Shandong Provincial Hospital, Shandong University, 324 Jingwuweiqi Road, Jinan City, Shandong Province, China, 250021; Cheeloo College of Medicine, Shandong University, 44 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China, 250014; Gynecology Laboratory, Shandong Provincial Hospital, Jinan, Shandong Province, China, 250021.
Department of Radiology, Qingzhou People's Hospital, Qingzhou, Shandong, China. 262500; Department of Radiology, Qilu Hospital of Shandong University, Shandong University, 107 Wenhua West Road, Lixia District, Jinan City, Shandong Province, China, 250014.
Reprod Biomed Online. 2023 Sep;47(3):103231. doi: 10.1016/j.rbmo.2023.05.003. Epub 2023 May 9.
Does iron overload in patients with endometriosis affect ovarian function? Can a method be developed to visually reflect this?
Magnetic resonance imaging (MRI) R2* was used to evaluate the correlation between iron deposition of ovarian and anti-Müllerian hormone (AMH) in patients with endometriosis. All patients underwent T2* MRI scanning. Serum AMH levels were measured preoperatively. The area of focal iron deposition, iron content of the cystic fluid and AMH levels between the endometriosis and control groups were compared using non-parametric tests. The effects of iron overload on AMH secretion in mouse ovarian granulosa cells were investigated by adding different concentrations of ferric citrate to the medium.
A significant difference was found between endometriosis and control groups in area of iron deposition (P < 0.0001), cystic fluid iron content (P < 0.0001), R2* of lesions (P < 0.0001) and R2* of the cystic fluid (P < 0.0001). Negative correlations were found between serum AMH levels and R2* of cystic lesions in patients with endometriosis aged 18-35 years (r = -0.6484, P < 0.0001), and between serum AMH levels and R2* of cystic fluid (r = -0.5074, P = 0.0050). Transcription level (P < 0.0005) and secretion level (P < 0.005) of AMH significantly decreased with the increase in iron exposure.
Iron deposits can impair ovarian function, which is reflected in MRI R2*. Serum AMH levels and R2* of cystic lesions or fluid in patients aged 18-35 years had a negative correlation with endometriosis. R2* can be used to reflect the changes of ovarian function caused by iron deposition.
子宫内膜异位症患者的铁过载是否会影响卵巢功能？是否可以开发一种方法来直观地反映这一点？
使用磁共振成像（MRI）R2评估子宫内膜异位症患者卵巢铁沉积与抗苗勒管激素（AMH）之间的相关性。所有患者均行 T2MRI 扫描。术前检测血清 AMH 水平。采用非参数检验比较子宫内膜异位症组和对照组的局灶性铁沉积面积、囊液铁含量和 AMH 水平。通过向培养基中添加不同浓度的柠檬酸铁来研究铁过载对小鼠卵巢颗粒细胞 AMH 分泌的影响。
铁沉积面积（P<0.0001）、囊液铁含量（P<0.0001）、病变 R2*（P<0.0001）和囊液 R2*（P<0.0001）在子宫内膜异位症组和对照组之间存在显著差异。18-35 岁子宫内膜异位症患者血清 AMH 水平与囊性病变 R2呈负相关（r=-0.6484，P<0.0001），与囊液 R2呈负相关（r=-0.5074，P=0.0050）。AMH 的转录水平（P<0.0005）和分泌水平（P<0.005）随着铁暴露的增加而显著降低。
铁沉积可损害卵巢功能，这在 MRI R2中有所体现。18-35 岁子宫内膜异位症患者血清 AMH 水平和囊性病变或囊液的 R2与子宫内膜异位症呈负相关。R2*可用于反映铁沉积引起的卵巢功能变化。
