Department of Neurology, The Affiliated Hospital of Yangzhou University, No. 368, Hanjiang Road, Yangzhou, Jiangsu 225012, China.
Epilepsy Res. 2021 Jan;169:106527. doi: 10.1016/j.eplepsyres.2020.106527. Epub 2020 Dec 10.
Women with epilepsy (WWE) have a high risk of sexual dysfunction (SD). We aimed to investigate the incidence of SD, the correlation between SD, sex hormone and estrogen receptor (ER) gene polymorphism in Chinese Han WWE.
This cross-sectional study examined 112 married WWE in the Affiliated Hospital of Yangzhou University who were taking antiepileptic drugs (AEDs) for ≥1 year, and 120 healthy controls without epilepsy, all of Chinese Han nationality. The age, menstruation, fertility of all the subjects and disease details of WWE were recorded. The Chinese version of female sexual function index (FSFI) was used to investigate the sexual function of the subjects. The chemiluminescence method was used for the detection of sex hormones, while polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine the ER gene polymorphism. The differences of the sexual function, sex hormone, ER genotype, and allele frequency were compared between the two groups. The correlation between SD, sex hormone and ER gene polymorphism was also analyzed.
(1) A high rate (70.5%) of SD was detected in WWE. (2) The serum prolactin (PRL) level (P = 0.039) and the ratio of estradiol to progesterone (E2/P) (P＜0.001) in the WWE group were significantly higher than those in the control group. The allele frequencies of ERα-PvuII C (P = 0.001) and ERβ-AluI A (P = 0.001) in the WWE group were significantly higher than those in the control group. (3) Binary logistic regression analysis showed that serum testosterone level [odds ratio (OR) = 0.412, 95 % confidence interval (CI): 0.201-0.842, P = 0.015], and PvuII CC genotype [odds ratio (OR) = 6.074, 95 % confidence interval (CI): 1.257-29.352, P = 0.025] were independently correlated with SD.
The incidence of SD in Chinese Han WWE is high. High serum testosterone levels may exert a protective effect on sexual function. ERα-PvuII polymorphism is related to the susceptibility of SD, and PvuII CC genotype may be the risk genotype of SD.
患有癫痫的女性（WWE）存在较高的性功能障碍（SD）风险。本研究旨在调查中国汉族 WWE 患者 SD 的发生率，以及 SD 与性激素和雌激素受体（ER）基因多态性之间的相关性。
本横断面研究纳入了在扬州大学附属医院接受抗癫痫药物（AEDs）治疗≥1 年的 112 名已婚 WWE 患者和 120 名无癫痫的健康对照者，均为汉族。记录所有受试者的年龄、月经、生育情况以及 WWE 患者的疾病细节。采用中文版女性性功能指数（FSFI）调查受试者的性功能。采用化学发光法检测性激素，聚合酶链反应-限制性片段长度多态性（PCR-RFLP）检测 ER 基因多态性。比较两组受试者的性功能、性激素、ER 基因型和等位基因频率的差异。还分析了 SD、性激素和 ER 基因多态性之间的相关性。
（1）WWE 患者 SD 发生率较高（70.5%）。（2）WWE 组患者的血清催乳素（PRL）水平（P = 0.039）和雌二醇/孕酮（E2/P）比值（P＜0.001）显著高于对照组。WWE 组患者 ERα-PvuII C 的等位基因频率（P = 0.001）和 ERβ-AluI A 的等位基因频率（P = 0.001）显著高于对照组。（3）二项逻辑回归分析显示，血清睾酮水平[比值比（OR）=0.412，95%置信区间（CI）：0.201-0.842，P = 0.015]和 PvuII CC 基因型[OR = 6.074，95%CI：1.257-29.352，P = 0.025]与 SD 独立相关。
中国汉族 WWE 患者 SD 的发生率较高。较高的血清睾酮水平可能对性功能具有保护作用。ERα-PvuII 多态性与 SD 的易感性相关，且 PvuII CC 基因型可能是 SD 的风险基因型。
