RESUMEN
Objetivo: la hormona antimülleriana es un marcador clínico de la reserva ovárica pero no disponemos de sus valores de referencia en la población española. Se han determinado sus valores de normalidad en relación a la edad en una amplia muestra de población española. Sujetos y métodos: se estudiaron 10.443 mujeres (edad 20-45 años). Todas las determinaciones séricas de hormona antimülleriana se realizaron mediante un test de ELISA (hormona antimülleriana Gen II ELISA assay; Beckman Coulter, Brea, CA, USA). Resultados: la edad media fue 36,6 ± 4,3 años. Los niveles de la hormona antimülleriana se correlacionaron inversamente con la edad (r = −0,35; p < 0,001). La edad ovárica aumentaba 1 año por cada descenso medio de 0,2 ng/ml de hormona antimülleriana. Se obtuvieron diferencias significativas en los valores de hormona antimülleriana entre Cataluña, Baleares y Andalucía. Conclusiones: este estudio ofrece estimaciones de los valores de referencia de hormona antimülleriana en función de la edad y contribuye a determinar con mayor precisión la reserva ovárica de las mujeres españolas (AU)
Objetives: Antimüllerian hormone is considered clinically useful in the evaluation of ovarian reserve, and few data exists regarding its distribution in the Spanish population. We determine normality values of antimüllerian hormone related to age in a large Spanish community cohort. Subjects and methods: We study 10,443 women (aged 20-45). Antimüllerian hormone values were analysed using an ELISA assay (antimüllerian hormone Gen II ELISA assay; Beckman Coulter, Brea, CA, USA). Results: The mean age of women was 36.6 ± 4.3 years. Antimüllerian hormone values were inversely correlated with age (r = −0.35; p < 0.001). From the regression equation, the estimated yearly decrease in antimüllerian hormone was 0.2 ng/ml. Significant differences were obtained in mean values of antimüllerian hormone among Cataluña, Baleares, and Andalucía. Conclusions: This study reports the distribution of antimüllerian hormone values in different age groups in Spain, and contribute to determine the ovarian reserve in Spanish women (AU)
Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Hormona Antimülleriana/uso terapéutico , Pruebas de Función Ovárica/métodos , Reserva Ovárica/fisiología , Fertilidad/fisiología , Técnicas de Maduración In Vitro de los Oocitos/métodos , Hormona Antimülleriana/metabolismo , Ensayo de Inmunoadsorción Enzimática/métodos , Estudios Transversales/métodos , Análisis de Varianza , Hormona Antimülleriana/administración & dosificación , Técnicas de Maduración In Vitro de los OocitosRESUMEN
OBJECTIVE: To assess the relationship between insulin resistance (IR) and left ventricular diastolic dysfunction (LVDD) in asymptomatic patients with morbid obesity (MO). METHODS: The study cohort consisted of 231 patients (165 women and 66 men) with MO (mean body mass index [BMI] of 46.0 kg/m2) and a control group of 93 age-and sex-matched apparently healthy control subjects (56 women and 37 men; mean BMI of 24.1 kg/m2). Tissue Doppler imaging echocardiography was used to provide measurements of ejection fraction, LVDD (peak early tissue Doppler velocity/peak late tissue Doppler velocity or Em/Am ratio), left ventricular mass (LVM), and left ventricular hypertrophy (LVH). Adiponectin levels, the homeostasis model assessment index, and the ratio of triglycerides to high-density lipoprotein cholesterol (TG/HDL) were used as surrogate markers of IR. RESULTS: The ejection fraction was normal and similar in the patient and control groups. LVDD (Em/Am ratio <1.0) and LVH prevalences were 52% and 30%, respectively, in the group with MO (significantly higher than in the control group; P<0.0005). The patients with MO displayed higher IR on the basis of all 3 surrogate markers (P<0.0005, respectively). Log-transformed adiponectin showed the strongest correlations with LVM and Em/Am ratios; log-transformed homeostasis model assessment index and TG/HDL ratio displayed less robust yet significant correlations. Stepwise multiple linear regression analysis identified hypertension and the TG/HDL ratio as independent predictors of 35.5% of the variance of LVDD. In contrast, LVM was mainly predicted by BMI, hypertension, and sex. CONCLUSION: LVH and LVDD are highly prevalent in asymptomatic patients with MO. IR is significantly correlated with both variables. Furthermore, LVDD is independently predicted by the presence of hypertension and the TG/HDL ratio. The prognostic implications of these findings warrant further studies.