Korelasi Jumlah Folikel Antral dengan Kadar 25(OH)D Serum pada Penderita Sindrom Ovarium Polikistik
Abstract
Sindrom ovarium polikistik (SOPK) ditandai oleh hiperandrogenisme, oligo atau anovulasi, dan morfologi ovarium polikistik. Penanda ovarium polikistik, yaitu terdapat ≥12 folikel antral dengan diameter 2–9 mm pada pemeriksaan ultrasonografi. Vitamin D (25-hidroksivitamin D; 25(OH)D) berperan pada proses steroidogenesis di sel teka ovarium dan pengaturan ekspresi reseptor follicle stimulating hormone (FSH) di sel granulosa ovarium. Defisiensi 25(OH)D menyebabkan penurunan aktivitas FSH, sehingga folikel antral di ovarium berukuran kecil dan berjumlah banyak. Tujuan penelitian ini mengetahui korelasi jumlah folikel antral dengan kadar 25(OH)D serum pada penderita SOPK. Uji observasional analitik dengan rancangan potong lintang di Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS) Bandung dilakukan selama bulan September 2017─Juni 2018. Subjek penelitian adalah 52 penderita SOPK yang telah didiagnosis oleh klinisi obstetri dan ginekologi RSHS Bandung. Pengambilan darah vena dilakukan untuk pemeriksaan kadar 25(OH)D serum dengan metode ELISA. Hasil penelitian ini mendapatkan 56% subjek memiliki kadar 25(OH)D serum ≤20 ng/mL. Hasil uji korelasi Spearman didapatkan korelasi negatif kuat yang bermakna (r = -0,867, p<0,001) jumlah folikel antral dengan kadar 25(OH)D serum. Kadar 25(OH)D serum yang rendah pada penderita SOPK berkorelasi dengan jumlah folikel antral yang banyak. Terdapat korelasi negatif antara jumlah folikel antral dan kadar 25(OH)D serum pada penderita SOPK.
Kata kunci: Folikel antral, 25(OH)D serum, sindrom ovarium polikistik
Correlation between Antral Follicles Count and Serum 25(OH)D Levels in Polycystic Ovary Syndrome Patients
Polycystic ovary syndrome (PCOS) is characterized by hyperandrogenism, oligo- or anovulation, and polycystic ovarian morphology. Vitamin D (25-hydroxyvitamin D; 25(OH)D) plays a role in the steroidogenesis process in the ovarian theca cells and regulates follicle stimulating hormone (FSH) receptor expression in granulosa cells. In 25(OH)D deficiency there is a decrease in FSH activity that the follicles become small and the antral follicles count in the ovary increases. The aim of this study was to determine the relationship between antral follicles count and serum 25(OH)D levels in PCOS patients. A cross-sectional analytical observational study was conducted in Dr. Hasan Sadikin General Hospital Bandung in September 2017─June 2018. Subjects of this study were 52 PCOS patients diagnosed by obstetricians and gynecologists of the hospital. Blood vein samples were collected to examine serum 25(OH)D levels using ELISA method. Serum 25(OH)D level of ≤20 ng/mL was found in 55.8% of the subjects in this study. Analysis using Spearman’s correlation test showed a significant negative correlation (r = -0.867, p <0.001) between antral follicles count and serum 25(OH)D level in patients with PCOS. Lower levels of 25(OH)D serum in PCOS patients correlates with higher number of antral follicles count. There is a negative correlation between antral follicles count and serum 25(OH) D level in PCOS patients.
Key words: Antral follicle count, 25(OH)D serum levels, polycystic ovary syndrome
Keywords
Full Text:
PDFReferences
Azziz R, Carmina E, Chen ZJ, Dunaif A, Laven JSE, Legro RS dkk. Polycystic ovary syndrome. J Nature Rev. 2016;2:1–18.
Sriwastva MK, Ganie MA. Polycystic ovarian syndrome: a multi- specialty, multi system galloping epidemic. Diabetes Obes Int J. 2016;1(3):1–4.
