Chen Dongying, Yuan Shiwen, Zhan Zhongping, Zhan Yanfeng, Yang Xiuyan, Liang Liuqin
Department of Rheumatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
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Zhonghua Yi Xue Za Zhi. 2014 Apr 8;94(13):977-80.
To evaluate the serum level of anti-Müllerian hormone (AMH) in female patients with systemic lupus erythematosus (SLE) and identify its correlations with age and cyclophosphamide (CYC) therapy.
A total of 77 SLE female patients and 38 control healthy women with regular menstrual cycles were recruited. AMH was measured by enzyme linked immunosorbent assay (ELISA) kit. Follicle-stimulating hormone (FSH), estradiol (E2) and antral follicle count (AFC) of bilateral ovary were detected at the third day of menstrual cycle.
Their mean age was (29 ± 5) years (range, 20-40) and the mean duration (2.7 ± 2.4) years. The mean serum level of AMH was (1.5 ± 1.3) µg/L and AFC 10 ± 7. Linear regression revealed AFC (r = 0.9, P < 0.01) was associated with the level of AMH. The mean levels of AMH and AFC were significantly higher in patients naїve to CYC therapy than in those under exposure, but lower than that in healthy control (P < 0.01). No difference existed in FSH and E2 among 3 groups. Compared with those above 30 years old, the patients aged 30 years and younger had significantly higher level of AMH (P < 0.01). The Spearman's correlation analysis indicated that each 5 gm of CYC exposure were independently associated with a lower level of AMH (r = -0.4, P < 0.01).
As a more sensitive marker of ovarian reserve, AMH is associated with age and the cumulative dose of CYC. SLE patients aged >30 years and under exposure to CYC >10 g should be closely monitored for potential adverse events.
评估系统性红斑狼疮(SLE)女性患者血清抗苗勒管激素(AMH)水平,并确定其与年龄及环磷酰胺(CYC)治疗的相关性。
招募77例SLE女性患者及38例月经周期规律的健康对照女性。采用酶联免疫吸附测定(ELISA)试剂盒检测AMH。在月经周期第3天检测双侧卵巢的卵泡刺激素(FSH)、雌二醇(E2)及窦卵泡计数(AFC)。
她们的平均年龄为(29±5)岁(范围20 - 40岁),平均病程为(2.7±2.4)年。AMH平均血清水平为(1.5±1.3)μg/L,AFC为10±7。线性回归显示AFC(r = 0.9,P < 0.01)与AMH水平相关。未接受CYC治疗的患者AMH和AFC平均水平显著高于接受CYC治疗的患者,但低于健康对照(P < 0.01)。3组间FSH和E2无差异。与30岁以上患者相比,30岁及以下患者的AMH水平显著更高(P < 0.01)。Spearman相关性分析表明,每暴露于5 g CYC均独立与较低的AMH水平相关(r = -0.4,P < 0.01)。
作为卵巢储备更敏感的标志物,AMH与年龄及CYC累积剂量相关。年龄>30岁且暴露于CYC>10 g的SLE患者应密切监测潜在不良事件。