RESUMEN
The article presents data on the relationship of pathogenetic mechanisms for the development of menstrual disorders of functional and organic origin in connection with mental disturbances from the point of view of the psychosomatic concept. According to the latter, functional disorders of the menstrual cycle are considered as psychosomatic, in which gynecological pathology develops as a result of psychopathological illness. A striking example of such a disorder is functional hypothalamic amenorrhea. At the same time, endocrinopathies, such as polycystic ovary syndrome and premature ovarian insufficiency, can also be considered in the paradigm of psychosomatic illnesses of ovarian function due to the high prevalence of anxiety and depressive disorders in this cohort of patients. This review highlights the importance of interdisciplinary collaboration between a gynecologist and a psychiatrist for the most effective reproductive rehabilitation of patients with amenorrhea. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2018 to 2023.However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1985.
Asunto(s)
Menopausia Prematura , Síndrome del Ovario Poliquístico , Femenino , Humanos , Amenorrea/epidemiología , Amenorrea/etiología , Trastornos Psicofisiológicos/complicaciones , Trastornos Psicofisiológicos/epidemiología , Trastornos de la MenstruaciónRESUMEN
BACKGROUND: 2025 is going to be the 100th anniversary of the first historical description of Turner syndrome - complex of genomic abnormalities, congenital gonadal disruption and hypergonadotropic hypogonadism. Total estrogenic deficiency triggers development of age-related comorbidities. There is no doubt that personalized search for replicative markers of cellular aging among females with Turner syndrome is needed. AIM: To evaluate features of replicative (telomere length) and biochemical (lipid profile, calcium-phosphate album, thyroid hormones, markers cytolysis and cholestasis, carbohydrate metabolism, nitrogenic metabolism, electrolytes, FSH) markers among females with Turner syndrome. MATERIALS AND METHODS: Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022. Females with non-iatrogenic hypergonadotropic hypogonadism caused by Turner syndrome (45,X0; 45,X/46,XX; 45,X/46,X,r(X); 13-40 y.o.; n=26) and primary ovarian insufficiency (18-39 нyears=26); healthy females of reproductive age (15-49 y.o.; n=24). Patients have undergone laboratory genetic (leucocyte telomere length), biochemical (fasting glycaemia, urea, creatinine, common/conjugated bilirubin, ALT, AST, gamma-glutamyl transferase, triglycerides, HDL-P, LDL-P, common cholesterol, common/ionized calcium, phosphate, vitamin D, sodium/potassium/chlorides, FSH, HbA1c) analyses. Body measurements - body mass, body height. DNA extraction - provided with Qiagen DNA blood mini kit (Germany). Leukocyte telomere length - with real-time polymerase chain reaction PCR (Flow-fish). Soft program IBM SPSS Statistics (version 26,0 for Windows). RESULTS: 1. Females with Turner syndrome have significantly lower mean telomere length (8,22 kB [6,63-9,30]) than with primary ovarian insufficiency (10, 34 кР[8,41-13,08], p<0,001) and healthy reproductive age females (10,77 kB [9,95-13,16], Ñ>0,05).2. Telomere length correlates directly and significantly with longevity of menopausal hormonal therapy among females with primary ovarian insufficiency (ρ = 505; p<0,001).3. Patients with Turner syndrome are inclined to vitamin D deficiency (Ñ<0,001), dyslipidemia (Ñ=0,01); increase of levels of aminotransferases, cholestasis markers, phosphate and FSH (Ñ<0,001). CONCLUSION: Turner syndrome is serious genetic disease that leads not only to infertility but to significant decrease of quality/life longevity out of "healthy aging" conception.
