Özgül Özgan ÇELİKEL, Özlem BARAK SERKANT

Metabolik Sendromlu Hastalarda Endometriumun Değerlendirilmesi

Giriş: Metabolik hastalıklar endometrial hastalıklar ve endometrium kanseri riskini artırabilmektedir. Metabolik sendromlu hastalar endometrial patolojiler açısından risk altındadırlar. Tanı alan hastaları jinekolojik yakınması olmasa bile rutin olarak jinekolojik muayeneye yönlendirmek erken tanı için faydalı olabilir.Materyal Metod: Dahiliye polikliniğinde metabolik sendrom tanısı alan 120 hasta jinekoloji polikliniğinde endometrial hastalıklar açısından değerlendirilmiştir. Veriler SPSS 16 istatistik programında analiz edilmiş Ki kare(chisquare) testi uygulanmıştır. P<0.05 istatistiksel olarak anlamlı kabul edilmiştir.Bulgular: 36 hastaya probe küretaj yapılmıştır. Endometrial kansere rastlanmamıştır. Atipisiz endometrial hiperplazi anlamlı olarak anormal uterin kanaması olan grupta; postmenopozal kanama ve endometrial kalınlığı bulunan menopozlu hasta grubuna gore daha fazla bulunmuştur (p=0.001). Sonuç: Metabolik sendromlu hastaların %15’de endometrial patoloji tesbit edilmiştir. Hasta sayısı artırılarak yapılan çalışmalarla klinik pratikte metabolik sendromlu hastaların jinekolojik muayenelerinin rutin olarak yapılıp yapılmamasının tesbit edilebileceği kanaatine varılmıştır.

Anahtar Kelimeler:

metabolik sendrom, endometrial polip

THE ENDOMETRIUM IN PATIENTS WITH METABOLIC SYNDROME

Introduction: Metabolic disorders can increase the risk of endometrial diseases and endometrial cancer. Patients with metabolic syndrome are at risk for endometrial pathologies. Advising routine gynecological examination even to the patients with metabolic syndrome having no gynecological complaints may be helpful in early diagnosis.Materials and Method: 120 patients diagnosed with metabolic syndrome in the Internal Diseases Outpatient Clinic were examined for endometrial diseases in the Gynecology Clinic. Data were analyzed using SPSS 16 statistical software, and Chi-square test was performed. p<0.05 was considered as statistically significant. Results: 36 patients had undergone a diagnostic curettage. There was no endometrial cancer in any patient. The rate of endometrial hyperplasia without atypia was found significantly increased in the patient group with abnormal uterine bleeding when compared to the patient group with menopause having postmenopausal bleeding and an increased endometrial thickness (p=0.001). Conclusion: Endometrial pathology was diagnosed in 15% of the patients with metabolic syndrome. It was concluded that the question of whether routine gynecological examination of metabolic syndrome patients is required in clinical practice could be answered by further studies including larger patient groups.

Keywords:

