Urine Albumin/Creatinine Ratio and Renal Function Differences in Phenotypes of Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is one of the endocrinological diseases that affects 5-20% of women of reproductive age; It is characterized by oligoanovulation, clinical or biochemical hyperandrogenemia, and the appearance of polycystic ovaries. The diagnosis of this syndrome is made according to the revised 2003 Rotterdam criteria; These criteria; 1) Oligo-anovulation, 2) Clinical and/or biochemical hyperandrogenism findings, 3) polycystic ovary (PCO) appearance in the ovaries. For diagnosis, it is sufficient to have two of these criteria and the absence of another disease that causes this.

Polycystic ovary syndrome; Metabolic disorders such as insulin resistance, dyslipidemia, glucose intolerance, hypertension and obesity are often accompanied, and increased inflammation is the main characteristic of this syndrome. While the presence or absence of PCOS was important until recently, recent studies have shown that metabolic changes and inflammation occur at different degrees in different phenotypesof PCOS. Therefore, PCOS cases are divided into 4 phenotypes. These; phenotypes A has hyperandrogenemia + oligoanovulation + PCO appearance on ultrasonography (USG), phenotypes B has hyperandrogenemia + oligoanovulation, phenotypes C has hyperandrogenemia + PCO appearance on USG, and phenotypes D has oligoanovulation + PCO appearance on USG. As the phenotypesnumber of polycystic ovary syndrome decreases, the severity and frequency of metabolic disorders and inflammation accompanying polycystic ovary syndrome increase.

Polycystic ovary syndrome is associated with both subclinical low-grade inflammation, which may cause deterioration in renal functions in the long term, and metabolic disorders such as insulin resistance, dyslipidemia, glucose intolerance, hypertension and obesity, which may bring about glomerular filtration rate (GFR) changes. Additionally, increased urinary albumin/creatinine ratio (ACR) is a result of vascular leak and endothelial damage and is associated with increased cardiovascular risk. It has been suggested that the albumin-creatinine ratio in urine is increased in patients with polycystic ovary syndrome, and to detect the increased cardiovascular risk in patients with PCOS, the albumin/creatinine ratio in spot urine should be measured in these patients.

In this study, the investigators used different PCOS phenotypes; The investigators aimed to investigate whether there is a difference between GFR (eGFR) calculated from blood creatinine level and urinary ACR calculated from morning spot urine. Although there are studies on the renal functions of patients with PCOS in the literature review, as mentioned above, the number of studies evaluating renal complications in PCOS phenotypes is limited. The investigators aimed to contribute to the knowledge in this field with this study.