Auge Antonio Pedro, Longui Carlos Alberto, Almeida Prado Roberto A, Rocha Mylene Neves, Hirota Andrea, Busso Newton Eduardo, Monte Osmar, Aldrighi José Mendes
Department of Gynecology and Obstetrics, Endocrinology Gynecology Unit, Santa Casa de São Paulo - Faculty of Medical Sciences, São Paulo, Brazil.
Gynecol Endocrinol. 2005 Jul;21(1):7-11. doi: 10.1080/09513590500128716.
The present study aimed to establish inhibin A and B serum levels during the menstrual cycle of obese women, and its usefulness as an index of luteal-phase follicular development.
Twenty-one obese patients (mean body mass index: 34.9+/-3.7 kg/m2; range: 30.0-45.0 kg/m2) were submitted to basal hormonal measurements and an oral glucose tolerance test after challenge with 75 g glucose. Progesterone and inhibin A and B levels were determined 5-7 days after the menstrual cycle and 7 days prior to expected menses.
As expected, an increase in inhibin A and a decrease in inhibin B were observed when first-phase samples were compared with samples obtained after 15-20 days. On the other hand, the percentage variation of both inhibin A and B was at least four times smaller than the values for normal women described previously by other authors employing the same enzyme-linked immunosorbent assays. A small number of obese women presented ovulatory cycles characterized by progesterone concentration higher than 5.8 ng/ml. The percentage elevation (>190%) of inhibin A in the second samples was in agreement with the progesterone levels, but it seemed to be more sensitive for the detection of follicle luteinization.
We conclude that obese women present less percentage variation of both inhibin A and B during the menstrual cycle, associated with a low frequency of ovulatory cycles. In obese women, the percentage increase of inhibin A can represent an additional marker to recognize follicle luteinization.
本研究旨在确定肥胖女性月经周期中抑制素A和B的血清水平，以及其作为黄体期卵泡发育指标的实用性。
21名肥胖患者（平均体重指数：34.9±3.7kg/m²；范围：30.0 - 45.0kg/m²）在接受75g葡萄糖激发后进行基础激素测量和口服葡萄糖耐量试验。在月经周期第5 - 7天和预期月经前7天测定孕酮、抑制素A和B的水平。
正如预期的那样，将第一阶段样本与15 - 20天后获得的样本进行比较时，观察到抑制素A增加而抑制素B减少。另一方面，使用相同酶联免疫吸附测定法，抑制素A和B的百分比变化至少比其他作者先前描述的正常女性的值小四倍。少数肥胖女性呈现出以孕酮浓度高于5.8ng/ml为特征的排卵周期。第二个样本中抑制素A的百分比升高（>190%）与孕酮水平一致，但它似乎对检测卵泡黄素化更敏感。
我们得出结论，肥胖女性在月经周期中抑制素A和B的百分比变化较小，且排卵周期频率较低。在肥胖女性中，抑制素A的百分比增加可作为识别卵泡黄素化的额外标志物。
