Investigation of Relationship Between Nesfatin' S, Chemerin' S, Apelin' S Levels and Insulin Resistance and Metabolik Syndrome in Polycystic Ovary Syndrome (PCOS) Patients
Abstract
Polikistik over sendromu (PKOS) reprodüktif dönemdeki kadınların %5- 10' unda görülen, anovülasyon, hiperandrojenemi ve insülin direnci ile karakterize bir durumdur. Hiperinsülinemi hem PKOS' un oluşması hem de eşlik eden metabolik bozuklukların mekanizmasında merkezi rol oynamaktadır. Apelin, önceleri kardiyak kontraktilite ve sıvı dengesinin sağlanmasında rol aldığı düşünülen ancak son dönemde insülin duyarlılığının korunmasında temel bir peptid olduğu ortaya konulan bir adipokindir. Son zamanlarda keşfedilen bir hormon olan nesfatin; enerji balansı, glikoz metabolizması, obezite ve muhtemelen gonadal fonksiyonlar üzerine etki etmektedir. Chemerin ise ilk kez enflamatuar süreçlerde chemR23 eksprese eden makrofajlarda ve dentritik hücrelerde kemotaktik peptid olarak keşfedilmiştir. Pleiotropik işlevlere sahip olduğu görülen chemerin adipokinlerin farklılaşmasını sağladığı ve bu sayede glikoz uptake' inde görev aldığı için adipokin olarak sınıflandırılmıştır. Bu çalışmaya; European Society for Human Reproduction and Embryology / The American Society for Reproductive Medicine (ESHRE/ASRM) tanı kriterlerine göre PKOS tanısı koyulan 80 (40 obez ve 40 nonobez) hasta ve 40 sağlıklı olgu dahil edilmiştir. PKOS' lu hasta gruplarının serum nesfatin, chemerin, apelin düzeyleri kontrol grubuile karşılaştırılmış ayrıca bu peptidlerle gonadotropinler, androjenler, insülin, insülin rezistansı (IR) ve lipid profili ve Metabolik Sendrom (MS) arasında ilişki olup olmadığı araştırılmıştır. Çalışmamızda; nonobez PKOS hasta ve obez PKOS hasta grubunun nesfatin değerleri (0,847 ± 0,091), (0,741 ± 0,14) kontrol grubundan (2,108 ± 0,13) anlamlı düzeyde düşük bulundu. Nonobez PKOS hasta ve obez PKOS hasta grubunun chemerin değerleri (313,573 ± 37,904), (344.312 ± 38,623) kontrol grubundan (232,788 ± 22,187) anlamlı düzeyde yüksek bulundu. Nonobez PKOS hasta ve obez PKOS hasta grubunun apelin değerleri (0,304 ± 0,093), (0,311 ± 0,042) kontrol grubundan (0,233 ± 0,027) anlamlı düzeyde yüksek bulundu. Nesfatin, chemerin ve apelin değerleri obez PKOS hasta grubunda MS ile anlamlı şekilde korele izlendi. Nonobez PKOS hasta grubunda; HOMA-IR (Homeostasis Model Assesment – İnsülin Resistance) ile apelin ( r:0,403, p < 0,01) ve nesfatin ( r:-0,365, p < 0,05)arasında istatistiksel olarak anlamlı şekilde negatif korelasyon saptandı. Obez PKOS hasta grubunda; HOMA-IR ile apelin ( r:-0,379, p < 0,05) ve nesfatin ( r:-0,376, p < 0,05) arasında istatistiksel olarak anlamlı şekilde negatif korelasyon saptandı. Chemerin ile HOMA-IR arasında hiçbir grupta anlamlı düzeyde korelasyon saptanmadı. Sonuç olarak; PKOS tanısı alan ve insülin direnci saptanan hastaların serumlarında nesfatin düzeyi sağlıklı kontrol grubuna göre anlamlı şekilde düşük, apelin düzeyi ise yüksek saptanırken chemerin ve insülin direnci arasında ilişki saptanmamıştır. PKOS tanısı koyulan hastalarda serum nesfatin ve apelin düzeylerine bakılarak insülin direnci öngörülebilir. Anahtar Kelimeler: polikistik over sendromu, apelin, chemerin, nesfatin, insülin direnci.