Lizneva D, Suturina L, Walker W, Brakta S, Jordan LG, Azziz R. The criteria, prevalence and phenotypes of PCOS. Fertil Steril. 2016;106(1):6–15.
Santoso B, Puspaningsih NNT, Riawan W. Apakah perbedaan androgen serum menyebabkan perbedaan manifestasi klinik berupa amenorrhea, oligomenorrhea, dan perdarahan uterus disfungsional pada kasus sindrom ovarium polikistik?. Maj Obs Gin Indones. 2008;32:38–41.
Fauser B, Tarlatzis BC, Rebar RW, Legro RS, Balen Ah, Lobo R dkk. Consensus on women’s health aspects of PCOS: the Amsterdam ESHRE /ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012;97(1):28–38.
Suhartono R, Sugiarti N. Diagnosis PCOS: kriteria diagnosis spesifik, evaluasi klinis, laboratorik dan USG. Dalam: Permadi W, Djuwantono T, penyunting. Cara mudah penanganan sindrom ovarium polikistik dalam praktik sehari-hari Departemen Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran, RSUP Dr. Hasan Sadikin Bandung: Kongres Obstetri dan Ginekologi Indonesia (KOGI) ke-XVI;2015:17–26.
Wolf J, Barnes CL, Aubuchorn M. Polycystic ovarian syndrome: a diagnosis of exclution. Dalam: Pal L, penyunting. Polycystic ovary syndrome: current and emerging concepts. Edisi ke-2. New York: Springer; 2014. hlm. 11–23.
Fulghesu AM, Canu E, Porru C, Cappai A. Ultrasound diagnosis criteria of polycystic ovarian syndrome: current guidelines, criticism and possible update. Austin J Obstet Gynecol. 2017;4(2):1–6.
Nandi A, Sinha N, Ong E, Sonmetz H, Poretsky L. Is there a role for vitamin D in human reproduction?. Horm Mol Biol Clin Invest. 2016;25(1):15–28.
Nikbakht R, Moramezi F, Farhadi S, Cheraghian B. Vitamin D deficiency in infertile women with polycystic ovary syndrome: a case-control study. Int J Pharm Res Allied Sci. 2016;5(2):144–50.
Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Kesehatan Reproduksi. Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. Jakarta: KEMENKES Republik Indonesia; 2015.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, dkk. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–30.
Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim S, dkk Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J COPD. 2017;12:2465–75.
Moy FM, Bulgiba A. High prevalence of vitamin D insufficiency and its association with obesity and metabolic syndrome among Malay adults in Kuala Lumpur, Malaysia. BMC Public Health. 2011;11:735.
Sidabutar E, Halim B, Siregar MFG, Lutan D, Adenin I, Kaban Y. Vitamin D levels in women with polycystic ovary syndrome. ASPIRE Conference Proceedings, the 6th Congress of the Asia Pacific Initiative on Reproduction, KnE Medicine; 08–10 April 2016; Jakarta: ASPIRE; 2016. hlm. 125–132. DOI 10.18502/kme.v1i1.547
Bellia A, Garcovich C, D’Adamo M, Lombardo M, Tesauro M, Donadel G dkk. Serum 25-hydroxyvitamin D levels are inversely associated with systemic inflammation in severe obese subjects. J Int Emerg Med. 2013;8(1):33–40.
Shishehgar F, Tehrani FR, Mirmiran P, Hajian S, Baghestani AR, Moslehi N. Factors influencing physical activity in women with polycystic ovary syndrome in comparison to eumenorrheic non hirsute women. Global J Health Sci. 2016;8(10):127–34.
Montes LD, Catena MR, Faus JC. Polycysic ovary syndrome and vitamin D, where do we stand?. J Annals Adv Med Sci. 2018;2(1):R1–5.
Merhi Z, Doswell A, Krebs K, Cipolla M. Vitamin D alters genes involved in follicular development and steroidogenesis in human cumulus granulosa cells. J Clin Endocrinol Metab. 2014;99(6):E1137–45.
DOI: https://doi.org/10.15395/mkb.v50n4.1469
Article Metrics
Abstract view : 11817 timesPDF - 883 times
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats