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Yıl 2022, Cilt 44, Sayı 4, 397 - 403, 31.12.2022
https://doi.org/10.7197/cmj.1216549

Öz

Kaynakça

  • 1. Glintborg D, Rubin KH, Nybo M, Abrahamsen B, Andersen M. Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome. Cardiovasc Diabetol 2018;17(1):37. doi: 10.1186/s12933-018-0680-5.
  • 2. Trikudanathan S. Polycystic ovarian syndrome. Med Clin North Am 2015;99(1):221–35. doi: 10.1016/j.mcna.2014.09.003.
  • 3. Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.
  • 4. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36 Suppl 1(Suppl 1):S67-74. doi: 10.2337/dc13-S067.
  • 5. Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol 2006; 154: 141-5. doi: 10.1530/eje.1.02058.
  • 6. Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Horowtiz BN, Teede HJ, Yildiz BO. Polycystic ovary syndrome. Nat Rev Dis Primers 2016;2:16057. doi: 10.1038/nrdp.2016.57.
  • 7. Zore T, Joshi NV, Lizneva D, Azziz R. Polycystic Ovarian Syndrome: Long-Term Health Consequences. Semin Reprod Med 2017;35(3):271–81. doi: 10.1055/s-0037-1603096.
  • 8. Hsu MI, Liou TH, Chou SY, Chang CY, Hsu CS. Diagnostic criteria for polycystic ovary syndrome in Taiwanese Chinese women: comparison between Rotterdam 2003 and NIH 1990. Fertil Steril. 2007; 88: 727-9. doi: 10.1016/j.fertnstert.2006.11.149.
  • 9. Belosi C, Selvaggi L, Apa R, Guido M, Romualdi D, Fulghesu AM, Lanzone A. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Hum Reprod 2006; 21: 3108-15. doi: 10.1093/humrep/del306.
  • 10. Shroff R, Syrop CH, Davis W, Van Voorhis BJ, Dokras A. Risk of metaboliccomplications in the new PCOS phynotypes based on the Rottedam criteria. Fertil Steril 2007; 88: 1389-95. doi: 10.1016/j.fertnstert.2007.01.032.
  • 11. Wijeyaratne CN, Nirantharakumar K, Balen AH, Bart JH. Plasma homocystein in PCOS. Does it correlate with insulin resistance and ethnicity? Clin Endocrinol 2004; 60: 560-7. doi: 10.1111/j.1365-2265.2004.02019.x.
  • 12. Chae SJ, Kim JJ, Choi YM, Hwang KR, Jee BC, Ku SY, Suh CS, Kim SH, Kim JG, Moon SY. Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Hum Reprod 2008; 23: 1924-31. doi: 10.1093/humrep/den239.
  • 13. Welt CK, Gudmundsson JA, Arason G, Adams J, Palsdottir H, Gudlaugsdottir G, Ingadottir G, Crowley WF. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and matabolic features. J Clin Endocrinol Metab 2006; 91: 4842-8. doi: 10.1210/jc.2006-1327.
  • 14. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol 2007; 66: 513-7. doi: 10.1111/j.1365-2265.2007.02764.x.
  • 15. Skrha J, Haas T, Sindelka G, Prázný M, Widimský J, Cibula D, Svacina S. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis medel assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metab 2004; 89: 135-41. doi: 10.1210/jc.2002-030024.
  • 16. Pehlivanov B, Orbetzova M. Characteristics of different phenotypes of polycystic ovary syndrome in a Bulgaria population. Gynecol Endocrinol 2007; 23: 604-9. doi: 10.1080/09513590701536246.
  • 17. Diamanti-Kandarakis E, Panidis D. Unravelling the phenotypic map of polycystic ovary syndrome (PCOS): a prospective study of 634 women with PCOS. Clin Endocrinol 2007; 67: 735-42. doi: 10.1111/j.1365-2265.2007.02954.x.
  • 18. Gilling-Smith C, Willis DS, Beard RW, Franks S. Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. J Clin Endocrinol Metab 1994; 79: 1158-65. doi: 10.1210/jcem.79.4.7962289.
  • 19. Barnes RB, Rosenfield RL, Burstein S & Ehrmann D. Pituitary-ovarian responses to nafarelin testing in polycystic ovary syndrome. N Eng J Med 1989; 320: 559-65.
  • 20. Şahin Y, Kelestimur F. 17-Hydroxyprogesterone response to buserelin testing in polycystic ovary syndrome. Clin Endocrinol 1993; 39: 151-5. doi: 10.1111/j.1365-2265.1993.tb01767.x.

