抑制素B和抗苗勒管激素作为男性和女性克罗恩病患者生育能力的替代标志物：一项病例对照研究。

Inhibin B and antiMüllerian hormone as surrogate markers of fertility in male and female Crohn's disease patients: a case-control study.

作者信息

Gutiérrez Ana, Muñoz-Pérez Roser, Zapater Pedro, Mira Cristina, Rodríguez Andrés, Sempere-Robles Laura, Torregrosa María Eugenia, Alfayate Rocio, Moreno-Torres Violeta, Bernal Lorena, Belén-Galipienso Olivia, Cameo Jose Ignacio, Sirera Paula, Herreros Belen, Bernabeu Puri, Moreno-Pérez Oscar, Madero-Velázquez Lucía

机构信息

Department of Gastroenterology, Hospital General Universitario Dr Balmis de Alicante, Alicante, Spain.

Instituto de Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.

出版信息

Front Med (Lausanne). 2024 Apr 25;11:1374603. doi: 10.3389/fmed.2024.1374603. eCollection 2024.

DOI:10.3389/fmed.2024.1374603

PMID:38725465

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11080652/

Abstract

BACKGROUND

Several studies suggest that women with Crohn disease (CD) have reduced fertility due to decreased ovarian reserve, among other causes. On the other hand, male CD patients could have difficulties conceiving. The present study aimed to test the effect of CD on both male and female fertility potential, Sertoli cell function and ovarian reserve, assessed by inhibin-B (IB) plus IB:FSH ratio (IFR) and antiMüllerian hormone (AMH), respectively. Sexual dysfunction (SD) was studied as secondary endpoint.

METHODS

We performed a cross-sectional, case-control study. Serum IB levels plus IFR were measured in 58 men with CD and compared to 25 age-matched healthy controls (HC). Serum AMH levels were measured in 50 women with CD and in 30 HC matched by age. SD was assessed by means of the International Index of Erectile Function (IIFE-15) in males and the Index of Female Sexual Function (IFSF) in women.

RESULTS

A total of 108 CD patients and 55 HC were included. IB serum levels were significantly lower in CD men than in HC (177 ± 58 vs. 234 ± 75 pg./mL, = 0.001). IFR was also decreased in CD patients compared to HC (58.27 ± 59.5 vs. 91.35 ± 60.04, = 0.014). Women with CD > 30 years had lower serum AMH levels compared to HC (1.15 ± 0.74 . 2.14 ± 1.68 ng/mL, = 0.033). In addition, CD women >30 years presented a serum AMH < 2 ng/mL more frequently than HC (90% . 40%, = 0.004). The prevalence of SD was significantly higher among both male and female CD patients compared to HC, without association to fertility potential. Age was the only predictor of low ovarian reserve.

CONCLUSION

Testicular Sertoli cell function assessed through serum IB levels and IFR is decreased in CD male patients compared to HC, regardless of age. Age > 30 years is the single independent predictor of reduced ovarian reserve in women with CD. These results should be confirmed in further studies in order to properly counsel patients with CD and desire for offspring.

摘要

背景

多项研究表明，除其他原因外，克罗恩病（CD）女性因卵巢储备功能下降而生育能力降低。另一方面，男性CD患者可能存在受孕困难。本研究旨在通过分别检测抑制素B（IB）加IB：FSH比值（IFR）和抗苗勒管激素（AMH），来测试CD对男性和女性生育潜力、支持细胞功能及卵巢储备的影响。性功能障碍（SD）作为次要终点进行研究。

方法

我们进行了一项横断面病例对照研究。检测了58例CD男性患者的血清IB水平及IFR，并与25例年龄匹配的健康对照（HC）进行比较。检测了50例CD女性患者及30例年龄匹配的HC的血清AMH水平。男性通过国际勃起功能指数（IIFE - 15）、女性通过女性性功能指数（IFSF）评估SD。

结果

共纳入108例CD患者和55例HC。CD男性患者的血清IB水平显著低于HC（177±58 vs. 234±75 pg./mL，P = 0.001）。与HC相比，CD患者的IFR也降低（58.27±59.5 vs. 91.35±60.04，P = 0.014）。年龄>30岁的CD女性血清AMH水平低于HC（1.15±0.74 vs. 2.14±1.68 ng/mL，P = 0.033）。此外，年龄>30岁的CD女性血清AMH<2 ng/mL的频率高于HC（90% vs. 40%，P = 0.004）。与HC相比，男性和女性CD患者中SD的患病率均显著更高，且与生育潜力无关。年龄是卵巢储备功能低下的唯一预测因素。