First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 300381 Tianjin, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300381 Tianjin, China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, 300381 Tianjin, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, 300381 Tianjin, China.
Joint Bone Spine. 2024 Jul;91(4):105728. doi: 10.1016/j.jbspin.2024.105728. Epub 2024 Apr 3.
Systemic Lupus Erythematosus (SLE) is an autoimmune disease that occurs at higher rates in young women. Evidence suggests that SLE may be associated with ovarian dysfunction. Therefore, it is crucial to investigate the possible effects of SLE on ovarian reserve function.
PubMed, Embase, Web of Science, Scopus, Cochrane Library, and ClinicalTrials.gov databases were searched from inception to July 2023 to identify studies that compared ovarian reserve in patients with SLE to that of healthy individuals. The study examined anti-müllerian hormone (AMH), antral follicle count (AFC), and follicle-stimulating hormone (FSH) as outcomes.
Thirteen studies (n=1017) were eligible for meta-analysis. Females with SLE had significantly lower levels of AMH (weighted mean difference [WMD]: -1.07, 95% confidence interval [CI]: -1.37 to -0.76, P<0.001) and AFC (WMD: -3.46, 95% CI: -4.57 to -2.34, P<0.001). There was no significant difference in FSH levels. Subgroup analyses by age of onset revealed that SLE patients with adult-onset had significantly lower AMH levels (WMD: -1.44, 95% CI: -1.71 to -1.18, P<0.001), lower AFCs (WMD: -3.11, 95% CI: -3.60 to -2.61, P<0.001) and higher FSH levels (WMD: 0.60, 95% CI: 0.15 to 1.05, P<0.01). However, SLE patients with juvenile-onset did not exhibit significant differences in their AMH and FSH levels, except for AFCs (WMD: -7.27, 95% CI: -12.39 to -2.14, P<0.01).
The impact of SLE on ovarian reserve is significant, and the effect may be particularly severe in cases of adult-onset SLE.
系统性红斑狼疮（SLE）是一种在年轻女性中发病率较高的自身免疫性疾病。有证据表明，SLE 可能与卵巢功能障碍有关。因此，研究 SLE 对卵巢储备功能的可能影响至关重要。
检索 PubMed、Embase、Web of Science、Scopus、Cochrane 图书馆和 ClinicalTrials.gov 数据库，从建库至 2023 年 7 月，以比较 SLE 患者和健康个体的卵巢储备功能。研究检测了抗苗勒管激素（AMH）、窦卵泡计数（AFC）和卵泡刺激素（FSH）作为结局指标。
13 项研究（n=1017）符合纳入标准，进行 meta 分析。SLE 女性的 AMH 水平（加权均数差 [WMD]：-1.07，95%置信区间 [CI]：-1.37 至-0.76，P<0.001）和 AFC（WMD：-3.46，95% CI：-4.57 至-2.34，P<0.001）显著降低。FSH 水平无显著差异。按发病年龄的亚组分析显示，成人发病的 SLE 患者的 AMH 水平显著降低（WMD：-1.44，95% CI：-1.71 至-1.18，P<0.001），AFC（WMD：-3.11，95% CI：-3.60 至-2.61，P<0.001）和 FSH 水平显著升高（WMD：0.60，95% CI：0.15 至 1.05，P<0.01）。然而，除 AFC（WMD：-7.27，95% CI：-12.39 至-2.14，P<0.01）外，幼年发病的 SLE 患者的 AMH 和 FSH 水平无显著差异。
SLE 对卵巢储备的影响显著，成人发病的 SLE 患者的影响可能更为严重。
