Menopozun ve tibolon kullanımının kemik dögüsü belirteçleri üzerine etkisi
The effect of using tibolone and menopause to bone turnover markers
Yazar: ÖZGE TOPCU
Danışman: DOÇ.DR. NESLİHAN BUKAN
Gazi Üniversitesi / Sağlık Bilimleri Enstitüsü / Biyokimya Ana Bilim Dalı
Derece: Yüksek Lisans, 2007
Konu: Biyokimya = Biochemistry

Özet:
Biz çahsmamizda, postmenopozal osteoporoz tanisi almis olankadinlarda tibolon kullaniminin biyokimyasal kemik döngiisii belirteçleriüzerine olan etkisini arastirdik.Gazi Üniversitesi Tip Fakiiltesi Hastanesi Kadin Dogum AnabilimDah Poliklinigine basvuran 21 postmenopozal osteoporoz tespit edilen HRTalmamis hastalar ile bu hastalara benzer özellik gösteren 12 premenopozalsaghkh kadin üzerinde çahsmamiz gerçeklestirildi. Ayrica, postmenopozalosteoporoz tespit edilen 21 hastadan 6 ay süreyle düzenli sekilde tibolonukullanan ve poliklinige basvuran 10 tanesi, 3. ay ve 6. ay sonunda gahsmamizadahil edildi. Biitün hastalarda ve kontrol grubunda; vitamin D, fosfor, kalsiyum,alkalen fosfataz, piridinolin ve deoksipiridinolin degerlerine bakildi.Qahsmamizda, premenopozal saghkh grubun vitamin D3 degerleri,postmenopozal osteoporoz tanisi almis olan ancak HRT almamis gruptan dahayiiksek bulunmustur(p=0.000). Postmenopozal osteoporoz tanisi konrnushastalarm 3 ay süreyle tibolon kullandiktan sonraki vitamin D3 degerlerinde isebaslangig degerlerine göre diisme izlenirken(p=0.005), 6 ay tibolon kullandiktansonraki vitamin D3 degerlerinde anlamh yükselme görülmüstür(p=0.013).Ayrica, postmenopozal osteoporoz tanisi konmus hastalarm 6 ay tibolonkullandiktan sonraki fosfor degerlerinde ise diisme gözlenmistir (p=0.009).Postmenopozal osteoporoz tanisi almis olan ancak HRT almamis grubunpiridinolin ve deoksipiridinolin degerleri premenopozal saghkh gruba göredaha yiiksek bulunmustur(p=0.000, p=0.000). Postmenopozal osteoporoz tanisikonmus hastalarm 3 ay ve 6 ay tibolon kullandiktan sonraki piridinolin vedeoksipridinolin degerlerinde ise anlamh derecede diisme göriilmiistiir(p=0.005, p=0.005).Sonuç olarak, postmenopozal osteoporozda tibolon kullanimininkemik döngiisii belirteçleri üzerine olumlu etki yaptigi söylenebilir.

Abstract:
In our study, we have determined the effect of using tibolone tobiochemical bone turnover markers on postmenopausal osteoporotic women.Our study performed on 21 postmenopausal osteoporotic patientsnot under HRT treatment and on 12 healthy premenopausal women showingsimilar properties with these patients who consulted to Gazi University Facultyof Medicine, Department of Obstetrics and Gynecology. Moreover, 10 patientsof 21 postmenopausal osteoporotic patients used tibolone during 6 monthsregularly participated in the end of 3th and 6th month. The levels of vitamin D,phosphorus, calcium, alkaline phosphatase, pyridinoline anddeoxypyridinoline in all patients and control group were determined.In our study, vitamin D3 levels of premenopausal healthy groupfound as higher than the group of defined as postmenopausal osteoporosisbut not using HRT(p=0.000). Although decrease observed on vitamin D3 levelsof postmenopausal osteoporotic patients after using tibolone for 3 months inaccordance with onset levels(p=0.005), significant increase seen on vitamin D3levels after using tibolone for 6 months (p=0.013). Besides, decrease observedon phosphoric levels of defined as postmenopausal osteoporotic patients afterusing tibolone for 6 months (p=0.009). The levels of pyridinoline anddeoxypyridinoline of patients group determined as postmenopausalosteoporosis not under HRT treatment, found higher than according to healthypremenopausal women(p=0.000, p=0.000). Significant decrease observed onthe levels of pyridinoline and deoxypyridinoline of patients determined aspostmenopausal osteoporosis after using tibolone 3 months and 6months(p=0.005, p=0.005).In conclusion, using of tibolone on postmenopausal osteoporosiscan be said that makes positive effect on bone turnover markers.