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Colestasis , Hipogonadismo , Insuficiencia Ovárica Primaria , Síndrome de Turner , Animales , Humanos , Femenino , Síndrome de Turner/complicaciones , Síndrome de Turner/genética , Insuficiencia Ovárica Primaria/genética , Calcio , ADN , Fosfatos , Hormona Folículo EstimulanteRESUMEN
Ageing (as known as eldering, senescence) is a genetically and epigenetically programmed pathophysiological process. Velocity of biological ageing is defined as balance between alteration and reparation of body structures. According to last World Health Organization (WHO) highlights ageing still stays an extremely actual scientific, social and demographic problem: in 2020 total number of people older than 60 years and older was 1 billion people; in 2030 future number may be 1,4 billion people, in 2050 - 2,1 billion people. Absence of single universal theory of aging nowadays is reason for scientifical and clinical collaboration between biologists and doctors, including endocrinologists. Designing of potentially effective newest anti-ageing strategies (such as natural/synthetic telomerase regulators, mesenchymal stem cells etc.) is of interest to scientific community. The aim of present article is a review of modern omics (genomic, proteomic, metabolomic) ageing mechanisms, potential ways of targeted prevention and treatment of age-related disease according to conception of personalized medicine. Present review is narrative, it does not lead to systematic review, meta-analysis and does not aim to commercial advertisement. Review has been provided via PubMed article that have been published since 1979 until 2022.
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Envejecimiento , Proteómica , Humanos , Envejecimiento/genéticaRESUMEN
Menopausal symptoms can disrupt the life course of women at the peak of their career and family life. Currently, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormonal therapy is the fear of doctors who are afraid of doing more harm to patients than good. Caution is especially important when it comes to women with underlying health conditions. Moreover, it should be recognized that there is a lack of high-quality research regarding the safety of MHT for major chronic non-infectious diseases and common comorbid conditions. The presented consensus document analyzed all currently available data obtained from clinical trials of various designs and created a set of criteria for the acceptability of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, doctors of various specialties who advise women in menopause will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real practice.
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Terapia de Reemplazo de Estrógeno , Enfermedades Metabólicas , Humanos , Femenino , Terapia de Reemplazo de Estrógeno/efectos adversos , Ginecólogos , Endocrinólogos , Obstetras , Consenso , Calidad de Vida , Menopausia , Enfermedades Metabólicas/tratamiento farmacológico , Enfermedades Metabólicas/etiología , HormonasRESUMEN
Menopausal symptoms can impair the life of women at the peak of their career and family life. At the present time, the most effective treatment for these manifestations is menopausal hormone therapy (MHT). The presence of cardiovascular and metabolic diseases in itself does not exclude the possibility of prescribing MHT to relieve menopausal symptoms and improve quality of life. However, often an obstacle to the use of this type of hormone therapy is the fear of physicians to do more harm to patients than good. Caution is especially important when it comes to women with concurrent diseases. Moreover, it should be recognized that there is a shortage of high-quality research on the safety of MHT for underlying chronic non-infectious diseases and common comorbidities. The presented consensus analyzed all currently available data from clinical trials of various designs and created a set of criteria for the appropriateness of prescribing MHT to women with concomitant cardiovascular and metabolic diseases. Based on the presented document, physicians of various specialties who advise menopausal women will receive an accessible algorithm that will allow them to avoid potentially dangerous situations and reasonably prescribe MHT in real-life practice.
