Serum adipsin, irisin ve osteopontin düzeyleri ile polikistik over sendromu ve metabolik anormalliklerin arasındaki ilişkinin araştırılması
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Polikistik over sendromu (PKOS) üreme çağındaki kadınlar arasında en sık görülen endokrin ve metabolik bozukluklardan biridir. Amacımız serum adipsin, irisin ve osteopontin düzeyleri ile polikistik over sendromu ve metabolik anormalliklerin arasındaki ilişkinin araştırılması ve bu moleküllerin PKOS etiyopatogenezindeki olası rolünü ve/veya PKOS tanısında önemli birer belirteç olabilme potansiyellerini ortaya koymaktır. Gereç ve Yöntem: Düzce Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Bölümü jinekoloji polikliniğine Haziran 2022-Haziran 2023 tarihleri arasında başvuran 18-45 yaş arası ek hastalığı olmayan 96 PKOS hastası ve 80 sağlıklı kontrol grubu çalışmaya dahil edilmiştir. Çalışma için Rotterdam kriterleri kullanılmış olup, 3 kriterden 2'sinin sağlanması durumunda PKOS tanısı konulmuştur. Hastaların tamamından araştırma izni ve aydınlatılmış onam alınmıştır. Hastaların demografik verileri muayene sırasında kaydedilmiştir. Biyokimyasal parametreler için yazılı ya da elektronik kayıtlara geçen hastaların rutin poliklinik kontrollerindeki sonuçlarından yararlanılmıştır. Tüm bireylerin mensin 2.veya 3. Gününde 8 saat açlığı takiben alınan venöz kanda serum açlık glukoz, insülin (açlık), HbA1c, kolesterol, LDL-C, HDL-C, Trigliserid, CRP, FSH, LH, E2, total testesteron, TSH, prolaktin düzeyleri belirlenmiştir. İnsülin direncini belirlemek için Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) hesaplanmıştır. Hirsutizm için modifiye Ferriman Gallwey skoru kullanılmıştır. Eş zamanda adipsin, irisin ve osteopontin için alınan venöz kan örnekleri jelli biyokimya tüplerine alınarak 5000 devirde 10 dakika santrifüj edilip elde edilen serum 1,5 ml'lik eppendorf tüplerine koyularak çalışma gününe kadar -80°C'de saklanmıştır. Adipsin, irisin ve osteopontin ölçümleri BIO-TEK EL X 800 marka cihazda Elabscience marka ticari kitlere kalibrasyon -kontrol işlemlerinden sonra kolorometrik yöntemle analiz edildi. Sonuçlar adipsin ng/ml, irisin pg/ml ve osteopontin ng/ml cinsinden verildi. Elde edilen tüm veriler IBM SPSS Statistics 23 programı kullanılarak değerlendirildi. Bulgular: Çalışmaya 96 PKOS ve 80 sağlıklı kontrol grubu dahil edilmiştir. Her iki grup da kendi içerisinde vücut kitle indeksine göre obez (VKİ>30) ve obez olmayan(VKİ<30) olmak üzere iki gruba ayrılarak toplamda 4 hasta grubu elde edilmiştir. PKOS grubunda adipsin değeri kontrol grubundan istatistiksel olarak anlamlı derecede yüksek bulunmuştur (p=0,020). PKOS grubunda irisin değeri kontrol grubundan istatistiksel olarak anlamlı farklılık göstermemiştir (p>0,005). PKOS grubunda osteopontin değeri kontrol grubundan istatistiksel olarak anlamlı derecede düşük bulunmuştur (p=0,000). PKOS obez olmayan grupta adipsin, osteopontin değeri PKOS obez grubundan istatistiksel olarak anlamlı farklılık göstermemiştir (p>0,005). PKOS obez olmayan grubunda irisin değeri PKOS obez gubundan istatistiksel olarak anlamlı derecede düşük bulunmuştur (p=0,000). PKOS grubunda HOMA-IR ile osteopontin ve irisin ölçümleri arasında pozitif yönde istatistiksel olarak anlamlı derecede bir ilişki bulunmuştur (p<0,013, p< 0,003). PKOS grubunda TyG indeks ile adipsin, osteopontin ve irisin ölçümleri arasında istatistiksel olarak anlamlı derecede bir ilişki bulunmamıştır (p>0,05). PKOS grubunda adipsin ile VKİ ölçümleri arasında pozitif yönde, E2, HbA1c, açlık glukoz ölçümleri arasında negatif yönde istatistiksel olarak anlamlı derecede bir ilişki bulunmuştur. PKOS grubunda irisin ile kilo, VKİ, bel/kalça oranı, HbA1C, insülin (açlık), HOMA-IR, CRP ölçümleri arasında pozitif yönde, HDL ölçümü arasında negatif yönde istatistiksel olarak anlamlı derecede bir ilişki bulunmuştur. PKOS grubunda osteopontin ile kilo, VKİ, bel/kalça oranı, insülin (açlık), HOMA-IR ölçümleri arasında pozitif yönde istatistiksel olarak anlamlı derecede bir ilişki bulunmuştur. PKOS grubunda fenotipler arasında adipsin, osteopontin ve irisin değeri arasında istatistiksel olarak anlamlı bir fark bulunmamıştır. PKOS gelı?