抗苗勒管激素评估类风湿关节炎患者卵巢储备功能的系统评价和荟萃分析。

Assessment of the Ovarian Reserve by Serum Anti-Müllerian Hormone in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis.

机构信息

Department of Gynecology and Obstetrics, Children's Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, China.

Department of Rheumatology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Tongji Medical College, Huazhong University of Science and Technology, Taiyuan, China.

出版信息

Int Arch Allergy Immunol. 2022;183(4):462-469. doi: 10.1159/000520133. Epub 2021 Dec 20.

DOI:10.1159/000520133

PMID:34929705

Abstract

BACKGROUND

The ovarian reserve has been reported to be diminished in patients with rheumatoid arthritis. However, these results are still controversial. Anti-Müllerian hormone (AMH) is considered a reliable biomarker for the ovarian reserve. We thus performed a meta-analysis to evaluate the AMH levels and the effect of DMARDs on the ovarian reserve in rheumatoid arthritis patients.

METHODS

PubMed, EMBASE, the Cochrane Library, and 2 Chinese databases (CNKI and Wanfang database), up to September 2021, were searched for relevant studies. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Pooled standard mean difference (SMD) with 95% confidence intervals (CIs) were determined with the random-effects model. The heterogeneity was described by I2 statistic and p value from the Cochrane Q test.

RESULTS

Eight eligible studies (679 patients and 1,460 controls) were included in the meta-analysis. Compared with healthy control, the AMH levels in RA patients were significantly lower with the pooled SMD of -0.40 (95% CI: -0.66 to -0.14). However, in comparison of AMH with and without DMARD treatment, there was no significant difference with the pooled SMD of -0.1 (95% CI: -0.39 to 0.19).

CONCLUSION

The results indicated that there was an increased risk of ovarian failure in RA patients and which is not related to DMARD treatment.

摘要

背景

据报道，类风湿关节炎患者的卵巢储备功能降低。然而，这些结果仍存在争议。抗苗勒管激素（AMH）被认为是卵巢储备的可靠生物标志物。因此，我们进行了一项荟萃分析，以评估 AMH 水平以及 DMARD 对类风湿关节炎患者卵巢储备的影响。

方法

检索了 PubMed、EMBASE、Cochrane 图书馆以及 2 个中文数据库（CNKI 和万方数据库），检索时间截至 2021 年 9 月，以评估相关研究。采用 Newcastle-Ottawa 量表（NOS）评估纳入研究的质量。采用随机效应模型确定合并标准均数差（SMD）及其 95%置信区间（CI）。用 I2 统计量和 Cochrane Q 检验的 p 值描述异质性。

结果

共有 8 项符合条件的研究（679 例患者和 1460 例对照）纳入荟萃分析。与健康对照组相比，类风湿关节炎患者的 AMH 水平明显较低，合并 SMD 为-0.40（95%CI：-0.66 至-0.14）。然而，在比较 DMARD 治疗前后的 AMH 水平时，合并 SMD 为-0.1（95%CI：-0.39 至 0.19），差异无统计学意义。