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Terapia de Reemplazo de Estrógeno , Calidad de Vida , Femenino , Humanos , Terapia de Reemplazo de Estrógeno/efectos adversos , Consenso , Menopausia , Federación de Rusia , Terapia de Reemplazo de HormonasRESUMEN
AIM: To compare the efficiency of two surgical methods, holmium laser enucleation of prostate (HoLEP) and laparoscopic retropubic simple prostatectomy with clamping of internal iliac arteries and vesicourethral anastomosis [LPA+CIIA+VUA]) for treating of patients with benign prostatic hyperplasia (BPH) and type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: A total of 56 men with T2DM who underwent surgical treatment of BPH in the National Research Centre for Endocrinology of the Russian Ministry of Health (director - corresponding member of RAS Mokrysheva N.G..) in a period from 2021 until 2022 were included in the study. Patients with T2DM received two types of antidiabetic drugs: basal-bolus insulin therapy and metformin (1000 mg/day per os). Patients were divided into the group of LPA+CIIA+VUA (n=28) and HoLEP (n=28). Preoperative, intraoperative and postoperative examinations with an evaluation of intraoperative and early postoperative complications (I, II, III, IV grades according to the Clavien-Dindo scale) were performed. After 1 year of follow-up, International Prostatic Symptom Score (IPSS), "Quality of Life" score (QoL), International Index of Erectile Function-5 score (IIEF-5), maximal urine flow rate (Qmax), and postvoid residual volume (ml) were assessed. Efficiency of surgical procedures was estimated according to "trifecta": absence of postoperative complications, urine continence, maximal urine flow (Qmax) >15 ml/sec. RESULTS: In the group of HoLEP, shorter postoperative bladder catheterization time but higher risk of urinary incontinence, bladder neck contracture and urethral strictures was found. LPA+CIIA+UVA leaded to a two-fold decrease in intraoperative hemoglobin loss with no necessity of repeat procedures. CONCLUSIONS: Our preliminary results demonstrated higher efficacy of LPA+CIIA+VUA for treatment of BPH in patients with T2DM than HoLEP. Patients who underwent LPA+CIIA+VUA were more often achieved the "trifecta". In order to implement LPA+CIIA+VUA into clinical practice, multi-center, large-scale, double-blind, placebo-controlled ("scar-surgery") randomized studies are required.
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Diabetes Mellitus Tipo 2 , Terapia por Láser , Láseres de Estado Sólido , Hiperplasia Prostática , Resección Transuretral de la Próstata , Masculino , Humanos , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/cirugía , Hiperplasia Prostática/diagnóstico , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/cirugía , Calidad de Vida , Resultado del Tratamiento , Resección Transuretral de la Próstata/métodos , Terapia por Láser/métodos , Láseres de Estado Sólido/uso terapéutico , Complicaciones Posoperatorias/cirugíaRESUMEN
BACKGROUND: Estrogenic deficiency is the basic condition of human ageing that leads to hypergonadotropic hypogonadism. The existence of correlation between hypergonadotropic hypogonadism, replicative (leukocyte telomere length) and biochemical data is widely supposed among females with physiological (menopausal) and pathological (primary ovarian insufficiency) estrogenic deficiency is not unreasonable. AIM: To evaluate features of replicative (telomere length) and biochemical (metabolic syndrome) ageing markers among females with physiological (menopausal) and pathological (primary ovarian insufficiency) estrogenic deficiency. MATERIALS AND METHODS: Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022.110 females (20-75y.o.) have participated in the present research.Group 1: 26 females receiving menopausal hormonal therapy (MHT) ≥ 5 years with 0,5; 1; 2 mg estrogenic component.Group 2: 27 females in physiological menopause without MHTGroup 3: 33 females with primary ovarian insufficiency and receiving sex-steroid replacement therapy.Group 4: 24 healthy reproductive age females without sex-steroid replacement therapy.Patients have undergone laboratory genetic (leucocyte telomere length), biochemical analyses.DNA extraction - with Qiagen DNA blood mini kit (Germany). Biological material was cito conserved with Ficoll solution. Leukocyte telomere length - with real-time polymerase chain reaction PCR (Flow-fish).Soft program IBM SPSS Statistics (version 26,0 for Windows) has been used for statical analysis. RESULTS: 1.Menopausal females receiving MHT were inclined to highest HDL-P levels (p<0,006).2.Females with primary ovarian insufficiency were inclined to relatively highest serum creatinine level (p<0,001).3.Reproductive age females had relatively highest telomere length (p<0,001).4.FSH level correlates negatively and moderately (ρ= - 0,434) leukocyte telomere length (Ñ<0,001) among females. CONCLUSION: Females with premature ovarian insufficiency are most sensible to ageing due to features of replicative and biochemical markers.