Metabolic Characteristics In The Subgroups Of Polycystic Ovary Syndrome

Yıl 2022, Cilt 44, Sayı 4, 397 - 403, 31.12.2022
https://doi.org/10.7197/cmj.1216549

Öz

Aim: Polycystic ovary syndrome (PCOS) is a heterogenous disease that is characterized with chronic anovulation, menstrual irregularities and hyperandrogenism. In the present study we aimed to compare the metabolic features of PCOS'subgroups based on revised Rotterdam diagnostic criterias.
Materials and Methods: Ninety-five women with PCOS were enrolled into the study and divided into four groups. Group 1; oligomenorrhea and/or anovulation with biochemical hyperandrogenemia and/or hyperandrogenism, group 2; biochemical hyperandrogenemia and/or hyperandrogenism with polycystic ovaries, group 3; oligomenorrhea and/or anovulation with polycystic ovaries and group 4; polycystic ovaries with oligomenorrhea and/or anovulation with biochemical hyperandrogenaemia and/or hyperandrogenism. Body mass indeces (kg/m2) and waist to hip ratios were calculated in all study patients. Fasting glucose, lipid levels, kidney and liver function tests were measured after 12 hours fasting. Oral glucose tolerance test (OGTT) was performed to evaluate the responses of glucose and insülin. Hormone levels were measured during the follicular phase of the menstrual cycle. Adrenocorticotrophic hormone (ACTH) (0.5 mg Synacthen IM) and gonadotrophin-releasing hormone agonist (buserelin) tests were performed in order to evaluate adrenal and ovarian hyperandrogenemia. Ovarian ultrasonography was performed on all study patients to define PCO morphology.
Results: The frequency of the classical PCOS phenotype was higher than the non-classical PCOS phenotype (74.7% and 25.2%, respectively). Body mass indexes, waist-hip ratios, serum total, LDL and HDL-cholesterol levels were similar in all groups. Serum triglyceride levels were found to be significantly lower in group 2 compared to other groups (p< 0.01). Peak insulin and AUC insulin levels were significantly lower in group 2 (p< 0.05). The prevalence of impaired fasting glucose and impaired glucose tolerance was similar in all groups. Free testosterone and androstenedione levels were significantly lower in group 3 compared to group 4.
Conclusion: Metabolic disturbances of patients with PCOS without hyperandrogenism (OA+PCO; group 3) were similar to the classical PCOS groups contrary to the expectations. The metabolic disturbances found in patients with PCOS without menstrual dysfunction (HA+PCO; group 2) were found to be milder in terms of lipid levels and insulin resistance. These findings support that newly developed HA+PCO and OA+PCO groups are the part of wide PCOS spectrum and also it supports that PCO morphology is one of the diagnostic criterias of PCOS.

