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辅酶Q10预处理对接受子宫切除术加双侧输卵管切除术女性卵巢储备功能的影响:一项随机、双盲、安慰剂对照试验。

The effect of coenzyme Q10 pretreatment on ovarian reserve in women undergoing hysterectomy with bilateral salpingectomy: a randomised, double-blind, placebo-controlled trial.

作者信息

Micaraseth Kanockpetch, Tantanavipas Siriluk, Hongsakorn Woradej, Singwongsa Artitaya

机构信息

Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok10400, Thailand.

Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Br J Nutr. 2025 Jan 28;133(2):213-220. doi: 10.1017/S0007114524003131. Epub 2024 Dec 9.

Abstract

The effect of diminished ovarian reserves after undergoing hysterectomies with bilateral salpingectomies is one of the health concerns among reproductive-age women with benign gynecological diseases. Coenzyme Q10 (CoQ10), an antioxidant, is crucial in mitochondrial energy production, improving oocyte quality and quantity. This study compares the benefit of a 14-d preoperative (CoQ10) . placebo on ovarian reserve by measuring anti-Müllerian hormone (AMH) in women undergoing hysterectomy with bilateral salpingectomy. A double-blinded, randomised, placebo-controlled trial was conducted. Forty-four women with benign gynecological diseases were randomised to receive either oral CoQ10 300 mg per d or placebo for 14 d before undergoing hysterectomy with bilateral salpingectomy. Serum AMH levels were collected for analysis before taking CoQ10 and 6 weeks postoperatively in each group. The baseline demographic, clinical characteristics and baseline AMH levels were comparable between the groups (1·47 (0·45, 2·49) . 1·29 (0·47, 2·11), = 0·763). The serum AMH levels after the surgery were significantly decreased from preoperative levels (median 0·99 (0·37, 1·63) . 1·34 (0·57, 2·30)), = 0·001. However, there was no significant difference in the AMH change between the CoQ10 group and the placebo group (AMH per cent change -28·2 % (64·09, -4·81) . -20·07 % (-61·51, -2·92)), = 0·99, respectively. Age, gynecological disease, operative time and blood loss were not significantly associated with the AMH change. There were no significant side effects or adverse operative outcomes among CoQ10 users. In conclusion, hysterectomy with bilateral salpingectomy led to a significantly decreased AMH level. However, pretreatment with CoQ10 for 2 weeks was ineffective in protecting an ovarian reserve.

摘要

对于患有良性妇科疾病的育龄妇女而言,子宫切除加双侧输卵管切除术后卵巢储备功能下降的影响是一个健康问题。辅酶Q10(CoQ10)作为一种抗氧化剂,在线粒体能量产生中起关键作用,可提高卵母细胞的质量和数量。本研究通过测量接受子宫切除加双侧输卵管切除术女性的抗苗勒管激素(AMH),比较术前14天补充CoQ10与安慰剂对卵巢储备功能的影响。进行了一项双盲、随机、安慰剂对照试验。44例患有良性妇科疾病的女性在接受子宫切除加双侧输卵管切除术之前,被随机分为两组,一组每天口服300mg CoQ10,另一组服用安慰剂,持续14天。每组在服用CoQ10前及术后6周采集血清AMH水平进行分析。两组之间的基线人口统计学、临床特征和基线AMH水平具有可比性(1.47(0.45,2.49)对1.29(0.47,2.11),P = 0.763)。术后血清AMH水平较术前显著降低(中位数0.99(0.37,1.63)对1.34(0.57,2.30)),P = 0.001。然而,CoQ10组和安慰剂组之间的AMH变化无显著差异(AMH变化百分比-28.2%(64.09,-4.81)对-20.07%(-61.51,-2.92)),P = 0.99。年龄、妇科疾病、手术时间和失血量与AMH变化无显著相关性。CoQ10使用者中未出现显著的副作用或不良手术结局。总之,子宫切除加双侧输卵管切除术导致AMH水平显著降低。然而,术前2周使用CoQ10预处理对保护卵巢储备功能无效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8730/11813623/e5151671f2d4/S0007114524003131_fig1.jpg

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