Polikistik Over Sendromlu Ergenlerde Kas Kuvvetinin Değerlendirilmesi
Özet
Polycystic ovary syndrome (PCOS) is an endocrinological disease, the foundations of which are are laid in adolescence, is most common in women of reproductive age and progresses with androgen elevation and chronic anovulation. Although there are studies on evaluating the muscle strength level of PCOS in adults, there are no studies investigating muscle strength and mass in adolescence. In this study, the primary hypothesis is that quadriceps muscle strength and thickness measurements may increase in the PCOS group compared to the healthy group due to increased testosterone levels, and the second hypothesis is that muscle strength parameters, which are thought to increase due to testosterone exposure in the patient group, may decrease due to decreased testosterone as a result of oral contraceptive treatment. The aim of the study was to compare muscle strength and thickness in PCOS during adolescence before and after oral contraceptive treatment and to investigate the relationships between anthropometric, biochemical and hormonal parameters and muscle strength and mass. The study included 20 adolescents with PCOS patients who met the PCOS diagnostic criteria specific to adolescence and 20 healthy adolescents at a similar pubertal stage, matched by age and BMI. Muscle strength of the participants was measured by isokinetic dynamometer, which is considered the gold standard for lower extremity analysis, and a practical and widely used hand dynamometer for the upper extremity. Anterior thigh muscle thickness measurement was performed with ultrasound, which was used for the first time in the literature for mass measurement in PCOS. The mean age in the PCOS patient and control group was 15.7±0.6 and 15.8±1.3 years (p=0.684), and the median body mass index (BMI) values were 22.9 (17.9-39.7) and 22.2 (17.6-39.2) (p=0.808) respectively. There was also no statistically significant difference between the groups in terms of initial physical activity score(p=0,461), thigh muscle thickness(p=0,525), isokinetic 60° extension (p=0,889), 180° extension (p=0,402) and hand dynamometer strength analysis results (p=0,746). In the patient group, height (p=0.010), weight (p=0.035) and BMI (p=0.030), LDL (low density lipoprotein cholesterol) (p=0.001), total cholesterol (p<0.001), triglyceride (p=0.003) and HDL (high density lipoprotein cholesterol) (p=0.030) values increased statistically significantly, luteinizing hormone (LH) (p=0.000), folicular stimulating hormone (FSH) (p=0.017) and total testosteron (p=0.001) values were found to decrease statistically significantly at the 6th month. In PCOS patients, although no statistically significant difference was observed in thigh thickness measurements and upper extremity strength measurements (p>0.05), statistically significant increase was observed in isokinetic lower extremity 60° extension (p=0.008), 60° flexion (p=0.018) and 180° extension (p=0.001) peak torque (PT) measurements after the 6th month of treatment. A positive relationship was observed between BMI measurement, thigh thickness (r=0.672, p=0.001), 60° extension PT (r=0.535, p=0.015), 60° flexion PT (r=0.707, p<0.001), 180° flexion PT ( r=0.560, p=0.010), also a positive relationship between the serum insulin levels and 60° extension PT (r=0.498, p=0.025), 60° flexion PT (r=0.457, p=0.043) and 180° flexion PT (r=0.565, p=0.009) measuremts, and HOMA-IR values and 60° extension PT (r=0.615, p=0.004), 180° extension PT (r=0.489, p=0.029) and maximum hand grip strength (r=0.557, p=0.011) measurements. No relationship was found between fasting blood sugar and testosterone measurement values and thigh thickness, maximum hand grip strength and strength parameters (p>0.05). Increasing the studies examining the PCOS-muscle relationship in the literature is very important in terms of developing appropriate exercise programs in exercise management, which is essential in the holistic management of the disease.