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Hipogonadismo , Insuficiencia Ovárica Primaria , Femenino , Humanos , Envejecimiento/genética , ADN , Reacción en Cadena en Tiempo Real de la Polimerasa , Esteroides , Adulto Joven , Adulto , Persona de Mediana Edad , AncianoRESUMEN
BACKGROUND: One of the most dangerous reproductive pathologies is primary ovarian insufficiency (POI). Except manifestation in the age <40 years old it leads to demographical losses, decrease of chances for healthy aging. POI can be characterized as summary of secondary amenorrhea, total estrogenic deficiency and hypergonadotropic hypogonadism. Hence, POI has probably harmful effect on telomere length. Telomere length determining and sex steroid replacement therapy may be promising and effective to prevent decrease of life quality/ longevity among females with POI. AIM: To evaluate features of replicative (telomere length) and biochemical (metabolic syndrome) markers among females with primary ovarian insufficiency. MATERIALS AND METHODS: Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022. Females with non-iatrogenic hypergonadotropic hypogonadism caused by primary ovarian insufficiency (n=33); healthy females of reproductive age (18-49 y.o.; n=24). Patients have undergone laboratory genetic (leucocyte telomere length), biochemical analyses. DNA extraction - with Qiagen DNA blood mini kit (Germany).Leukocyte telomere length - with real-time polymerase chain reaction PCR (Flow-fish). Soft program IBM SPSS Statistics (version 26,0 for Windows). RESULTS: Females with POI due to estrogenic deficiency have slightly shorter mean telomere length (10,0 [7,9-10,7] kB, than healthy females of reproductive age (10,8 [10,0-13,1] кÐ, Ñ<0,001). Females with POI due to estrogenic deficiency have higher chances for development of carbohydrate metabolism disturbances (prediabetes) (Ñ<0,043), increasement of FSH level (Ñ<0,001). FSH level correlates moderately and negatively (ρ=0,434) with leukocyte telomere length (Ñ<0,001). CONCLUSIONS: Female with POI and receiving sex steroid replacement therapy have decrease of telomere length and increase of chances for carbohydrate metabolism disturbances in opposite to healthy reproductive females.
Asunto(s)
Hipogonadismo , Insuficiencia Ovárica Primaria , Humanos , Animales , Femenino , Insuficiencia Ovárica Primaria/genética , Amenorrea/genética , Hormonas Esteroides Gonadales , Hormona Folículo Estimulante , EsteroidesRESUMEN
Present worldwide healthcare researches prove that female patients are more sensitive to the population aging. Menopause or climacteria (climax) - is not as ageing itself, but a physiological unstoppable process. The main task for a physician is to improve life quality for female despite of ageing problems. Menopausal hormone therapy (MHT) due to the estrogen component has an anti-inflammatory, antioxidant effect and promotes the expression of telomerase, which together changes the homeostasis and integrity of telomeres. The use of MHT for five years or more can not only significantly change the quality of life, but also increase its duration. Literature search was carried out in national (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The priority was free access to the full text of articles. The choice of sources was prioritized for the period from 2019 to 2021. However, taking into account the insufficient knowledge of the chosen topic, the choice of sources dates back to 1989.
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Calidad de Vida , Rejuvenecimiento , Senescencia Celular/genética , Femenino , Humanos , Menopausia , Telómero/genéticaRESUMEN
BACKGROUND: The cocaine-amphetamine regulated transcript has been discovered long time ago (circa over 25 years ago) but still stays not enough investigated. Just during last five years scientist's society started providing interest to the genomic, proteomic and metabolic essence of the cocaine-amphetamine regulated transcript. AIM: The evaluation of historical pathway and perspectives of the cocaine-amphetamine regulated transcript medical investigations. MATERIALS AND METHODS: The literature search has been provided via Russian (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases and among articles on Russian and English languages. The main criteria for article selection was free access and 2019-2021 years of publishing. Although the introduction is based on the articles published in 1989. The present article was created according to the federal project «Central and peripheral pathophysiological mechanisms of adipose tissue diseases and their clinical and hormonal manifestations паÑоÑизиологиÑеÑкие Ð¼ÐµÑ Ð°Ð½Ð¸Ð·Ð¼Ñ ÑазвиÑÐ¸Ñ Ð±Ð¾Ð»ÐµÐ·Ð½ÐµÐ¹ жиÑовой Ñкани Ñ ÑÑеÑом клиниÑеÑÐºÐ¸Ñ Ð¸ гоÑмоналÑнÑÑ Ñ Ð°ÑакÑеÑиÑÑик¼ (2020-2022)RESULTS AND CONCLUISON: It is necessary to keep on investigating genomic, proteomic and metabolomic markers because they contain important clues for successful resistance against human diseases. The 21st century is the era of transformation from simple clinical medicine to personalized science. For example, researches in the area of cocaine-amphetamine regulated transcript may result in invention of genetic medicine against dangerous metabolic diseases.