Metabolic syndrome, probe curettage,

PDF

___

1. Simpson ER. Aromatization of androgens in women: current concepts and findings. Fertil Steril 2002; 77: 6-10.2. Russo A, Autelitano M, Bisanti L. Metabolic syndrome and cancer risk. Eur J Cancer. 2008 Jan;44(2):293-7. Epub 2007Dec 4.3. Laure D, Annekatrin L, sabina R, Naomi A, Anne C, Susen B, Anne T, Louise H, Kim O. Nathalie C et al. Hormonal, Metabolic, and Inflamatory profiles and endometrial cancer risk within the EPIC Cohort-A Factor Analisy. Am Journal of Epidemiol. 2013 177 (8): 787-799. Doi: 10.1093/aje/kws309 First published online : March 13,20134. Zhan Y, wang J, ma Y, Liu Z, Xu H, Lu S, Lu B. Serum insülin-like, growth factor binding protein-related protein 1(IGFBP-rP1) and endometrial cancer risk in Chinese women. Int J Cancer. 2013 Jan 15;132(2):411-6. Doi:10.1002/ijc.27622. Epub 2012 May 18 5. Spesific of hormonal and energy balance in patients with hperplasia and endometrial neoplasia with metabolic syndrome in the background.. Vopr onkol 2013;59(1):65-716. Campagnoli C, Abba C, Ambroggio S, Brucato T, Pasanisi P Lyfe style and metformin for prevention of endometrial pathology in postmenopasual women.. Gynecol Endocrinol 2013 Feb;29(2):119-24. Doi: 10.3109/09513590.2012.706671. Epub 2012 Sep 57. Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Manson JE, Li J, et al. A prospective evaluation of insulin and insulinlike growth factor-I as risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev 2008; 17: 921-9.8. Beral V. On Behalf of Million Women Study Collaborators.Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet 2005; 365: 1543-51.9. Makimura H, Wei J, Dolan-Lobby SE, Ricchiuti V, Grinspoon S. Retinol-Binding Protein levels are increased in association with gonadotropin levels in healthy women. Metabolism 2009; 58(4): 479-87.10. Allen NE, Key TJ, Dossus L, Rinaldi S, Cust A, Lukanova A,et al.Endogenous sex hormones and endometrial cancer risk in women in the European Prospective Investigation into Cancer and Nutrition (EPIC) Endocr Relat Cancer 2008;15:.485-97.11. Lukanova A, Lundin E, Micheli A, Arslan A, Ferrari P, Rinaldi S, et al. Circulating levels of sex steroid hormones and risk of endometrial cancer in postmenopausal women Int J Cancer 2004; 108: 425-32.12. Gunter MJ, Hoover DR, Yu H, Wassertheil-Smoller S, Manson JE, Li J, et al. A prospective evaluation of insulin and insulinlike growth factor-I as risk factors for endometrial cancer.Cancer Epidemiol Biomarkers Prev 2008; 17: 921-9.13. Hirasawa A, Makita K, Akahane T, Yokota M, Yamagami W, Banno K, Susumu N, Aoki D Hypertriglyceridemia is frequent in endometrial cancer survivors.. Jpn J Clin Oncol 2013 Nov;43(11):1087-92.doi:10.1093/jjco/hyt125.Epub 2013 Sep 1.14. Bueloni-Dias FN1, Spadoto-Dias D, Delmanto LR, Nahas-Neto J, Nahas EA. Metabolic syndrome as a predictor of endometrial polyps in postmenopausal women. Menopause. 2016 Jul;23(7):759-64. doi: 10.1097/GME.0000000000000616. 15. Association between endometrial cancer and metabolic syndrome. Shou HF, Ni J, Zhu T, Chen JH, Zhang X, Xu XX, Chen L, Yu H.Zhonghua Fu Chan Ke Za Zhi. 2010 Feb;45(2):128-31. Chinese.16. Tone B, Tanja S, Annekatrin L, Steinar T, Randi S at al Metabolic Syndrome and Endometrial Carcinoma.. Am J Epidemiol 2010 Apr 15;171(8): 892-902. Doi:10.1093/aje/kwq006. Epub 2010 Mar 1017. Ni J, Zhu T, Zhao L, Che F, Chen Y, Shou H, Yu A. Metabolic syndrome is an independent prognostic factor for endometrial edenocarcinomaClin Transl Oncol. 2015 Oct;17(10):835-9. Doi 10.1007/s12094-015-1309-8 Epub 2015 Aug 11.18. Trabert B, Wentzensen N, Felix AS, Yang HP, Sherman ME, Brinton LA. Metabolic syndrome and risk of endometrial cancer in the United states: a study in the SEER- medicare linked database. Cancer Epidemiol Biomarkers Prev 2015 Jan;24(1):261-7. Doi: 10.1158/1055-9965.EPI-14-0923.19. Ni J, Lou H, Zhu T, Zhao L, Shou H.Zhonghua Fu Chan Ke Za Zhi Association between metabolic syndrome and prognosis of endometrioid carcinoma].. 2014 Oct;49(10):768-71. Chinese 20. TangjitgamolS, Khunnarong J, Srijaipracharoen S. Medical morbidities in endometrial cancer patients .Int Gynecol Cancer 2014 Nov;24(9):1623-7. Doi: 10.1097/IGC.0000000000000291.21. Nilgün GÜDÜCÜ Herman İŞÇİ Alin BAŞGÜL YİĞİTER İlkkan DÜNDER. Relationship of Endometrial Thickness with Metabolic Parameters and Sex-steroids in Postmenopausal Women. 2013 Düzce Medical Journal e-ISSN 1307- 671X www.tipdergi.duzce.edu.tr. duzcetipdergisi@duzce.edu.tr 22. Özdemir S, Batmaz G, Ates S, Celik C, Incesu F, Peru C. Relation of metabolic syndrome with endometrial pathologies in patients with abnormal uterine bleeding Gynecol Endocrinol. 2015;31(9):725-9. doi: 10.3109/09513590.2015.1058355. Epub 2015 Jul 16..