Andrade Aline Zyman de, Rodrigues Jhenifer Kliemchen, Dib Luciana Azôr, Romão Gustavo Salata, Ferriani Rui Alberto, Jordão Junior Alceu Afonso, Navarro Paula Andrea de Albuquerque Salles
Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brasil.
Rev Bras Ginecol Obstet. 2010 Jun;32(6):279-85. doi: 10.1590/s0100-72032010000600005.
to compare serum markers of oxidative stress between infertile patients with and without endometriosis and to assess the association of these markers with disease staging.
this was a prospective study conducted on 112 consecutive infertile, non-obese patients younger than 39 years, divided into two groups: Endometriosis (n=48, 26 with minimal and mild endometriosis - Stage I/II, and 22 with moderate and severe endometriosis - Stage III/IV) and Control (n=64, with tubal and/or male factor infertility). Blood samples were collected during the early follicular phase of the menstrual cycle for the analysis of serum malondialdehyde, glutathione and total hydroxyperoxide levels by spectrophotometry and of vitamin E by high performance liquid chromatography. The results were compared between the endometriosis and control groups, stage I/II endometriosis and control, stage III/IV endometriosis and control, and between the two endometriosis subgroups. The level of significance was set at 5% (p < 0.05) in all analyses.
vitamin E and glutathione levels were lower in the serum of infertile women with moderate/severe endometriosis (21.7 ± 6.0 mMol/L and 159.6 ± 77.2 nMol/g protein, respectively) compared to women with minimal and mild endometriosis (28.3 ± 14.4 mMol/L and 199.6 ± 56.1 nMol/g protein, respectively). Total hydroxyperoxide levels were significantly higher in the endometriosis group (8.9 ± 1.8 µMol/g protein) than in the Control Group (8.0 ± 2 µMol/g protein) and among patients with stage III/IV disease (9.7 ± 2.3 µMol/g protein) compared to patients with stage I/II disease (8.2 ± 1.0 µMol/g protein). No significant differences in serum malondialdehyde levels were observed between groups.
we demonstrated a positive association between infertility related to endometriosis, advanced disease stage and increased serum hydroxyperoxide levels, suggesting an increased production of reactive species in women with endometriosis. These data, taken together with the reduction of serum vitamin E and glutathione levels, suggest the occurrence of systemic oxidative stress in women with infertility associated with endometriosis. The reproductive and metabolic implications of oxidative stress should be assessed in future studies.
比较有和没有子宫内膜异位症的不孕患者之间的氧化应激血清标志物，并评估这些标志物与疾病分期的关联。
这是一项前瞻性研究，对112名年龄小于39岁、连续的、非肥胖的不孕患者进行，分为两组：子宫内膜异位症组（n = 48，26例为轻度和中度子宫内膜异位症——I/II期，22例为重度和中度子宫内膜异位症——III/IV期）和对照组（n = 64，患有输卵管和/或男性因素不孕）。在月经周期的卵泡早期采集血样，通过分光光度法分析血清丙二醛、谷胱甘肽和总过氧化氢水平，通过高效液相色谱法分析维生素E水平。比较子宫内膜异位症组与对照组、I/II期子宫内膜异位症组与对照组、III/IV期子宫内膜异位症组与对照组以及两个子宫内膜异位症亚组之间的结果。所有分析的显著性水平设定为5%（p < 0.05）。
与轻度和中度子宫内膜异位症患者（分别为28.3 ± 14.4 mMol/L和199.6 ± 56.1 nMol/g蛋白）相比，重度和中度子宫内膜异位症不孕女性血清中的维生素E和谷胱甘肽水平较低（分别为21.7 ± 6.0 mMol/L和159.6 ± 77.2 nMol/g蛋白）。子宫内膜异位症组的总过氧化氢水平（8.9 ± 1.8 µMol/g蛋白）显著高于对照组（8.0 ± 2 µMol/g蛋白），III/IV期疾病患者（9.7 ± 2.3 µMol/g蛋白）高于I/II期疾病患者（8.2 ± 1.0 µMol/g蛋白）。两组之间血清丙二醛水平未观察到显著差异。
我们证明了与子宫内膜异位症相关的不孕、疾病晚期和血清过氧化氢水平升高之间存在正相关，表明子宫内膜异位症女性体内活性物质的产生增加。这些数据，连同血清维生素E和谷胱甘肽水平的降低，表明与子宫内膜异位症相关的不孕女性存在全身性氧化应激。氧化应激对生殖和代谢的影响应在未来的研究中进行评估。