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Anfetamina , Cocaína , Cocaína/farmacología , Humanos , Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/metabolismo , Proteómica , Federación de RusiaRESUMEN
Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. Depending on the period of a woman's life, the clinical picture, diagnosis, and treatment tactics of the disease are different. PCOS has a complex of reproductive, metabolic and psychological characteristics. The target audience of these clinical recommendations are obstetrician-gynecologists, endocrinologists, general practitioners, general practitioners. In these clinical guidelines, all information is ranked according to the level of persuasiveness of recommendations and the reliability of evidence, depending on the number and quality of studies on this issue.
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Síndrome del Ovario Poliquístico , Endocrinólogos , Femenino , Humanos , Síndrome del Ovario Poliquístico/diagnóstico , Síndrome del Ovario Poliquístico/psicología , Síndrome del Ovario Poliquístico/terapia , Reproducibilidad de los ResultadosRESUMEN
According to present medical databases there many trials to provide in vivo researches in vivo to confirm/refute shortening process of telomeres among patients with Turner syndrome. Despite the successful clinical experience of providing such patients with Turner syndrome, a lot of omics (proteomic and metabolomic) aspects still stay unclear. Main disadvantages of most researches are small volume and minimized mathematical correlation with chronic disease (coronary heart disease, essential hypertension, cardiovascular malformations). Finally, organization of international prospective multi-centered researches in vivo including patients with mosaic cariotype and co-operation between physicians and biologists are optimal solutions for this present problem.
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Anomalías Cardiovasculares , Síndrome de Turner , Femenino , Humanos , Masculino , Estudios Prospectivos , Proteómica , Telómero/genética , Telómero/patología , Síndrome de Turner/complicaciones , Síndrome de Turner/genética , Síndrome de Turner/patologíaRESUMEN
BACKGROUND: Melatonin is the main hormone of the pineal gland. By regulating circadian rhythms and being an immune regulator and antioxidant, this hormone takes part in the work of the ovaries: its high concentrations block apoptosis and neutralize reactive oxygen species involved in folliculogenesis, ovulation, egg maturation and corpus luteum formation. AIM: To study melatonin status and its relationship with menstrual dysfunction and sleep disorders in obese women of reproductive age. MATERIALS AND METHODS: In a one-stage comparative study, women 18-35 years old took part: 30 patients with obesity and menstrual disorders of an inorganic nature and 30 healthy women in the comparison group with normal weight and regular menstrual cycle. All participants underwent a questionnaire to identify somnological disorders, and the level of melatonin in saliva and 6-sulfatoxymelatonin in urine was also investigated. RESULTS: In the group of patients with obesity (n=30), various sleep disorders were encountered in 47% of cases (p=0.003), including more often obstructive sleep apnea syndrome was recorded (30% of cases), and a correlation was found between the indicators of the questionnaire survey of subjective sleep characteristics and body mass index of patients (r=0.450, p=0.030) compared with a group of healthy women with normal weight (n=30). In the main group, the level of melatonin in saliva was statistically significantly lower than in the control: median 12.6 pg / ml and 25.5 pg / ml, respectively (p=0.008), the same pattern was recorded for 6-sulfatoxymelatonin: 14, 72 pg / ml and 31.12 pg / ml, respectively. CONCLUSION: Patients with obesity and menstrual dysfunction are more likely to suffer from various sleep disorders and have lower levels of melatonin in saliva and 6-sulfatoxymelatonin in urine.
