ORİJİNAL ARAŞTIRMALAR
Prematür Over Yetmezliği Tanısı Alan Kadınlarda Serum Androjen Seviyeleri
Circulating Androgen Levels in Women with Premature Ovarian Insufficiency
Received Date : 13 Jan 2023
Accepted Date : 10 Jul 2023
Available Online : 20 Jul 2023
Seda ATEŞa, Çaglar ÇETİNa, Taha Süreyya FİRİDİNa, Serdar AYDINb
aDepartment of Obstetrics and Gynecology, Bezmialem Vakıf University, Faculty of Medicine, İstanbul, Türkiye
bDepartment of Obstetrics and Gynecology, Ko. University School of Medicine, İstanbul, Türkiye
Doi: 10.24074/tjrms.2023-95446 - Makale Dili: EN
TJRMS. 2023;7(2):54-60
ÖZET
Amaç: Bu çalışmada prematür over yetmezliği (POY) tanısı alan kadınlarla aynı yaşta düzenli adet gören kadınlardaki serum androjen seviyelerinin
karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: POY tanısı almış 62 hasta ve düzenli adet siklusu olan 62 kadından oluşan
sağlıklı kontrol grubu vaka kontrol çalışmasına dahil edildi. Hastaların demografik özellikleri ve klinik bilgileri sorgulandı. Serum hormon
parametreleri arasında total testosteron, seks hormon bağlayıcı globulin (SHBG), dehidroepiandrosteron sülfat (DHEAS), dehidroepiandrosteron
(DHEA) ve androstenedion (AS), folikül uyarıcı hormon (FSH), estradiol ve antimüllerian hormon (AMH) seviyeleri ölçüldü. Ek olarak serbest
androjen indeksi (FAI) ve biyolojik olarak kullanılabilir (bioavailable) testosteron seviyeleri hesaplandı. Bulgular: POY grubu ile kontrol grubu
arasında total testosteron, hesaplanan androjen indeksleri (bioavailable testosteron, FAI), SHBG ve DHEA seviyeleri arasında fark bulunmazken
DHEAS ve AS konsantrasyonu, POY grubunda kontrol grubuna göre anlamlı olarak daha düşük olarak saptandı (sırasıyla p=0,002; p=0,036).
Çalışmamızda POY tanısı alan 62 kadından sadece 15'i (%24) HRT kullanmıştır. DHEAS konsantrasyonu kontrol grubunda, POY'lu kadınlara
(HRT kullanan veya kullanmayan) kıyasla anlamlı olarak daha yüksekti (p=0.002). BMI, FAI (r= 0.318, p< 0.001) ve bioavailable testosteron
(r= 0.241, p= 0.008) ile pozitif korelasyon gösterdi. Yaş ile DHEAS düzeyleri arasında ters yönde korelasyon saptandı (r= -0.209, p= 0.002).
Sonuç: Bulgularımız POY grubunda serum androjen profilinin DHEAS seviyeleri haricinde sağlıklı kontrol grubuyla benzer olduğunu göstermektedir.
Bu çalışma POY’da görülen androjen düşüklüğü primer olarak bir adrenal defekte bağlı olabileceğini göstermiştir.
Anahtar Kelimeler: Prematür over yetmezliği, androjen, testosteron, DHEAS
ABSTRACT
Objective: The objective of our study was to assess the androgen status in women with premature ovarian insufficiency (POI) compared to agematched
regularly menstruating women. Material and Methods: Sixty-two women with POI and 62 healthy women with regular menstrual
cycles as the control group participated in this case control study. The information about their clinical characteristics were collected. Serum hormone
parameters included total testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone
(DHEA), and androstenedione (AS). Levels of follicle stimulating hormone (FSH), estradiol and AMH were also measured.
Additionally, the free androgen index (FAI), and bioavailable testosterone were calculated. Results: The levels of total testosterone, calculated
androgen indices (bioavailable testosterone, FAI), SHBG and DHEA did not differ between POI group and the control group. The levels of
DHEAS and AS were significantly lower in POI group compared with the controls (p=0.002; p=0.036, respectively). In our study, only 15 of the
62 women with POI (24%) used HRT. DHEAS levels were significantly higher in the control group compared to the women with POI who did
or did not use HRT (p=0.002). BMI correlated positively with FAI (r= 0.318, p< 0.001) and with bioavailable testosterone (r= 0.241, p= 0.008).
An inverse correlation was found between age and DHEAS levels (r= -0.209, p= 0.002). Conclusion: Our findings indicate that the androgen
profile in women with POI is similar to those observed in healthy controls with the exception of serum DHEAS levels. This study showed that
androgen decline seen in POI may be primarily related to an adrenal defect.
Keywords: Premature ovarian insufficiency, androgen, testosterone, DHEAS
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