ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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ORİJİNAL ARAŞTIRMALAR

Farklı Fenotiplere Sahip Polikistik Over Sendromlu Hastaların Klinik ve Laboratuvar Parametreleri Yönünden Değerlendirilmesi
Characteristics of Different Phenotypes of Polycystic Ovary Syndrome in a Turkish Population: a Prospective Study
Received Date : 21 Dec 2020
Accepted Date : 09 Feb 2021
Available Online : 23 Feb 2021
Doi: 10.24074/tjrms.2020-80730 - Makale Dili: TR
TJRMS. 2021;5(2):47-54
ÖZET
Amaç: Polikistik over sendromu oligo/anovulasyon, klinik veya biyokimyasal hiperandrojenemi, polikistik overlerle karakterize heterojen bir hastalıktır. Bu çalışmada amacımız farklı fenotiplere sahip polikistik over sendromlu (PCOS) hastaların klinik ve laboratuvar parametreleri yönünden değerlendirilmesini sağlayarak hastalığın uygun tanı ve tedavisine katkı sağlamaktır. Gereç ve Yöntemler: Çalışma Ekim 2013–Mayıs 2015 tarihleri arasında Ufuk Üniversitesi Tıp Fakültesi Dr. Rıdvan Ege Hastanesi ve Zekai Tahir Burak Kadın Sağlığı Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum kliniklerinde ortak olarak yürütülmüştür. Çalışmaya PCOS tanısı konulan 760 (%89.1) hasta ve 93 (%10.1) sağlıklı birey dahil edilmiştir. PKOS’lu hastalar dört ana fenotipe ayrılmış olup, bu fenotipler hem kendi aralarında hem de kontrol grubu ile karşılaştırıldılar. Bulgular: PKOS fenotiplerin ülkemizdeki prevalansı 1.fenotip % 45.7, 2.fenotip % 10, 3.fenotip % 17.8 ve 4.fenotip için % 26.6 olarak saptandı. Fenotip 1 klinik ve biyokimyasal olarak en hiperandrojen fenotip olarak tespit edildi. 1. ve 2. fenotiplerde BMI değerleri daha yüksekti dolayısıyla obeziteye diğer fenotiplerden daha yatkındılar. Her 4 fenotipin ortalama sistolik ve diyastolik kan basınçları kontrol grubuna göre anlamlı yüksekti (p<0.05). HOMA indeksi fenotip 1’de en yüksek düzeydi. Metabolik sendrom açısından da fenotip 1 en riskli grubu oluşturmaktaydı (p<0.05). Sonuç: Farklı PKOS fenotipleri arasında klinik, metabolik ve hormonal parametreler yönünden birçok farklılık mevcuttur. Her fenotip için farklı riskler söz konusu olduğundan PKOS tanısı konulurken hastaların hangi fenotipe dahil olduğu uygun şekilde sınıflandırılmalıdır. Bu sayede hastaların karşılaşabilecekleri kısa ve uzun dönemli sağlık riskleri daha iyi hesaplanabilir.
ABSTRACT
Objective: Polycystic ovary syndrome is a heterogeneous disorder characterized by oligo or anovulation, biochemical or clinical manifestations of hyperandrogenemia and polycystic ovaries. The aim of this study was to compare clinical, hormonal, and metabolic variables among polycystic ovary syndrome phenotypes. Material and Methods: This prospective cohort study was conducted in Ufuk University School of Medicine and Zekai Tahir Burak Women Health, Education and Research Hospital between October 2013 and May 2015. During this period, a total of 760 subjects were diagnosed as PCOS and were defined as eligible for the prospective follow-up. Patients with PCOS were further divided into four main phenotypes based on diagnostic features. Additionally, total of 93 subjects were included in the prospective follow-up as for the control group. Clinical and biochemical variables were compared between PCOS phenotypes and the control group. Results: The overall prevalance of phenotypes 1, 2, 3 and 4 in our population were found as % 45.7, % 10, % 17.8 and % 26.6, respectively. Phenotype I was the most hyperandrogenic group in terms of clinical and biochemical features and associated with higher waist-to-hip ratio when compared with other phenotypes. Body mass index (BMI) values were significantly higher in Phenotype 1 and 2 than other phenotypes and controls. Mean systolic and diastolic blood pressure of each phenotype were significantly higher than the control group (p<0.05). Homeostatic Model Assessment Insuline Resistance (HOMA-IR) levels were significantly higher in phenotype 1 than other groups (p<0.05). Metabolic Syndrome prevalance was significantly higher in phenotype 1 when compared with other phenotypes (p<0.05). Conclusion: There are significant differences in terms of clinical, hormonal. metabolic features between different PCOS phenotypes that evaluated according to diagnostic criterias. Since each phenotype reveals different metabolic and cardiovascular risks, subjects that diagnosed with PCOS should be carefully evaluated and classified according to individual phenotype. Following appropriate phenotypical classification of patients that diagnosed with PCOS, short and long term health risks would be better clarified.
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