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Melatonina , Adolescente , Adulto , Ritmo Circadiano/fisiología , Femenino , Humanos , Melatonina/orina , Obesidad/complicaciones , Saliva , Sueño/fisiología , Adulto JovenRESUMEN
BACKGROUND: The increasing prevalence of gestational diabetes mellitus (GDM), the high probability of unfavorable pregnancy outcomes for the mother and the fetus, as well as a number of long-term consequences in GDM are a serious medical and social problem and require the need for its prevention by correcting risk factors, timely diagnosis and effective treatment. AIM: Analysis of risk factors for the development of gestational diabetes mellitus (GDM), the relationship between GDM, the course and outcomes of pregnancy. MATERIALS AND METHODS: Retrospective analysis of 79 case histories of patients with confirmed GDM in the period from 2015 to 2017. RESULTS: In the structure of risk factors for mother and fetus, age over 30 years (73.1%), burdened heredity for type 2 diabetes mellitus (T2DM) (30.8%), mother's pre-pregnancy body mass index (BMI) (overweight / obesity (26.9%)) had the greatest impact. Among the complications of pregnancy, the most common was the caesarean section (47.4%). The incidence of other complications (macrosomia (9%), premature birth (7.7%), congenital malformations of the fetus (5.1%), preeclampsia (5.1%) was lower than the average frequency of these complications in GDM, described in the literature. Nevertheless, it is 1.5-2 times higher than the average population indicators. In the course of statistical analysis of the data it was revealed, that the higher the mother's pre-pregnancy BMI, the lower the Apgar score for the first minute in the newborn. CONCLUSION: Women with GDM require intensive monitoring of the course of pregnancy and timely hospitalization for planned delivery, and the provision of competent obstetric benefits.
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Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Adulto , Cesárea , Diabetes Gestacional/epidemiología , Femenino , Humanos , Recién Nacido , Embarazo , Resultado del Embarazo/epidemiología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
One of the new directions in the study of reproductive disorders in obese women is the effect and receptor sensitivity of melatonin on the gonadotropic function of the pituitary gland and ovariogenesis, taking into account the chronology of «light pollution¼. At the present stage, there is very little literature on the influence of the aspects of «light pollution¼ on the problem of obesity and reproductive disorders in the literature. This review is an attempt to combine the above problem in terms of the impact of «light pollution¼ and the level of receptor sensitivity of melatonin in women of reproductive age with obesity. The literature search was carried out in Russian (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. Free access to the full text of the articles was a priority. The selection of sources was prioritized for the period from 2015 to 2019. However, given the insufficient knowledge of the chosen topic, the choice of sources was dated from 1992. The work was carried out as part of the study «Central and peripheral pathophysiological mechanisms of development of adipose tissue diseases, taking into account clinical and hormonal characteristics¼ 2020-2022.
Asunto(s)
Melatonina , Enfermedades del Ovario , Femenino , Humanos , Obesidad/epidemiología , Reproducción , Federación de RusiaRESUMEN
AIM: To compare ovarian reserve in healthy women of reproductive age - carriers of antithyroid antibodies (ATA) and in healthy women of reproductive age negative for ATA. MATERIALS AND METHODS: 70 healthy women of young reproductive age in the state of euthyroidism (from 18 to 38 years old) were examined. Participants were divided into equal groups (n=35) depending on the status of the presence of antithyroid antibodies (AT-TPO, AT-TG). On the 2nd-4th days of the menstrual cycle, the following markers of the ovarian reserve were determined: serum levels of anti-Müllerian hormone (AMG), inhibin B, FSH, LH, estradiol, testosterone and progesterone, as well as ultrasound parameters - the number of antral follicles and the volume of the ovaries. In addition, to determine the predisposition to premature ovarian failure, an analysis was performed to the number of CGG repeats in the FMR1 gene. RESULTS AND DISCUSSION: Statistically significantly differs such parameters as the level of estradiol and testosterone, while the differences were not clinically significant. All the parameters evaluated were within the normal range, the main predictors of the ovarian reserve (levels of AMG and inhibin B, the number of antral follicles) remained in the normal range. An increase in the number of repeats of CGG in the FMR1 gene was not detected in any of the participants in the study. CONCLUSION: In healthy young reproductive age women, the status of ATA does not have a direct effect on the ovarian reserve.