şı?m rı?skı? I?çin yapılan logı?stı?k regresyon analı?zi sonucunda, yaş, VKİ, FSH, LH/FSH, total kolesterol ve osteopontin ölçümlerinin gruplar üzerinde istatistiksel olarak anlamlı derecede bir etkisi bulunmuştur (p<0,05). ROC analizi ile yapılan değerlendirme sonucunda osteopontin ölçümünün gruplar üzerinde istatistiksel olarak anlamlı derecede etkisinin olduğu tespit edilmiştir. Osteopontin değerinin 2,323 ng /ml değerinin altına düşmesi PKOS riski oluşturmaktadır. Sonuç: Çalışmamızda adipsinin değerlerinin PKOS ile önemli ölçüde ilişkili olduğunu ve bunun VKİ'ye bağlı olduğunu ve aynı zamanda irisinin ise antropometrik ölçümler ve metabolik parametreler ile ilişkili olduğunu gösterilmiştir. Osteopontinin tanısal değerini belirlemeye yönelik yapılan ROC analizinde osteopontin değerinin 2,323 değerinin altına düşmesinin PKOS riski oluşturduğu tespit edilmiştir ve PKOS'lu hastalarda metabolik anormalliklerle de ilişkisi olduğu gösterilmiştir. Osteopontin düzeyinin kalorimetrik ölçümleri PKOS ve PKOS'la ilişkili metabolik hastalıkların erken tanısında, tedavisinde ve takibinde katkı sağlayabilir. Ancak bu alanda daha büyük çaplı prospektif çalışmalara ihtiyaç vardır. Anahtar kelimeler: polikistik over sendrom, metabolik sendrom, insülin rezistansı, adipsin, irisin, osteopontin
Purpose: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders among women of reproductive age. Our aim was to investigate the relationship between serum adipsin, irisin and osteopontin levels and polycystic ovary syndrome and metabolic abnormalities and to reveal the possible role of these molecules in the etiopathogenesis of PCOS and/or their potential as important markers in the diagnosis of PCOS. Materials and Methods: A total of 96 PCOS patients aged 18-45 years with no comorbidities and 80 healthy controls who applied to the gynaecology outpatient clinic of the Department of Obstetrics and Gynaecology of Düzce University Faculty of Medicine Hospital between June 2022 and June 2023 were included in the study. Rotterdam criteria were used for the study and PCOS was diagnosed if 2 of the 3 criteria were met. Research permission and informed consent were obtained from all patients. Demographic data of the patients were recorded during the examination. For biochemical parameters, the results of the patients' routine outpatient clinic controls, which were recorded in written or electronic records, were utilised. Serum fasting glucose, insulin (fasting), HbA1c, cholesterol, LDL-C, HDL-C, triglyceride, CRP, FSH, LH, E2, total testosterone, TSH, prolactin levels were determined in venous blood obtained after 8 hours of fasting on the 2nd or 3rd day of menstruation. Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) was calculated to determine insulin resistance. Modified Ferriman Gallwey score was used for hirsutism. At the same time, venous blood samples taken for adipsin, irisin and osteopontin were taken into gel biochemistry tubes and centrifuged at 5000 rpm for 10 minutes and the serum obtained was put into 1.5 ml eppendorf tubes and stored at -80°C until the study day. Adipsin, irisin and osteopontin measurements were analysed by colorometric method in BIO-TEK EL X 800 brand device after calibration-control procedures with Elabscience brand commercial kits. Results were expressed as adipsin ng/ml, irisin pg/ml and osteopontin ng/ml. All data obtained were evaluated using IBM SPSS Statistics 23 programme. Results: The study included 96 PCOS and 80 healthy control groups. Both groups were divided into two groups as obese (BMI>30) and non-obese (BMI<30) according to body mass index and 4 patient groups were obtained in total. In the PCOS group, adipsin value was found to be statistically significantly higher than the control group (p=0.020). The