
Workshop Group. Revised 2003 consensus on diagnostic
criteria and long-term health risks related to polycystic ovary
syndrome. Fertil Steril. 2004;81:19-25.
- 11. Tsigos C, Hainer V, Basdevant A, Finer N, Fried M, Mathus-
Vliegen E, Micic D, Maislos M, Roman G, Schutz Y, Toplak
H, Zahorska-Markiewicz B, Obesity Management Task
Force of the European Association for the Study of Obesity.
Management of obesity in adults: European clinical practice
guidelines. Obesity Facts. 2008;1:106-116.
- 12. Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile
S, Midiri M, Galluzzo A, AlkaMeSy Study Group. Visceral
Adiposity Index: a reliable indicator of visceral fat function
associated with cardiometabolic risk. Diabetes Care.
2010;33:920-922.
- 13. Bergman RN, Stefanovski D, Buchanan TA, Sumner AE,
Reynolds JC, Sebring NG, Xiang AH, Watanabe RM. A better
index of body adiposity. Obesity (Silver Spring). 2011;19:1083-
1089.
- 14. Thomas DM, Bredlau C, Bosy-Westphal A, Mueller M, Shen
W, Gallagher D, Maeda Y, McDougall A, Peterson CM,
Ravussin E, Heymsfield SB. Relationships between body
roundness with body fat and visceral adipose tissue emerging
from a new geometrical model. Obesity (Silver Spring).
2013;21:2264-2271.
- 15. Arslan M, Atmaca A, Ayvaz G, et al. (Türkiye Endokrinoloji
ve Metabolizma Derneği Metabolik Sendrom Çalışma Grubu).
Metabolik Sendrom Klavuzu 2009. (Accessed at http:// http://
temd.org.tr/admin/uploads/tbl_yayinlar/metabolik_sendrom.
pdf)
- 16. Goldzieher J, Green J. The polycystic ovary. I. Clinical and
histologic features. J Clin Endocrinol Metab. 1962;22:325-338.
- 17. Spritzer PM, Lecke SB, Satler F, Morsch DM. Adipose tissue
dysfunction, adipokines, and low-grade chronic inflammation
in polycystic ovary syndrome. Reproduction. 2015;149: 219-
227.
- 18. Jain S, Khera R, Corrales-Medina VF, Townsend RR,
Chirinos JA. Inflammation and arterial stiffness in humans.
Atherosclerosis. 2014;237:381-390.
- 19. Peters SAE, Grobbee DE, Bots ML. Carotid intima-media
thickness: A suitable alternative for cardiovascular risk as
outcome? Eur J Cardio Prevention and Rehab. 2011;18:167-
174.
- 20. Altin C, Erol V, Aydin E, Yilmaz M, Tekindal M.A, Sade LE,
Gülay H, Müderrisoğlu H. Impact of weight loss on epicardial
fat and carotid intima media thickness after laparoscopic sleeve
gastrectomy: A prospective study. Nutr Metab Cardiovasc Dis.
2018;28:501-509.
- 21. Altin C, Yilmaz M, Ozsoy HM, Gezmis E, Balci S, Tekindal MA,
Sade LE, Muderrisoglu H. Assessment of epicardial fat and
carotid intima media thickness in gestational hypertension. J
Obstet Gynaecol Res. 2018;44:1072-1079.
- 22. Bozkırlı E, Bakıner O, Ertörer E, Anafaroğlu İ, Tütüncü NB,
Demirağ NG. Insulin resistance in non-obese polycystic ovary
syndrome subjects and relation with family history of diabetes
mellitus. Turk JEM. 2015;19:55-59.
- 23. Anan F, Masaki T, Umeno Y, Iwao T, Yonemochi H, Eshima
N, Saikawa T, Yoshimatsu H. Correlations of visceral fat
accumulation and atherosclerosis in Japanese patients with
type 2 diabetes mellitus. Metabolism. 2008;57:280-284.
- 24. Gastaldelli A, Miyazaki Y, Pettiti M, Matsuda M, Mahankali
S, Santini E, DeFronzo RA, Ferrannini E. Metabolic effects of
visceral fat accumulation in type 2 diabetes. J Clin Endocrinol
Metab. 2002;87:5098-5103.
- 25. Shen S, Lu Y, Dang Y, Qi H, Shen Z, Wu L, Li F, Yang C, Qiang
D, Yang Y, Shui K, Bao Y. Effect of aerobic exercise on the
atherogenic index of plasma in middle-aged Chinese men with
various body weights. Int J Cardiol. 2017;230:1-5.
- 26. Elffers TW, de Mutsert R, Lamb HJ, de Roos A, Willems
van Dijk K, Rosendaal FR, Jukema JW, Trompet S. Body fat
distribution, in particular visceral fat, is associated with
cardiometabolic risk factors in obese women. PLoS One.
2017;12:e0185403
- 27. Barbalho SM, Oshiiwa M, Sato Fontana LC, Ribeiro Finalli EF,
Paiva Filho ME, Machado Spada AP. Metabolic syndrome and
atherogenic indices in school children: A worrying panorama
in Brazil. Diabetes Metab Syndr. 2017;11:397-401.
- 28. Liu PJ, Ma F, Lou HP, Zhu YN. Body roundness index and
body adiposity index: Two new anthropometric indices to
identify metabolic syndrome among Chinese postmenopausal
women. Climacteric. 2016;19:433-439.
- 29. Johnson W, Chumlea WC, Czerwinski SA, Demerath EW.
Concordance of the recently published body adiposity index
with measured body fat percent in European-American adults.
Obesity (Silver Spring). 2012;20:900-903.
- 30. Li G, Wu HK, Wu XW, Cao Z, Tu YC, Ma Y, Li BN, Peng QY,
Cheng J, Wu B, Zhou Z. The feasibility of two anthropometric
indices to identify metabolic syndrome, insulin resistance
and inflammatory factors in obese and overweight adults.
Nutrition. 2019;57:194-201.
- 31. Maessen MF, Eijsvogels TM, Verheggen RJ, Hopman MTE,
Verbeek ALM, de Vegt F. Entering a new era of body indices:
the feasibility of a body shape index and body roundness
index to identify cardiovascular health status. PLoS One.
2014;9:e107212.