Polycystic ovary syndrome (PCOS) is a condition seen % 5-10 in women of reproductive age which is characterized by anovulation, hyperandrogenism and insulin resistance. Hyperinsulinemia is seem to play a central role in PCOS and in the mechanism of concomitant metabolic disorders. Apelin is an adipokine, which has been previously thought to be only involved in cardiac contractility and maintaining fluid balance, but recently demonstrated that it is a basic peptide set forth in the protection of insulin sensitivity. The nesfatin, which recently discovered hormone, acts on energy balance, glucose metabolism, obesity, and possibly on gonadal functions. Chemerin was discovered the first time in inflammatory processes in macrophages and dendritic cells expressing chemr23 chemotactic peptide. Chemerin is classified as adipokine as a result of appearing have pleitropic functions that providing differentiation adipokins and this playing role in glukoz uptake. İn this study, 80 PCOS ' s patients (40 non-obese and 40 nonobese) diagnosed according to European Society for Human Reproduction and Embryology / The American Society for Reproductive Medicine (ESHRE/ASRM). İt is arranged to determine whether to show the changes PCOS patients' s nesfatin, chemerin, apelin levels according to healthy control group and whether the relationship between these peptides and gonadotropins, androgens, insulin, insulin resistance and lipid profile and also Metabolik Syndrome (MS). In our study, nonobese PCOS patients and obese nesfatin the value of PCOS patients (0,847 ± 0,091), (0,741 ± 0,142) than the control group (2,108 ± 0,977) were found to be significantly lower. In our study, nesfatin values of nonobese PCOS patients (0,847 ± 0,091) and obese patients (0,741 ± 0,142) were found to be significantly lower than the control group (2,108 ± 0,977). Chemerin values of Nonobese PCOS patients (313,573±37,904) and obese PCOS patients (344.312±38,623) found to be significantly higher than the control group (232,788±22,187). Apelin values of Nonobese PCOS patients (0,304 ± 0,093) and obese PCOS patients (0,311 ± 0,042) found to be significantly higher than the control group (0,233 ± 0,027). Nesfatin, Chemerin and Apelin values in obese PCOS patients were observed significantly correlated with MS. İn nonobese PCOS patients group; statistically significant positive correlation was found between the HOMA-IR (homeostasis model assesment - Insulin Resistance) and Apelin (r: 0.403, p <0.01). In obese PCOS patients group; Statistically, significant positive correlation was found between HOMA-IR and Apelin (r = 0.379, p <0.05). Statistically, significant negative correlation was found between HOMA-IR and nesfatin (r = -0.376, p <0.05). No significant correlations was found between HOMA-IR and Chemerin in any group. As a result, diagnosis of PCOS and insülin resistance was detected in the serum of patiance that according to the healthy control group Nesfatin level has significantly lowest figure and Apelin level has highest figure. On the ather hand, there is no relationship between Chemerin and insülin resistance. Diagnosis of PCOS patians coverage of the level of the serum Nesfatin and Apelin levels can be looking toward insulin resistance. Keywords: polycystic ovary syndrome, apelin, chemerin, nesfatin, insulin resistance,
Polycystic ovary syndrome (PCOS) is a condition seen % 5-10 in women of reproductive age which is characterized by anovulation, hyperandrogenism and insulin resistance. Hyperinsulinemia is seem to play a central role in PCOS and in the mechanism of concomitant metabolic disorders. Apelin is an adipokine, which has been previously thought to be only involved in cardiac contractility and maintaining fluid balance, but recently demonstrated that it is a basic peptide set forth in the protection of insulin sensitivity. The nesfatin, which recently discovered hormone, acts on energy balance, glucose metabolism, obesity, and possibly on gonadal functions. Chemerin was discovered the first time in inflammatory processes in macrophages and dendritic cells expressing chemr23 chemotactic peptide. Chemerin is classified as adipokine as a result of appearing have pleitropic functions that providing differentiation adipokins and this playing role in glukoz uptake. İn this study, 80 PCOS ' s patients (40 non-obese and 40 nonobese) diagnosed according to European Society for Human Reproduction and Embryology / The American Society for Reproductive Medicine (ESHRE/ASRM). İt is arranged to determine whether to show the changes PCOS patients' s nesfatin, chemerin, apelin levels according to healthy control group and whether the relationship between these peptides and gonadotropins, androgens, insulin, insulin resistance and lipid profile and also Metabolik Syndrome (MS). In our study, nonobese PCOS patients and obese nesfatin the value of PCOS patients (0,847 ± 0,091), (0,741 ± 0,142) than the control group (2,108 ± 0,977) were found to be significantly lower. In our study, nesfatin values of nonobese PCOS patients (0,847 ± 0,091) and obese patients (0,741 ± 0,142) were found to be significantly lower than the control group (2,108 ± 0,977). Chemerin values of Nonobese PCOS patients (313,573±37,904) and obese PCOS patients (344.312±38,623) found to be significantly higher than the control group (232,788±22,187). Apelin values of Nonobese PCOS patients (0,304 ± 0,093) and obese PCOS patients (0,311 ± 0,042) found to be significantly higher than the control group (0,233 ± 0,027). Nesfatin, Chemerin and Apelin values in obese PCOS patients were observed significantly correlated with MS. İn nonobese PCOS patients group; statistically significant positive correlation was found between the HOMA-IR (homeostasis model assesment - Insulin Resistance) and Apelin (r: 0.403, p <0.01). In obese PCOS patients group; Statistically, significant positive correlation was found between HOMA-IR and Apelin (r = 0.379, p <0.05). Statistically, significant negative correlation was found between HOMA-IR and nesfatin (r = -0.376, p <0.05). No significant correlations was found between HOMA-IR and Chemerin in any group. As a result, diagnosis of PCOS and insülin resistance was detected in the serum of patiance that according to the healthy control group Nesfatin level has significantly lowest figure and Apelin level has highest figure. On the ather hand, there is no relationship between Chemerin and insülin resistance. Diagnosis of PCOS patians coverage of the level of the serum Nesfatin and Apelin levels can be looking toward insulin resistance. Keywords: polycystic ovary syndrome, apelin, chemerin, nesfatin, insulin resistance,
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Kadın Hastalıkları ve Doğum, Apelin, Kimerin, Metabolik Sendrom, Nesfatin 1, Polikistik Over Sendromu, Insülin Direnci, Obstetrics and Gynecology, Apelin, Chemerin, Metabolic Syndrome, Nesfatin 1, Polycystic Ovary Syndrome, Insulin Resistance
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