irisin value in the PCOS group was not statistically significantly different from the control group (p>0,005). The osteopontin value in the PCOS group was found to be statistically significantly lower than the control group (p=0,000). In PCOS non-obese group, adipsin, osteopontin values were not statistically significantly different from PCOS obese group (p>0,005). In PCOS non-obese group, irisin value was found to be statistically significantly lower than PCOS obese group (p=0,000). There was a statistically significant positive correlation between HOMA-IR and osteopontin and irisin measurements in PCOS group (p<0,013, p<0,003). There was no statistically significant correlation between TyG INDEX and adipsin, osteopontin and irisin measurements in PCOS group (p>0,05). There was a statistically significant positive correlation between adipsin and BMI measurements and a negative correlation between E2, HbA1c and fasting glucose measurements in PCOS group. There was a statistically significant positive correlation between irisin and weight, BMI, waist/hip ratio, HbA1C, insulin (fasting), HOMA-IR, CRP measurements and a negative correlation between HDL measurement in PCOS group. A statistically significant positive correlation was found between osteopontin and weight, BMI, waist/hip ratio, insulin (fasting), HOMA-IR measurements in PCOS group. There was no statistically significant difference between adipsin, osteopontin and irisin values between phenotypes in PCOS group. As a result of logistic regression analysis for PCOS developmental risk, age, BMI, FSH, LH/FSH, total cholesterol and osteopontin measurements had a statistically significant effect on the groups (p<0.05). As a result of the evaluation by ROC analysis, it was determined that osteopontin measurement had a statistically significant effect on the groups. A decrease in osteopontin value below 2.323 ng / ml poses a risk of PCOS. Conclusion: In our study, it was shown that adipsin values were significantly associated with PCOS and this was related to BMI, while irisin was associated with anthropometric measurements and metabolic parameters. In the ROC analysis to determine the diagnostic value of osteopontin, it was found that a decrease in osteopontin value below 2.323 posed a risk of PCOS and was also shown to be associated with metabolic abnormalities in patients with PCOS. Calorimetric measurements of osteopontin levels may contribute to the early diagnosis, treatment and follow-up of PCOS and PCOS-related metabolic diseases. However, larger prospective studies are needed in this field. Key words: polycystic ovary syndrome, metabolic syndrome, insulin resistance, adipsin, irisin, osteopontin
Purpose: Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders among women of reproductive age. Our aim was to investigate the relationship between serum adipsin, irisin and osteopontin levels and polycystic ovary syndrome and metabolic abnormalities and to reveal the possible role of these molecules in the etiopathogenesis of PCOS and/or their potential as important markers in the diagnosis of PCOS. Materials and Methods: A total of 96 PCOS patients aged 18-45 years with no comorbidities and 80 healthy controls who applied to the gynaecology outpatient clinic of the Department of Obstetrics and Gynaecology of Düzce University Faculty of Medicine Hospital between June 2022 and June 2023 were included in the study. Rotterdam criteria were used for the study and PCOS was diagnosed if 2 of the 3 criteria were met. Research permission and informed consent were obtained from all patients. Demographic data of the patients were recorded during the examination. For biochemical parameters, the results of the patients' routine outpatient clinic controls, which were recorded in written or electronic records, were utilised. Serum fasting glucose, insulin (fasting), HbA1c, cholesterol, LDL-C, HDL-C, triglyceride, CRP, FSH, LH, E2, total testosterone, TSH, prolactin levels