Polikistik Over Sendromunda Obezite ve Metabolik Durumun Fertil ve İnfertil Gruplarda Değerlendirilmesi

AMAÇ : Polikistik over sendromunda(PKOS) fertil ve infertil gruplarin BKİ ve metabolik değerleri karşılaştırılarak obezite ve metabolik durumun fertilite üzerine etkisini belirlemektir.Polikistik over sendromunda(PKOS) fertil ve infertil grupların beden kitle indeksi (BKİ) ,metabolik değerleri karşılaştırılarak obezite ve metabolik durumun fertilite üzerine etkisini belirlemektir.YÖNTEM ve GEREÇLER: 2013- 2018 döneminde Rotterdam Tanı Kriterlerine göre PKOS tanısı alan 230 hastanın, klinik ve metabolik verileri retrospektif olarak değerlendirilmiştir. Beden kitle indeksi (BKİ), bel –kalça oranı , mensturasyon süreleri , fertilite durumu , fertilite süresi ,parite durumu , hirsutizm varlığı ve derecesi ile hastalara uygun diyet ve açlık süresini takiben 75 gr oral glikoz tolerans testi (OGTT) yapılmıştır.İnsulin direnci HOMA-IR ile belirlenmiştir. Total kolesterol,HDL ve LDL kolesterol düzeyleri belirlenmiştir. BKİ’ne göre hastalar ; normal kilolu,fazla kilolu ve obez olarak gruplara ayrılmış ve fertilite durumuna göre sonuçlar değerlendirilmiştir.Metabolik bozukluklar BKİ ve fertilite durumlarına uygun olarak karşılaştırılmıştır. Rotterdam tanı kriterlerine göre PKOS tanılı 230 hastanın klinik ve metabolik verileri retrospektif olarak değerlendirildi.Beden kitle indeksi (BKİ), bel / kalça oranı,mensturasyon,fertilite durumu, infertilite süresi,parite, hirsutizm, 75 g oral glukoz tolerans testi (OGTT), HOMA –IR değeri, total kolesteroll, HDL, LDL kolesterol düzeyleri belirlendi.BKİ'ne göre; normal kilolu, fazla kilolu ve obez gruplar fertilite durumuna göre gruplandırıldı ve değerlendirildi. Metabolik bozukluklar BMI ve fertilite durumuna göre karşılaştırıldı. BULGULAR: Yaş ortalaması 26,7’dir. BKİ ortalaması 28.92±5.95 kg/m2 ‘dir. Olguların %25’i normal kiloda olup,%73’ü normalden fazla kilodadır. Olguların 181’i (%78.5) infertildir, 49’u (%21,5) fertildir. İnfertilite süreleri 12 ile 196 ay arasında değişmekte olup, ortalaması 33.92±24.25 ay, medyanı 24 aydır. Bel çevresi 62 ile 135 cm arasında değişmekte olup, ortalaması 87.76±13.48 cmdir. Bel/kalça oranı 0.65 ile 0.98 arasında değişmekte olup, ortalaması 0.80±0.06 saptanmıştır. BKİ dağılımı fertil ve infertil grupta da benzerdir. Olguların 99’unda (%43.1) insülin direnci, 77’sinde (%33.5) bozulmuş glikoz toleransı, 12’sinde (%5.2) DM saptanmıştır.Lipid düzeyleri gruplar arasında anlamlı farklılık göstermemiştir. Glikoz metabolizması bozuklukları her iki grupta benzerdir.Yaş ortalaması 26.7, Ortalama BKİ 28.92 ± 5.95kg/m2 idi. Olguların% 25'i normal kilolu,% 73'ü fazla kilolu olduğu belirlendi. Olguların 181'i (% 78.5) infertil, 49'u (% 21.5) fertil ve infertilite süresi 12 ile 196 ay arasındaydı (ortalama 33.92 ± 24.25 ay, median 24 ay). Hastaların 99'unda (% 43.1) insülin direnci, 77'sinde (% 33.5) bozulmuş glukoz toleransı ve 12'sinde (% 5.2) DM vardı. Glikoz ve lipit metabolizması ve bozuklukları her iki grupta da benzerdir. SONUÇ: PKOS olgularında obezite ve metabolik bozukluklar daha sık görülmektedir. Ancak bu durumun fertilite üzerine etkisi, saptanmamıştır.

Anahtar Kelimeler:

Polikistik over sendromu, fertilite, metabolik durum

Evaluation of Obesity and Metabolic Status in Polycystic Ovary Syndrome in Fertile and Infertile Groups

OBJECTIVE: The aim of our study was to compare the BMI and metabolic values of fertile and infertile groups in patients with polycystic ovary syndrome (PCOS) and to determine the effect of obesity and metabolic status on fertility and infertile groups and the fertility effect of obesity. MATERIAL AND METHODS: The clinical and metabolic data of 230 patients who presented to the gynecology outpatient clinic of our hospital between 2013 and 2018 and were diagnosed with PCOS according to the Rotterdam Diagnosis Criteria were evaluated. Body mass index (BMI), waist ratio, menstrual period, fertility status, fertility duration, parity status, presence and degree of hirsutism were evaluated. 75 g oral glucose tolerance test (OGTT) was performed following appropriate diet and fasting period. Fasting glucose and insulin levels and insulin resistance cases were determined. Total cholesterol, HDL and LDL cholesterol levels were determined. Patients with BMI; The patients were divided into two groups as fertile and infertile, evaluated for obesity and metabolic data, and data on the relationship with BMI were calculated statistically. These metabolic disorders were compared to BMI and fertility status. RESULTS: The mean age of the patients was 26.7 years. The mean BMI was 28.92 ± 5.95 kg / m2. Only 25% of the patients had normal weight and 73% were overweight. 4 (1.7%) cases in the weak group with BMI less than 18.5, 58 (25.2%) cases in normal weight group with BMI 19-24.9, 71 (30.9%) in overweight group with BMI 25-29.9 There were 86 cases (37.4%) in obese group with BMI 30-39.9 and 11 cases (4.8%) in morbidly obese group with BMI of 40 and above. u (21.5%) is fertile. The duration of infertility ranged from 12 to 196 months, with a mean of 33.92 ± 24.25 months and a median of 24 months. The waist circumference is between 62 and 135 cm and the average is 87.76 ± 13.48 cm. The waist / hip ratio ranged from 0.65 to 0.98 and the mean was 0.80 ± 0.06. The distribution of BMI was similar in the fertile and infertile groups. 99 (43.1%) of the patients had insulin resistance, 77 (33.5%) had impaired glucose tolerance and 12 (5.2%) had DM. Mean blood lipid levels were not significantly different between fertile and infertile groups. The distribution of glucose metabolism disorders was similar in both groups. CONCLUSION: Obesity and metabolic disorders are more common in PCOS cases. There was no significant difference between fertile and infertile groups according to BMI.

Keywords:

Policystic ovary syndrome, fertility, metabolic situations,

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