Polikistik over sendromu tanılı hastaların cushing sendromu açısından taranması
Yükleniyor...
Dosyalar
Tarih
2014
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Polikistik over sendromu (PKOS) ve Cushing sendromu hirsutizm, menstrual düzensizlik, obezite, glukoz intoleransı, dislipidemi gibi birçok ortak klinik bulguya sahiptir. Bu çalışmanın amacı hirsutizm ve/veya menstrual düzensizlik nedeniyle başvuran ve PKOS tanısı koyduğumuz hastaları Cushing sendromu açısından taramaktır.
Gereç ve Yöntemler: Çalışmaya PKOS tanısı koyduğumuz, yaşları 14-35 arasında değişen 109 hasta dahil edildi. Tüm hastalarda antropometrik, hormonal ve metabolik ölçümler yapıldı. Cushing sendromu açısından tüm hastalara 1 mg- deksametazon supresyon testi (DST) uygulandı.
Bulgular : Hastaların ortalama beden kitle indeksi ölçümleri 35.6± 9.5 kg/m2 olup, hastaların %75.2’sini obez grup oluşturuyordu. Hastaların ortalama Ferriman- Gallwey skoru 12.6 ± 3.7 olup, %61.1’inde menstrual düzensizlik mevcuttu. Hastaların ortalama açlık plazma glukoz düzeyleri 96.5 ± 12.8 mg/dl iken, ortalama HOMA-IR değerleri 3.2± 1.9 olarak saptandı. Hastaların %52.3’ünde HOMA-IR>2.7 olarak bulundu. Hastalar 1 mg DST ile tarandığında; sadece 3 hastada kortizol düzeylerinde supresyon olmadı. Daha sonra üç hastaya da 2 gün 2 mg DST uygulandı ve her üç hastada da kortizol düzeylerinin 1.8 µg/dl’nin altına indiği görüldü. Ciddi hirsutizmi olan hastalarda (n=34) ortalama1-mg DST değeri 0.73 ± 0.7 mg/dL idi; fakat hafif ya da orta düzeyde hirsutizmi olan hastalarda bu değer 0.64 ± 0.4 mg/dL olarak saptandı (p=0.427).
Sonuç: Polikistik over sendromu tanısı koyduğumuz genç kadınların hiçbirinde Cushing sendromu saptanmadı.
Objective: Polycystic ovary syndrome (PCOS) and Cushing’s syndrome share several clinical features such as hirsutism, irregular menses, obesity, glucose intolerance and dyslipidemia. The aim of this study was to investigate the presence of Cushing’s syndrome in patients who were admitted with the complaints of hirsutism and/or irregular menses and were diagnosed with PCOS. Material and Methods: One hundred nine patients with PCOS (aged 14-35 years) were included in the study. We evaluated anthropometric, hormonal, and metabolic parameters. All the patients were evaluated with 1-mg dexamethasone suppression test (DST) for Cushing’s syndrome. Results: The mean body mass index of the patients was 35.6 ± 9.5 kg/m2 and 75.2% of the patients were obese. The mean Ferriman-Gallwey score of the patients was 12.6 ± 3.7 and 61.1% of them had menstural irregularities. While the mean fasting plasma glucose level of the patients was 96.5 ± 12.8 mg/dl, mean value of HOMA-IR was 3.2 ± 1.9. We observed HOMA-IR>2.7 in 52.3% of the patients. Three patients failed to suppress plasma cortisol following1 mg- dexamethasone administration. Then, we performed 2-day 2 mg DST and observed that all the three patients suppressed cortisol levels to less than 1.8 µg/dl. In patients with severe hirsutism (n=34) the average 1-mg DST result was 0.73 ± 0.7 mg/dL in patients with mild and moderate hirsutism (n=75), however, this value was 0.64 ± 0.4 mg/dL (p=0.427). Conclusion: We did not observe Cushing’s syndrome in the young women who were diagnosed with PCOS.
Objective: Polycystic ovary syndrome (PCOS) and Cushing’s syndrome share several clinical features such as hirsutism, irregular menses, obesity, glucose intolerance and dyslipidemia. The aim of this study was to investigate the presence of Cushing’s syndrome in patients who were admitted with the complaints of hirsutism and/or irregular menses and were diagnosed with PCOS. Material and Methods: One hundred nine patients with PCOS (aged 14-35 years) were included in the study. We evaluated anthropometric, hormonal, and metabolic parameters. All the patients were evaluated with 1-mg dexamethasone suppression test (DST) for Cushing’s syndrome. Results: The mean body mass index of the patients was 35.6 ± 9.5 kg/m2 and 75.2% of the patients were obese. The mean Ferriman-Gallwey score of the patients was 12.6 ± 3.7 and 61.1% of them had menstural irregularities. While the mean fasting plasma glucose level of the patients was 96.5 ± 12.8 mg/dl, mean value of HOMA-IR was 3.2 ± 1.9. We observed HOMA-IR>2.7 in 52.3% of the patients. Three patients failed to suppress plasma cortisol following1 mg- dexamethasone administration. Then, we performed 2-day 2 mg DST and observed that all the three patients suppressed cortisol levels to less than 1.8 µg/dl. In patients with severe hirsutism (n=34) the average 1-mg DST result was 0.73 ± 0.7 mg/dL in patients with mild and moderate hirsutism (n=75), however, this value was 0.64 ± 0.4 mg/dL (p=0.427). Conclusion: We did not observe Cushing’s syndrome in the young women who were diagnosed with PCOS.
Açıklama
[Turgut Özal Tıp Merkezi Dergisi, (2014).21 (3)]
Anahtar Kelimeler
Polikistik Over Sendromu, Cushing Sendromu, 1 mg- Deksametazon Supresyon Testi, Polycystic Ovary Syndrome, Cushing’s Syndrome, 1 mg- Dexamethasone Supression Test
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
21
Sayı
3
Künye
Şahin, S. Baydur.,Sezgin, H.,Ayaz, T., Gür, E. Uslu.,İlkkılıç, K., Algün, E.,(2014).Polikistik over sendromu tanılı hastaların cushing sendromu açısından taranması.Turgut Özal Tıp Merkezi Dergisi, 21 (3).215-219 ss.