Kaynakça

  • 1. Glintborg D, Rubin KH, Nybo M, Abrahamsen B, Andersen M. Cardiovascular disease in a nationwide population of Danish women with polycystic ovary syndrome. Cardiovasc Diabetol 2018;17(1):37. doi: 10.1186/s12933-018-0680-5.
  • 2. Trikudanathan S. Polycystic ovarian syndrome. Med Clin North Am 2015;99(1):221–35. doi: 10.1016/j.mcna.2014.09.003.
  • 3. Rotterdam ESHRE/ASRM Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25.
  • 4. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013;36 Suppl 1(Suppl 1):S67-74. doi: 10.2337/dc13-S067.
  • 5. Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome (PCOS): lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol 2006; 154: 141-5. doi: 10.1530/eje.1.02058.
  • 6. Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Horowtiz BN, Teede HJ, Yildiz BO. Polycystic ovary syndrome. Nat Rev Dis Primers 2016;2:16057. doi: 10.1038/nrdp.2016.57.
  • 7. Zore T, Joshi NV, Lizneva D, Azziz R. Polycystic Ovarian Syndrome: Long-Term Health Consequences. Semin Reprod Med 2017;35(3):271–81. doi: 10.1055/s-0037-1603096.
  • 8. Hsu MI, Liou TH, Chou SY, Chang CY, Hsu CS. Diagnostic criteria for polycystic ovary syndrome in Taiwanese Chinese women: comparison between Rotterdam 2003 and NIH 1990. Fertil Steril. 2007; 88: 727-9. doi: 10.1016/j.fertnstert.2006.11.149.
  • 9. Belosi C, Selvaggi L, Apa R, Guido M, Romualdi D, Fulghesu AM, Lanzone A. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma? Hum Reprod 2006; 21: 3108-15. doi: 10.1093/humrep/del306.
  • 10. Shroff R, Syrop CH, Davis W, Van Voorhis BJ, Dokras A. Risk of metaboliccomplications in the new PCOS phynotypes based on the Rottedam criteria. Fertil Steril 2007; 88: 1389-95. doi: 10.1016/j.fertnstert.2007.01.032.
  • 11. Wijeyaratne CN, Nirantharakumar K, Balen AH, Bart JH. Plasma homocystein in PCOS. Does it correlate with insulin resistance and ethnicity? Clin Endocrinol 2004; 60: 560-7. doi: 10.1111/j.1365-2265.2004.02019.x.
  • 12. Chae SJ, Kim JJ, Choi YM, Hwang KR, Jee BC, Ku SY, Suh CS, Kim SH, Kim JG, Moon SY. Clinical and biochemical characteristics of polycystic ovary syndrome in Korean women. Hum Reprod 2008; 23: 1924-31. doi: 10.1093/humrep/den239.
  • 13. Welt CK, Gudmundsson JA, Arason G, Adams J, Palsdottir H, Gudlaugsdottir G, Ingadottir G, Crowley WF. Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and matabolic features. J Clin Endocrinol Metab 2006; 91: 4842-8. doi: 10.1210/jc.2006-1327.
  • 14. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol 2007; 66: 513-7. doi: 10.1111/j.1365-2265.2007.02764.x.
  • 15. Skrha J, Haas T, Sindelka G, Prázný M, Widimský J, Cibula D, Svacina S. Comparison of the insulin action parameters from hyperinsulinemic clamps with homeostasis medel assessment and QUICKI indexes in subjects with different endocrine disorders. J Clin Endocrinol Metab 2004; 89: 135-41. doi: 10.1210/jc.2002-030024.
  • 16. Pehlivanov B, Orbetzova M. Characteristics of different phenotypes of polycystic ovary syndrome in a Bulgaria population. Gynecol Endocrinol 2007; 23: 604-9. doi: 10.1080/09513590701536246.
  • 17. Diamanti-Kandarakis E, Panidis D. Unravelling the phenotypic map of polycystic ovary syndrome (PCOS): a prospective study of 634 women with PCOS. Clin Endocrinol 2007; 67: 735-42. doi: 10.1111/j.1365-2265.2007.02954.x.
  • 18. Gilling-Smith C, Willis DS, Beard RW, Franks S. Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. J Clin Endocrinol Metab 1994; 79: 1158-65. doi: 10.1210/jcem.79.4.7962289.
  • 19. Barnes RB, Rosenfield RL, Burstein S & Ehrmann D. Pituitary-ovarian responses to nafarelin testing in polycystic ovary syndrome. N Eng J Med 1989; 320: 559-65.
  • 20. Şahin Y, Kelestimur F. 17-Hydroxyprogesterone response to buserelin testing in polycystic ovary syndrome. Clin Endocrinol 1993; 39: 151-5. doi: 10.1111/j.1365-2265.1993.tb01767.x.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Dahili Tıp Bilimleri Araştırma Yazıları
Yazarlar

Mukaddes YILMAZ> (Sorumlu Yazar)
SİVAS CUMHURİYET ÜNİVERSİTESİ
0000-0002-7927-8480
Türkiye


Fahrettin KELEŞTEMUR>
YEDİTEPE ÜNİVERSİTESİ, TIP FAKÜLTESİ, DAHİLİ TIP BİLİMLERİ BÖLÜMÜ
0000-0002-2861-4683
Türkiye

Destekleyen Kurum YOK
Proje Numarası YOK
Yayımlanma Tarihi 31 Aralık 2022
Yayınlandığı Sayı Yıl 2022, Cilt 44, Sayı 4

Kaynak Göster

APA Yılmaz, M. & Keleştemur, F. (2022). Metabolic Characteristics In The Subgroups Of Polycystic Ovary Syndrome . Cumhuriyet Medical Journal , 44 (4) , 397-403 . DOI: 10.7197/cmj.1216549