were determined in venous blood obtained after 8 hours of fasting on the 2nd or 3rd day of menstruation. Homeostatic Model of Assessment-Insulin Resistance (HOMA-IR) was calculated to determine insulin resistance. Modified Ferriman Gallwey score was used for hirsutism. At the same time, venous blood samples taken for adipsin, irisin and osteopontin were taken into gel biochemistry tubes and centrifuged at 5000 rpm for 10 minutes and the serum obtained was put into 1.5 ml eppendorf tubes and stored at -80°C until the study day. Adipsin, irisin and osteopontin measurements were analysed by colorometric method in BIO-TEK EL X 800 brand device after calibration-control procedures with Elabscience brand commercial kits. Results were expressed as adipsin ng/ml, irisin pg/ml and osteopontin ng/ml. All data obtained were evaluated using IBM SPSS Statistics 23 programme. Results: The study included 96 PCOS and 80 healthy control groups. Both groups were divided into two groups as obese (BMI>30) and non-obese (BMI<30) according to body mass index and 4 patient groups were obtained in total. In the PCOS group, adipsin value was found to be statistically significantly higher than the control group (p=0.020). The irisin value in the PCOS group was not statistically significantly different from the control group (p>0,005). The osteopontin value in the PCOS group was found to be statistically significantly lower than the control group (p=0,000). In PCOS non-obese group, adipsin, osteopontin values were not statistically significantly different from PCOS obese group (p>0,005). In PCOS non-obese group, irisin value was found to be statistically significantly lower than PCOS obese group (p=0,000). There was a statistically significant positive correlation between HOMA-IR and osteopontin and irisin measurements in PCOS group (p<0,013, p<0,003). There was no statistically significant correlation between TyG INDEX and adipsin, osteopontin and irisin measurements in PCOS group (p>0,05). There was a statistically significant positive correlation between adipsin and BMI measurements and a negative correlation between E2, HbA1c and fasting glucose measurements in PCOS group. There was a statistically significant positive correlation between irisin and weight, BMI, waist/hip ratio, HbA1C, insulin (fasting), HOMA-IR, CRP measurements and a negative correlation between HDL measurement in PCOS group. A statistically significant positive correlation was found between osteopontin and weight, BMI, waist/hip ratio, insulin (fasting), HOMA-IR measurements in PCOS group. There was no statistically significant difference between adipsin, osteopontin and irisin values between phenotypes in PCOS group. As a result of logistic regression analysis for PCOS developmental risk, age, BMI, FSH, LH/FSH, total cholesterol and osteopontin measurements had a statistically significant effect on the groups (p<0.05). As a result of the evaluation by ROC analysis, it was determined that osteopontin measurement had a statistically significant effect on the groups. A decrease in osteopontin value below 2.323 ng / ml poses a risk of PCOS. Conclusion: In our study, it was shown that adipsin values were significantly associated with PCOS and this was related to BMI, while irisin was associated with anthropometric measurements and metabolic parameters. In the ROC analysis to determine the diagnostic value of osteopontin, it was found that a decrease in osteopontin value below 2.323 posed a risk of PCOS and was also shown to be associated with metabolic abnormalities in patients with PCOS. Calorimetric measurements of osteopontin levels may contribute to the early diagnosis, treatment and follow-up of PCOS and PCOS-related metabolic diseases. However, larger prospective studies are needed in this field. Key words: polycystic ovary syndrome, metabolic syndrome, insulin resistance, adipsin, irisin, osteopontin
Açıklama
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
