Polikistik Over Sendromlu Olgularda İnsülin Direnci ve Bozulmuş Glikoz Toleransının Serum Androjen Düzeylerine Etkisi Var mı?

Amaç: Bu çalışmamızda, Polikistik Over Sendromu (PKOS) tanısı almış 209 olguda androjen düzeylerinin insülin direncine etkisi araştırılmıştır. Gereçler ve Yöntem: Çalışmamız kliniğimize başvuran yaşları 18 ile 40 arasında ve polikistik over sendromu tanısı almış 209 olgu ile yapılmıştır. Hastaların bazal hormon düzeyleri , serum androjenleri; dehidroepiandrosteronsülfat (DHEASO4) , total testosterone (TT) ve serbest testosterone(ST) düzeyleri ölçüldü .İnsulin direnci Homeostatik Model Değerlendirmesi (HOMA-IR) yöntemine göre değerlendirildi. 75 gr . oral glikoz tolerans testi yapıldı.Ayrıca Beden Kitle İndeksi (BMI) , bel çevresi , menstürasyon düzeni, fertilite durumu değerlendirildi. Hirsutizm değerlendirimesinde modifiye Ferriman-Gallway skorlama sistemi kullanıldı. Elde edilen sonuçlar Oneway ANOVA testi ve Ki-Kare testi kullanılarak değerlendirildi. Bulgular: İnsülin direnci ile hirsutizm, DHEAS, total testosteron ve serbest testosteron arasında istatistiksel olarak anlamlı ilişki bulunmamıştır. İnsulin direnci ile BMI ve bel çevresi arasında istatistiksel olarak anlamlı ilişki bulunmuş olup, Bozulmuş glikoz toleransı ile BMI düzeyleri, bel çevresi, hirsutizm, DHEAS, total testosteron ve serbest testosteron arasında istatistiksel olarak anlamlı ilişki bulunmamıştır. Sonuç: 18 ile 40 yaşları arasında bulunan olgularda BMI ve bel çevresi yüksek olan olgularda insülin direnci yüksek saptanmıştır. Ancak hiperinsülinemi ve bozulmuş glikoz toleransının serum androjen düzeyine üzerine etkisi saptanamamıştır.

Does Insulin Resistance and Impaired Glucose Tolerance Affect Serum Androgen Levels in Patients with Polycystic Ovary Syndrome?

Objective: In this study, we investigated the effect of insulin resistance on the waist circumference - BMI - Androjeblerin (Total Testosterone, DHEAS04) in 209 cases with Policystic Over Syndrome. Material and Methods: The study was performed with 18 and 40 years of age and policystic ovary syndrome 209 cases. Basal hormone levels of patients, serum androgens; (DHEASO4), total testosterone (TT) and free testosterone (ST) levels were measured. Insulin resistance was assessed by Homeostatic Model Assessment (HOMA-IR) method. In addition, Body Mass Index (BMI), waist circumference, menstrual alignment, fertility status were assessed. A modified Ferriman-Galway scoring photo was used in hirsutism evaluation. The results were evaluated using the Oneway ANOVA test and Chi-Square test, Fisher test. Results: There was a statistically significant relationship between insulin resistance and BMI and waist circumference. No statistically significant relationship was found between hirsutism, DHEAS, total testosterone and free testosterone. There was no statistically significant relationship between impaired glucose tolerance and BMI levels, waist circumference, hirsutism, DHEAS, total testosterone and free testosterone. Conclusion: Insulin resistance was found to be high in cases with high body mass index and wide waist circumference women between 18 and 40 years. However, the effect of hyperinsulinemia and impaired glucose tolerance on serum androgen levels was not detected.

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