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卵巢储备功能评估在育龄期乳糜泻患者中的应用。

Ovarian Reserve Assessment in Celiac Patients of Reproductive Age.

机构信息

Department of Gastroenterology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

Department of Obstetrics and Gynecology, Cumhuriyet University Faculty of Medicine, Sivas, Turkey.

出版信息

Med Sci Monit. 2018 Feb 24;24:1152-1157. doi: 10.12659/msm.909033.

Abstract

BACKGROUND This study aimed to investigate ovarian reserve in patients of reproductive age with Celiac disease (CD) using anti-Müllerian hormone (AMH) levels, antral follicle counts (AFCs), and ovarian volume. MATERIAL AND METHODS We included into this study 46 CD female patients and 40 healthy female subjects of reproductive age, ages 18-45 years. Venous blood samples were taken from both groups on days 2-4 of the menstrual cycle, and follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and AMH levels were measured. On the same day, AFCs and ovarian volumes were determined. Data on body mass index (BMI), gravidity/parity/abortions/alive counts, disease duration, and Marsh histological classification were recorded. RESULTS There were no statistically significant differences between CD and control groups in terms of mean age, BMI, or median gravidity/parity/abortions/alive counts (p>0.05). Also, there were no statistically significant differences between the 2 groups in terms of mean FSH, LH, E2, PRL levels, right and left ovarian volumes, and median right and left ovarian AFCs (p>0.05). However, AMH level was significantly lower in the CD group (p=0.032). No statistically significant correlation was found between AMH levels and age, BMI, FSH, LH, E2, PRL levels, right and left ovarian volumes, right and left ovarian AFCs, or Marsh histological classification using the Spearman correlation test (p>0.05). However, an inverse correlation was detected showing that AMH levels decrease with increasing CD duration (r=-0.054, p=0.001). CONCLUSIONS We found that AMH level and ovarian reserve was decreased in CD patients of reproductive age compared to healthy controls, and that AMH level and ovarian reserve decreased with increasing disease duration in CD patients.

摘要

背景

本研究旨在通过抗苗勒管激素(AMH)水平、窦卵泡计数(AFC)和卵巢体积来探讨生育期女性中乳糜泻(CD)患者的卵巢储备情况。

材料与方法

我们纳入了 46 例 CD 女性患者和 40 例年龄在 18-45 岁之间的健康生育期女性作为研究对象。两组患者均在月经周期的第 2-4 天抽取静脉血,并检测卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、催乳素(PRL)和 AMH 水平。同日,还测定了 AFC 和卵巢体积。记录了患者的体重指数(BMI)、孕次/产次/流产次数/活产次数、疾病持续时间和 Marsh 组织学分类等数据。

结果

在平均年龄、BMI 或中位孕次/产次/流产次数/活产次数方面,CD 组与对照组之间无统计学差异(p>0.05)。此外,两组患者的 FSH、LH、E2、PRL 水平、左右卵巢体积以及左右卵巢 AFC 的中位数之间也无统计学差异(p>0.05)。然而,CD 组的 AMH 水平明显更低(p=0.032)。Spearman 相关性检验显示,AMH 水平与年龄、BMI、FSH、LH、E2、PRL 水平、左右卵巢体积、左右卵巢 AFC 或 Marsh 组织学分类之间均无统计学相关性(p>0.05)。然而,我们检测到了一个负相关关系,表明 AMH 水平随 CD 持续时间的增加而降低(r=-0.054,p=0.001)。

结论

我们发现,与健康对照组相比,生育期 CD 患者的 AMH 水平和卵巢储备下降,并且 AMH 水平和卵巢储备随 CD 持续时间的增加而降低。

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本文引用的文献

1
New Insights into the Pathogenesis of Celiac Disease.乳糜泻发病机制的新见解
Front Med (Lausanne). 2017 Aug 31;4:137. doi: 10.3389/fmed.2017.00137. eCollection 2017.
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Celiac disease: From pathophysiology to treatment.乳糜泻:从病理生理学到治疗
World J Gastrointest Pathophysiol. 2017 May 15;8(2):27-38. doi: 10.4291/wjgp.v8.i2.27.
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Dig Dis. 2015;33(2):141-146. doi: 10.1159/000369518. Epub 2015 Apr 22.
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Review and practice guidelines for celiac disease in 2014.2014年乳糜泻的综述与实践指南
Postgrad Med. 2015 Apr;127(3):259-65. doi: 10.1080/00325481.2015.1015926. Epub 2015 Feb 23.
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Diminished ovarian reserve in Behçet's disease patients.白塞病患者卵巢储备功能减退。
Clin Rheumatol. 2015 Jan;34(1):179-83. doi: 10.1007/s10067-014-2680-5. Epub 2014 May 31.

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