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Polikistik over sendromlu hastalarda metformin ile tedavi öncesi ve sonrası serumda yüksek sensitif C-reaktif protein değerlerinin karşılaştırılması

Başlık çevirisi mevcut değil.

  1. Tez No: 171635
  2. Yazar: HEMAYAT AMİRİ
  3. Danışmanlar: PROF.DR. ERTUĞRUL TAŞAN
  4. Tez Türü: Tıpta Uzmanlık
  5. Konular: Endokrinoloji ve Metabolizma Hastalıkları, Endocrinology and Metabolic Diseases
  6. Anahtar Kelimeler: Belirtilmemiş.
  7. Yıl: 2006
  8. Dil: Türkçe
  9. Üniversite: İstanbul Üniversitesi
  10. Enstitü: Cerrahpaşa Tıp Fakültesi
  11. Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
  12. Bilim Dalı: Belirtilmemiş.
  13. Sayfa Sayısı: 29

Özet

SUMMARY Objective: In this study, we aimed to compare pre- and post-treatment high sensitive C- reactive protein (hs CRP) levels by metformin use in 30 patients who have been admitted to Cerrahpaşa medical faculty, Endocrinology, Metabolism and Diabetes outpatient clinic with a diagnosis of polycystic ovary syndrome. Patients and method: Our study has been designed among totally 30 women with PCOS (average BMI:27,65 kg/m2) who were between 15-35 years of age. Patients who have being taken ciproteron acetate which is an oral contraceptive drug, used for PCOS treatment have been excluded. Moreover, use of drugs that may affect plasma lipid, glucose and insulin levels and having any disorder which may influence to those has been accepted as an exclusion criterion. PCOS has been diagnosed by means of the critera which goes as follows: typical appearence on transabdominal, transvaginal or transrectal ultrasonography; clinical manifestations of hyperandrogenism such as oligomenorrhea, acne and hirsutismus those are supported by routine laboratory tests ( FSH, LH, free testosteron, estradiol, 17-a hydroxyprogesterone, DHEAS04, all of which are examined in follicular phase of cyclus). All the 30 patients included were drawn blood for hsCRP analysis before the treatment. Then, they took metformin 850 mg tablet after meals once a day for the first week. After that, metformin dose has been increased up to 1700 mg, twice daily for the next three months. At the end of the third month of therapy, blood has been obtained from the patients for h-CRP analysis. Overall, blood samples were taken totally four times from the patients for simultaneous biochemical (which were obtained in non-follicular phase) and hormonal analyses in follicular phase. Results: In our study, post-treatment hsCRP levels by metformin use has been found to decrease in statistically significant degrees in women with PCOS. Additionally, infertility parameters has also decreased significantly. Although pre-treatment TG and LDL levels found in high levels in women with PCOS were observed to decrease after metformin treatment, this decreament has not reached to statistical significance. Besides, HDL, VLDL and total cholesterol levels were also not found to change significantly. Although there were not any statistically significant difference in pre- and post-treatment levels of HbAlc and insulin, a non-significant decreament in those levels has been observed in individual comparison. Conclusion: Agents such as metformin which setdown insulin levels have been shown to improve insulin sensitivity, hyperandrogenism, menstrual pattern, and ovulatory function in obese and non-obese women eventually by means of decreament in central obesity. Also in this study, pre-treatment hsCRP levels have been observed to decrease significantly in obese and non-obese women who have been treated by metformin in a 1700mg per day dose for a three months of time period. These results indicate that beneficial effects of metformin influence serum hsCRP levels either. More, serum hsCRP levels may have a role in follow-up of PCOS. 24

Özet (Çeviri)

SUMMARY Objective: In this study, we aimed to compare pre- and post-treatment high sensitive C- reactive protein (hs CRP) levels by metformin use in 30 patients who have been admitted to Cerrahpaşa medical faculty, Endocrinology, Metabolism and Diabetes outpatient clinic with a diagnosis of polycystic ovary syndrome. Patients and method: Our study has been designed among totally 30 women with PCOS (average BMI:27,65 kg/m2) who were between 15-35 years of age. Patients who have being taken ciproteron acetate which is an oral contraceptive drug, used for PCOS treatment have been excluded. Moreover, use of drugs that may affect plasma lipid, glucose and insulin levels and having any disorder which may influence to those has been accepted as an exclusion criterion. PCOS has been diagnosed by means of the critera which goes as follows: typical appearence on transabdominal, transvaginal or transrectal ultrasonography; clinical manifestations of hyperandrogenism such as oligomenorrhea, acne and hirsutismus those are supported by routine laboratory tests ( FSH, LH, free testosteron, estradiol, 17-a hydroxyprogesterone, DHEAS04, all of which are examined in follicular phase of cyclus). All the 30 patients included were drawn blood for hsCRP analysis before the treatment. Then, they took metformin 850 mg tablet after meals once a day for the first week. After that, metformin dose has been increased up to 1700 mg, twice daily for the next three months. At the end of the third month of therapy, blood has been obtained from the patients for h-CRP analysis. Overall, blood samples were taken totally four times from the patients for simultaneous biochemical (which were obtained in non-follicular phase) and hormonal analyses in follicular phase. Results: In our study, post-treatment hsCRP levels by metformin use has been found to decrease in statistically significant degrees in women with PCOS. Additionally, infertility parameters has also decreased significantly. Although pre-treatment TG and LDL levels found in high levels in women with PCOS were observed to decrease after metformin treatment, this decreament has not reached to statistical significance. Besides, HDL, VLDL and total cholesterol levels were also not found to change significantly. Although there were not any statistically significant difference in pre- and post-treatment levels of HbAlc and insulin, a non-significant decreament in those levels has been observed in individual comparison. Conclusion: Agents such as metformin which setdown insulin levels have been shown to improve insulin sensitivity, hyperandrogenism, menstrual pattern, and ovulatory function in obese and non-obese women eventually by means of decreament in central obesity. Also in this study, pre-treatment hsCRP levels have been observed to decrease significantly in obese and non-obese women who have been treated by metformin in a 1700mg per day dose for a three months of time period. These results indicate that beneficial effects of metformin influence serum hsCRP levels either. More, serum hsCRP levels may have a role in follow-up of PCOS. 24

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