Sažetak | Cilj istraživanja: Primarni cilj ovog istraživanja je pokazati korelaciju HOMA-IR indeksa s
razinama triglicerida i SHBG-a, promatrajući ih kao parametre predviđanja razvoja ili već
razvijene inzulinske rezistencije kod bolesnica s PCOS-om. Sekundarni cilj ovog istraživanja
je pookazati korelaciju HOMA-IR indeksa s razinama HbA1c, urata, HDL i LDL kolesterola
u pacijentica s PCOS-om.
Ispitanici i metode: U istraživanje je uključeno 30 ispitanica sa sindromom policističnih
jajnika što je bio jedini kriterij uključenja u istraživanje. Iz istraživanja su isključene bolesnice
na terapiji oralnim kontraceptivima i metforminom, trudnice, žene mlađe od 18 godina i žene
u menopauzi. Ispitanice su ispunile anketni upitnik o životnim navikama, fizičkoj aktivnosti,
redovitosti menstrualnog ciklusa, duljini trajanja dijagnoze PCOS-a i s tim sindromom
povezanih simptoma. Nakon toga su izvagane na bioimpendacijskoj vagi i uzorkovana je krv
za laboratorijsku dijagnostiku. U krvi su određene vrijednosti spolnih hormona, glukoze,
inzulina, HbA1c (glikolizirani hemoglobin), lipida, urata i vitamina D. Nakon izračunavanja
HOMA indeksa (umnožak vrijednosti inzulina i glukoze mjeren natašte podijeljen s 22,5),
promatrana je korelacija opisanih laboratorijskih parametara i HOMA indeksa.
Rezultati: Dokazana je pozitivna korelacija triglicerida i HOMA indeksa (ρ=0,604; P<0,001),
negativna korelacija SHBG-a i HOMA indeksa (ρ= -0,675; P<0,001) te HDL-a i HOMA
indeksa (ρ= -0,693, P<0,001). Nije dokazana statistički značajna korelacija između HOMA
indeksa i urata (ρ=0.384; P=0,07), HbA1c-a (ρ=0,3; P=0,136) te LDL-a (ρ=0,267; P=0,196).
Zaključak: Koncentracija triglicerida se zbog statistički značajne pozitivne korelacije s
HOMA indeksom može koristiti kao parametar predviđanja razvoja ili već razvijene
inzulinske rezistencije kod bolesnica s PCOS-om. Isto vrijedi i za SHBG te HDL koji zbog
statistički značajne negativne korelacije s HOMA indeksom, imaju protektivnu ulogu u
razvoju inzulinske rezistencije i ostalih metaboličkih komplikacija PCOS-a. Povećanje
koncentracije SHBG-a i HDL-a će utjecati na poboljšanje kliničke slike bolesnica s PCOSom, ali i smanjiti rizik razvoja metaboličkog sindroma. |
Sažetak (engleski) | Objectives and background: The primary goal of this research is to show the correlation of
HOMA-IR index with triglyceride and SHBG levels, observing them as parameters for
predicting the development or already developed insulin resistance in patients with PCOS.
The secondary goal of this research is to show the correlation of HOMA-IR index and
HbA1c, LDL, HDL and urate levels.
Patients and methods: There were 30 patients with polycystic ovary syndrome that were
included in the study, which was the only inclusion criteria. Patients on oral contraceptives
and metformin therapy, pregnant women, women under the age of 18 and women in
menopause were excluded from the study. Patients filled out a questionnaire about lifestyle
habits, physical activity, regularity of the menstrual cycle, duration of PCOS diagnosis and
symptoms associated with this syndrome. After that, they were weighed on a bioimpedance
scale and blood was sampled for laboratory diagnostics. The concentrations of sex hormones,
glucose, insulin, HbA1c (glycated haemoglobin), lipids, urate and vitamine D were
determined in the blood. After calculating the HOMA index (which is calculated by dividing
the product of fasting insulin and glucose values by 22.5), the correlation between the
described laboratory parameters and the HOMA index was observed.
Results: A positive correlation between triglycerides and HOMA index (ρ=0.604; P<0.001)
and a negative correlation between SHBG and HOMA index (ρ= -0.675; P<0.001) and HDL
and HOMA index (ρ= -0.693, P<0.001) was proven. No statistically significant correlation
between the HOMA index and urate (ρ=0.384; P=0.07), HbA1c (ρ=0.3; P=0.136) and LDL
(ρ=0.267; P=0.196) concentrations was proven.
Conclusion: Triglyceride concentration can be used as a parameter for predicting the
development or already developed insulin resistance in patients with PCOS due to the
statistically significant positive correlation with the HOMA index. The same applies to SHBG
and HDL, which, due to the statistically significant negative correlation with the HOMA
index, have a protective role in the development of insulin resistance and other metabolic
complications of PCOS. Increasing the concentration of SHBG and HDL will affect the
improvement of the clinical features of a patient with PCOS and reduce the risk of developing
metabolic syndrome later in life. |