Da li postoji korelacija oblika glikemijske krive i rezistencije na insulin u toku testa oralnog opterećenja glukozom kod žena obolelih od sindroma policističnih jajnika?
Sažetak
Apstrakt
Uvod/Cilj. Učestalost insulinske rezistencije u grupi bolesnica sa sindromom policističnih jajnika (PCOS) kreće se od 60% do 80%, dok u populaciji gojaznih žena sa PCOS iznosi čak 95%. Ranija istraživanja su pokazala da oblik glikemijske krive u toku testa oralnog opterećenja glukozom (OGTT) može biti koristan metabolički skrining parametar za rizik od nastanka dijabetesa melitusa tip II. Cilj rada bio je odrediti učestalost insulinske rezistencije prema homeostaznom modelu procene insulinske rezistencije (HOMA-IR) i metodom indirektne procene insulinske rezistencije na osnovu insulinemija u toku OGTT (u daljem tekstu “vrednosti insulinemija u toku OGTT”), kao i učestalost oblika glikemijske krive (monofazne, bifazne, trifazne) u populaciji bolesnica sa PCOS. Takođe, cilj studije je bio ispitivanje povezanosti oblika glikemijske krive, kao i vremena glikemijskog pika u toku OGTT sa insulinemijama, sa prisustvom insulinske rezistencije u populaciji žena sa PCOS. Metode. Bolesnice smo posmatrali u odnosu na prisustvo insulinske rezistencije, oblik glikemijske krive i u odnosu na vreme glikemijskog i insulinskog pika u toku OGTT. Rezultati. Učestalost insulinske rezistencije na osnovu HOMA-IR > 2,5 iznosila je 66,19%, dok je na osnovu vrednosti insulinemija u toku OGTT iznosila 78,42%. Monofazni oblik glikemijske krive
u toku OGTT je imalo 293 (70,26%), bifazni 56 (13,43%), a trifazni oblik krive 68 (16,31%) bolesnica. Statistički značajna razlika u pogledu učestalosti insulinske rezistencije u odnosu na oblik glikemijske krive registrovana je kada je insulinska rezistencija bila definisana na osnovu vrednosti insulinemija u toku OGTT (p = 0,005). Zaključak. Prema rezultatima studije, većina bolesnica sa PCOS ima monofazni oblik glikemijske krive. Kada govorimo o učestalosti insulinske rezistencije u odnosu na oblik krive, uočava se približno ista učestalost kada insulinsku rezistenciju definišemo po HOMA-IR. S druge strane, kada insulinsku rezistenciju definišemo na osnovu vrednosti insulinemija u toku OGTT, bolesnice sa insulinskom rezistencijom većinom imaju trifazni oblik glikemijske krive.
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