Hasan SÜT, Cem TERECE, Sevcan Arzu ARİNKAN, Murat MUHCU

OBEZ OLAN VE OLMAYAN POLİKİSTİK OVER SENDROMLU KADINLARDA İNSULİN REZİSTANSI VE İNSULİN REZİSTANSININ HORMONEL PARAMETRELERLE KORELASYONU

Amaç: Obez olan ve olmayan polikistik over sendromlu (PKOS) kadınlarda insulin rezistansı ve insulin rezistansının hormonel parametrelerle korelasyonunu araştırmayı amaçladık.Materyal Metod: Polikliniğe başvuran, 21 ile 40 yaşları arasında klinik ve endokrinolojik özelliklerine dayanılarak PKOS tanısı konulan ve çalışma şartlarını sağlayan 78 hasta çalışmaya dahil edildi. PKOS tanısı Rotterdam yeniden gözden geçirilmiş tanı kriterlerine göre konuldu. Hastalar, obez olanlar (Vücut Kitle İndeksi 25 üzerinde olanlar) ve Obez olmayanlar (Vücut Kitle İndeksi 25 altında olanlar) olarak iki grupta incelendiBulgular: Obez olan grupta bakılan QUİCKİ ve Açlık glukoz / Açlık insulin düzeyleri anlamlı düsük, HOMA-İR anlamlı olarak yüksek saptandı. Obez olan grupta LH düzeyi ve LH / FSH oranının HOMA-IR ve QUİCKİ ile korele olduğu saptandı. Obez olmayan grupta LH / FSH oranının HOMA-IR ve QUİCKİ ile korele olduğu ve yine obez olmayan grupta total testosteron düzeyinin QUİCKİ ile korele olduğu saptandı. FSH düzeyinin insulin rezistansı ile korele olmadığı görüldü.Sonuç: PKOS lu tüm hastaların insülin rezistansı açısından taranmasını önermekteyiz. Obez olan PKOS lu hastalarda LH düzeyinin insulin rezistansını öngörmede önemli olabileceğini düşünmekteyiz.

Anahtar Kelimeler:

Polikistik over sendromu, insulin direnci, FSH, LH, vucut kitle indeksi

Aim: The aim of our study was to investigate the correlation between insulin resistance and hormonal parameters of insulin resistance on the non-obese and obese patients with polycystic ovary syndrome (PCOS). Method: 78 women patient with age range 21 to 40 diagnosed with PCOS based on the clinical and endocrine features were included to our study. PCOS was diagnosed according to the reviewed Rotterdam criteria. PCOS patients were studied in two groups: Obese patients (the patients that body mass indexes over 25) non-obese patients (the patients that body mass indexes under 25) Results: It has been detected, fasting insulin, total testosterone and HbA1c levels were significantly higher and also HDL level was significantly lower in the obese group. Besides, QUİCKİ and fasting glucose / fasting insulin level have been detected significantly low, HOMA-IR was significantly higher in the obese group. In the non-obese group LH / FSH ratio is correlated with HOMA-IR and QUİCKİ and also total testosterone levels are correlated with QUİCKİ. Besides, it has been noted that the insulin resistance is not correlated with FSH level. PCOS patients Impaired glucose tolerance and the prevalence of DM are 5 times greater than the general population. PCOS is seen more frequently in type 2 DM patients. Conclusion: We suggest insulin resistance screening in all PCOS patients. However, if this is not possible, at least all patients that VKI levels over 25, should be screened. We think that, LH level in obese patients with PCOS is important to predict the insulin resistance.

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