卵巢早衰女性血液中可溶性Flt-1、胎盘生长因子和烟酸浓度的前瞻性比较研究。
A prospective and comparative investigation of blood sFlt-1, P1GF, and niacin concentrations in women with premature ovarian insufficiency.
作者信息
Ovayolu Ali, Bostancieri Nuray
机构信息
Department of Obstetrics and Gynecology, Medical School of Istinye University, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Liv Hospital, Gaziantep, Turkey.
出版信息
J Obstet Gynaecol Res. 2023 Apr;49(4):1198-1205. doi: 10.1111/jog.15554. Epub 2023 Jan 22.
OBJECTIVE
Endothelial dysfunction is an important component of preeclampsia like premature ovarian insufficiency (POI), and it is reported that placental growth factor (P1GF) and soluble fms-like tyrosine kinase receptor-1 (sFlt-1) levels are important in preeclampsia. Extra-placental sources for P1GF and sFlt-1 have also been identified, including various cell types. In animal models of POI, niacin treatment inhibited follicular apoptosis under hazardous conditions while significantly reducing cumulus cell apoptosis. The number of developing follicles also increased after niacin was given. This study was designed to determine blood sFlt-1, P1GF, and niacin concentrations in women with idiopathic POI (iPOI) compared with those of healthy women.
METHODS
The study comprised 45 women with iPOI and 45 healthy women. Blood was obtained and analyzed at the early follicular phase of the menstrual cycle and sFlt-1, P1GF, and niacin levels were measured using a commercially available enzyme-linked immunosorbent assay kit.
RESULTS
No significant differences were observed in the two groups according to the gravidity numbers, parity, abortion, live births, and menarche ages (p ≥ 0.05). In the iPOI group, the mean anti-mullerian hormone value was 0.03 ± 0.04 (min-max, 0.00-0.21) ng/ml. sFlt-1, P1GF, niacin levels, and also the sFlt-1/P1GF ratio were lower in the iPOI group (p < 0.01). A significant discriminative role of sFlt-1, P1GF, niacin levels, and the sFlt-1/P1GF ratio for the presence of iPOI, with cut-off values of 5.13, 10.28, 37.17, and 0.61 ng/ml, respectively, were reported in the receiver operating characteristics curve analysis.
CONCLUSIONS
Lower levels of P1GF, sFlt-1, niacin, and sFlt-1/P1GF ratios may be associated with the development of POI/iPOI. Further studies are required to better understand the etiopathogenesis of POI/iPOI.
CLINICAL TRIAL NUMBER
NCT04641624 (clinicaltrials.gov).
目的
内皮功能障碍是先兆子痫样卵巢早衰（POI）的重要组成部分，据报道胎盘生长因子（P1GF）和可溶性fms样酪氨酸激酶受体-1（sFlt-1）水平在先兆子痫中很重要。P1GF和sFlt-1的胎盘外来源也已被确定，包括各种细胞类型。在POI动物模型中，烟酸治疗在危险条件下抑制卵泡凋亡，同时显著减少卵丘细胞凋亡。给予烟酸后发育卵泡的数量也增加。本研究旨在确定特发性POI（iPOI）女性与健康女性相比血液中sFlt-1、P1GF和烟酸的浓度。
方法
该研究包括45例iPOI女性和45例健康女性。在月经周期的卵泡早期采集血液并进行分析，使用市售酶联免疫吸附测定试剂盒测量sFlt-1、P1GF和烟酸水平。
结果
两组在妊娠次数、产次、流产、活产和初潮年龄方面未观察到显著差异（p≥0.05）。在iPOI组中，平均抗苗勒管激素值为0.03±0.04（最小值-最大值，0.00-0.21）ng/ml。iPOI组中sFlt-1、P1GF、烟酸水平以及sFlt-1/P1GF比值均较低（p<0.01）。在受试者工作特征曲线分析中，报告了sFlt-1、P1GF、烟酸水平和sFlt-1/P1GF比值对iPOI存在的显著判别作用，截断值分别为5.13、10.28、37.17和0.61 ng/ml。
结论
较低水平的P1GF、sFlt-1、烟酸和sFlt-1/P1GF比值可能与POI/iPOI的发生有关。需要进一步研究以更好地理解POI/iPOI的病因发病机制。
临床试验编号
NCT04641624（clinicaltrials.gov）。
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