Rheumatology and Metabolic Bone Diseases Department, Hospital de Santa Maria, CHLN, Lisbon, Portugal.
Clin Rheumatol. 2017 Dec;36(12):2853-2854. doi: 10.1007/s10067-017-3797-0. Epub 2017 Aug 22.
Systemic lupus erythematosus (SLE) is a chronic immune-mediated inflammatory disease that affects predominantly females during childbearing age (Lateef and Petri Best Pract Res Clin Rheumatol 27(3):435-447, 2013). Fertility in SLE patients is considered to be normal (Clowse et al. Arthritis Care Res (Hoboken) 64(5):668-674, 2012; Ekblom-Kullberg et al. Scand J Rheumatol 38:375-380, 2009) but several known factors may negatively influence fertility. Immune mechanisms are also thought to be an important cause of premature ovarian senescence, characterized by reduced ovarian reserve markers such as anti-Müllerian hormone (AMH) (Oktem et al. Obstet Gynecol Surv 70(3):196-210, 2015; Bermas and Sammaritano Fertil Res Pract 1:13, 2015; Østensen Int J Clin Rheumtol 8(1):27-37, 2013; Ulug et al. Am J Reprod Immunol 72(1):85-88, 2014; Lawrenz et al. Lupus 20(11):1193-1197, 2011). We evaluated the ovarian reserve of women in reproductive age with SLE, by measuring AMH levels and we compared it to that of non-SLE women. We also analyzed the association of SLE disease characteristics with AMH levels. AMH levels were decreased in this population of SLE women, accounting for a high proportion of women with criteria for low ovarian reserve. Age and SLE damage were associated with abnormally lower AMH levels in our SLE patients. In this way, SLE may have a negative influence on the ovarian reserve.
系统性红斑狼疮（SLE）是一种慢性免疫介导的炎症性疾病，主要影响育龄期女性（Lateef 和 Petri，Best Pract Res Clin Rheumatol 27(3):435-447, 2013）。SLE 患者的生育能力被认为是正常的（Clowse 等人，Arthritis Care Res (Hoboken) 64(5):668-674, 2012；Ekblom-Kullberg 等人，Scand J Rheumatol 38:375-380, 2009），但有几个已知因素可能会对生育能力产生负面影响。免疫机制也被认为是导致卵巢早衰的重要原因，其特征是卵巢储备标志物如抗苗勒管激素（AMH）减少（Oktem 等人，Obstet Gynecol Surv 70(3):196-210, 2015；Bermas 和 Sammaritano，Fertil Res Pract 1:13, 2015；Østensen，Int J Clin Rheumtol 8(1):27-37, 2013；Ulug 等人，Am J Reprod Immunol 72(1):85-88, 2014；Lawrenz 等人，Lupus 20(11):1193-1197, 2011）。我们通过测量 AMH 水平来评估生育期 SLE 女性的卵巢储备情况，并将其与非 SLE 女性进行比较。我们还分析了 SLE 疾病特征与 AMH 水平之间的关系。我们发现，SLE 女性的 AMH 水平降低，有相当比例的女性符合低卵巢储备标准。年龄和 SLE 损害与我们 SLE 患者中 AMH 水平异常降低有关。因此，SLE 可能对卵巢储备产生负面影响。
