Romualdi Daniela, Proto Caterina, De Cicco Simona, Immediata Valentina, Barone Concetta, Romano Corrado, Lanzone Antonio
1Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Roma, Italia 2OASI Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italia.
Menopause. 2016 Nov;23(11):1247-1251. doi: 10.1097/GME.0000000000000695.
Women with Down's syndrome (DS) experience menopause earlier than healthy women and are twice as likely to undergo premature ovarian insufficiency. Menopause accelerates cognitive decline and is associated with a twofold increased mortality risk in DS women. Nonetheless, no previous studies investigated the ovarian reserve in this population. The aim of the present study was to evaluate the circulating antimullerian hormone (AMH) levels in DS women with regular menstrual cycles, in comparison with those observed in an age-matched group of healthy women.
Fourteen women with DS and 20 normo-ovulatory volunteers were enrolled in this study. A general physical examination was performed. Hormonal assays, including AMH, fasting insulin levels, and homeostatic model assessment-insulin resistance, were investigated in all participants.
AMH levels were significantly lower in DS women compared with controls (1.34 ± 1.11 vs 3.01 ± 1.65 ng/mL, P < 0.01). Prolactin concentrations were in the normal range, although higher in DS women compared with controls (P < 0.01). After dividing the participants according to age, AMH was significantly lower in the DS group compared with controls, both below and above 30 years of age (1.77 vs 3.73 ng/mL, P < 0.01; 0.28 vs 2.20 ng/mL, P < 0.01, respectively). AMH was inversely correlated with age in both groups, and directly correlated with testosterone and dehydroepiandrosterone sulfate only in DS women. In the same participants, AMH showed a tendency toward a direct correlation with insulin levels (P = 0.055).
AMH levels were significantly lower in DS women compared with age-matched controls. A subanalysis of data in DS participants under 30 years of age suggested an early follicular depletion related to trisomy 21.
唐氏综合征（DS）女性比健康女性更早经历绝经，且发生卵巢早衰的可能性是健康女性的两倍。绝经会加速认知能力下降，并且与DS女性死亡率增加两倍相关。尽管如此，此前尚无研究调查该人群的卵巢储备情况。本研究的目的是评估月经周期规律的DS女性的循环抗苗勒管激素（AMH）水平，并与年龄匹配的健康女性组进行比较。
本研究纳入了14名患有DS的女性和20名排卵正常的志愿者。进行了全面的体格检查。对所有参与者进行了激素检测，包括AMH、空腹胰岛素水平和稳态模型评估-胰岛素抵抗。
与对照组相比，DS女性的AMH水平显著降低（1.34±1.11 vs 3.01±1.65 ng/mL，P<0.01）。催乳素浓度在正常范围内，尽管DS女性的催乳素浓度高于对照组（P<0.01）。根据年龄对参与者进行分组后，DS组30岁及以下和30岁以上的AMH水平均显著低于对照组（分别为1.77 vs 3.73 ng/mL，P<0.01；0.28 vs 2.20 ng/mL，P<0.01）。两组中AMH均与年龄呈负相关，仅在DS女性中与睾酮和硫酸脱氢表雄酮呈正相关。在相同参与者中，AMH与胰岛素水平呈正相关趋势（P=0.055）。
与年龄匹配的对照组相比，DS女性的AMH水平显著降低。对30岁以下DS参与者的数据亚分析表明，与21三体相关的早期卵泡耗竭。
