ÇEVRESEL BİR ENDOKRİN BOZUCU KİMYASAL: BİSFENOL A VE POLİKİSTİK OVER SENDROMU OLUŞUMUNDA OLASI ETKİLERİ
Abstract views: 377 / PDF downloads: 382Keywords:
PKOS, , BPA,, insülin direnci, , hiperandrojenemiAbstract
Üreme çağındaki kadınlar arasında yaygın olarak gözlenen endokrin bozukluklardan birisi olan polikistik over sendromunun temel özellikleri arasında klinik ve/veya biyokimyasal hiperandrojenizm, ovulatuar disfonksiyon ve polikistik over morfolojisi bulunmaktadır. PKOS başlıca infertilite olmak üzere insülin direnci, obezite, tip 2 diabetes mellitus, kardiyovasküler hastalıklar, endometrium, meme ve over kanseri gibi ikincil durumlar ile de ilişkilendirilmektedir. Etiyolojisi açık olmamakla birlikte genetik ve çevresel faktörler sendromun oluşumunda rol oynamaktadır. Genetik temele dayanan ailesel geçişlerin yanı sıra birden fazla moleküler sinyal yolağına ait genlerin PKOS gelişiminden sorumlu olabileceği düşünülmektedir. Çevresel faktörler arasında biyolojik sistemlerde olumsuz etkiye yol açma potansiyeli yüksek olan endokrin bozucu kimyasallar da yer almaktadır. Polikarbonat plastiklerin ve epoksi reçinelerin sentezinde yaygın olarak kullanılan ve güçlü bir endokrin bozucu olduğu bilinen bisfenol A’nın yüksek miktarlarına karşı overlerin hassas olduğunu öne süren kanıtlar bulunmaktadır. Sentetik bir östrojen olan dietilstilbestrole olan benzer kimyasal yapısı nedeniyle BPA nükleer östrojen reseptörünün her iki alt tipine, ERα ve ERβ, bağlanma yeteneğine sahiptir. Bu nedenle, BPA östrojeni taklit eden ve hormon benzeri özellikler gösteren bir ksenoöstrojen olarak kabul edilmektedir. BPA ovaryan steroidogenezini, folikülogenezi ve over morfolojisini değiştirerek kadın üreme sistemini etkileyebilmektedir. Bu derlemede ise BPA maruziyetinin PKOS gelişimindeki olası etkilerini tartışmak amaçlanmıştır.
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