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POLİKİSTİK OVER SENDROMLU HASTALARDA KRONİK İNFLAMMASYON BELİRTEÇLERİ OLAN hS -CRP, sICAM-1, sVCAM-1 VE sE-SELEKTİN DÜZEYLERİ

CHRONIC INFLAMMATION MARKERS hs-CRP, sICAM-1, sVCAM-1 AND sE-SELECTIN LEVELS IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME

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Abstract (2. Language): 
Objective: Patients with polycystic ovary syndrome have many risk factors associated with development of cardiovascular disease development. Presence of low grade chronic inflammation has been indicated as a risk factor for cardiovascular disease. We investigated the levels of hs-CRP, sICAM-1, sVCAM-1 and sE-Selektin as markers of chronic inflammation. Materials and methods: 40 women with diagnosis of PCOS (Polycystic ovary syndrome) according to Rotterdam 2003 PCOS defining criteria and 39 premenauposal otherwise healthy women taken as a control group were included in the study. Insulin resistance was estimated by fasting glucose/insulin ratio and HOMA index. Plasma hs-CRP, sICAM-1, sVCAM-1 and sE-selektin levels were determined by sandwich ELISA method. Mann Whitney U and spearman‟s correlation tests were used statistics. Results: Insulin resistance was deteced in 40% of patients with polycystic ovary syndrome.When compared wih control patients total cholesterol (p<0.05), VLDL (p<0.0001) and triglyceride (p<0.01) were higher in patients with PCOS. There were no significant differences in the levels the LDL and HDL. The levels of hs-CRP (p<0.001), sICAM-1 (p<0.001) and sE-selectin (p<0.0001) in patients with PCOS were higher than control group but there was no difference in sVCAM-1 levels between the groups. There was positive correlation according to Spearman‟s test between hs-CRP/sICAM-1 (r=0.251; p<0.05) and sE-selektin/sICAM-1 (r=0.317; p<0.05). Conclusion In patients with PCOS the presence of chronic low grade inflammation which is a risk factor for endothelial dysfunction hence cardiovascular disease is demonstrated. But there is yet no prospective randomised study dealing with mortality due to cardiovascular disease in patients with PCOS.
Abstract (Original Language): 
Amaç: Polikistik over sendromlu hastalar, kardiovasküler hastalık geliĢimi için birçok risk faktörü taĢırlar. DüĢük derecede kronik inflammasyonun endotel disfonksiyonuna neden olarak kardiovasküler hastalığa yol açtıgı bilinmektedir.Biz de polikistik over sendromlu hastalarda bu sürecin belirteçlerinden olabileceğini düĢündüğümüz hs-CRP, sICAM-1, sVCAM-1 ve sE-Selektin düzeylerini araĢtırdık. Materyal ve metod: Rotterdam 2003 PKOS( polikistik over sendromu) tanı kriterleri kullanılarak PKOS tanısı konulan 40 hasta çalıĢma grubunu oluĢturuken 39 sağlıklı premenapozal kadının kontrol grubunu oluĢturduğu toplam 79 olgu çalıĢmaya dahil edildi. Ġnsülin direncini hesaplamada açlık glukoz/insülin oranları ve HOMA indeksi kullanıldı. Plazma hs-CRP, sICAM-1, sVCAM-1 ve sE-Selektin düzeyleri sandviç ELISA yöntemi kullanılarak ölçüldü. Parametrelerin karĢılaĢtırılmasında Mann Whitney –U ve Spearman korelasyon testleri kullanıldı. Bulgular: PKOS‟lu hastaların %40 ında insülin direnci saptandı. PKOS‟lu hastalarda total kolesterol (p<0,05), VLDL (p<0,0001) ve trigliserit (p<0,01) düzeylerinde kontrol grubuna kıyasla anlamlı bir artıĢ saptandı. LDL ve HDL konsantrasyonlarında ise kontrol grubuna kıyaslandığında anlamlı bir fark saptanmadı. hs-CRP, sICAM-1, sVCAM-1 ve sE-selektin seviyeleri açısından yapılan karĢılaĢtırmada PKOS‟lu kadınlarda plazma hs-CRP (p<0,001), sICAM-1 (p<0,001) ve sE-selektin (p<0,0001) düzeyleri kontrollere kıyasla daha yüksek olduğu saptandı, sVCAM konsantrasyonlarında ise bir fark bulunmadı. Spearman korrelasyon testi uygulandığında hs-CRP/sICAM-1 (r=0,251; p<0,05) ve sE-selektin/sICAM-1 (r=0,317; p<0,05) arasında pozitif bir korrelasyon olduğu saptandı. Sonuç: PKOS‟lu hastalarda endotel hasarına neden olarak kardiovasküler hastalık riskini arttıran düĢük seviyede kronik inflammasyonun varlığı gösterilmiĢtir. Her ne kadar kardiovasküler mortalitenin PKOS‟lu hastalarda artmıĢ olduğu tam olarak gösterilememiĢ olsa da henüz prospektif randomize bir çalıĢma mevcut değildir
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