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Reserva Ovárica , Enfermedades de la Tiroides , Adolescente , Adulto , Hormona Antimülleriana , Femenino , Hormona Folículo Estimulante , Proteína de la Discapacidad Intelectual del Síndrome del Cromosoma X Frágil , Humanos , Folículo Ovárico , Reproducción , Adulto JovenRESUMEN
AIM: To evaluate the ovarian reserve function in female patients with obesity in comparison with women without obesity. MATERIALS AND METHODS: This study evaluated 500 caucasian women, age 20-30 years, 250 with obesity (body mass index, BMI ≥30 kg/m2) and 250 without obesity (BMI <30 kg/m2). Anthropometrics, serum concentrations of anti-Mullerian hormone (AMH), inhibin B, follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, and testosterone were compared as ovarian volume (cm3) and antral follicle count (AFC), determined by ovarian transvaginal ultrasonography. RESULTS: We reveal statistically significant difference in following parameters: AMH (2.7±0.47 ng/ml vs. 3.8±0.63 ng/ml; p<0.05), testosterone (1.4±0.3 nmol/l vs. 0.7±0.2 nmol/l; p<0.01), ovarian volume (7.2±1.9 cm3 vs 9.5±1.7 cm3; p<0.05), and AFC (13.3±4.5 vs 20.7±7.2; p<0.01) in obesity group vs. control group respectively. CONCLUSION: Ovarian reserve function is significantly lower in obese patients than in healthy control subjects of young reproductive age, but ovarian reserve parameters are in normal reference range even in obese patients.
Asunto(s)
Obesidad , Reserva Ovárica , Hormona Antimülleriana , Femenino , Hormona Folículo Estimulante , Humanos , Obesidad/complicaciones , Folículo Ovárico , Ovario/metabolismoRESUMEN
Endocrine Medical Research center (EMRC) of the Ministry of health of Russia is unique clinical center, that have no analogs in the world. All forms of endocrine disorders may be diagnosed and treated here by implication of innovative methods. Institute of reproductive medicine of EMRC was open on 2017, director of this institute - MD, PhD E.N. Andreeva. Staff of this institute include highly experienced investigators and physicians. One of the most ambitious projects of the institute is development of prevention, diagnostic and treatment algorithm for patients with infertility of endocrine origin. For these purposes large prospective clinical trial (5000 patients) will be conducted with implementation of most modern genetic, laboratory and instrumental diagnostic methods. Results of this trial will allow diagnose, treat and prevent reproductive pathology in patients with endocrine diseases.
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Enfermedades del Sistema Endocrino , Infertilidad , Medicina de Precisión , Academias e Institutos , Enfermedades del Sistema Endocrino/complicaciones , Enfermedades del Sistema Endocrino/terapia , Humanos , Infertilidad/etiología , Infertilidad/terapia , Estudios Prospectivos , Medicina Reproductiva , Federación de RusiaRESUMEN
AIM: To investigate the impact of menopausal hormone therapy (MHT) on the expression of risk factors for cardiovascular events (CVEs) in patients with Shereshevsky-Turner syndrome (STS); to elaborate an algorithm for patient management using MHT. SUBJECTS AND METHODS: From 2010 to 2012, a total of 41 patients aged 14 to 35 years with STS were examined in the framework of a prospective observational study. 100 STS case histories in 2000 to 2009 were retrospectively analyzed. The indicators of the so-called cardiometabolic risk, such as body mass index (BMI), lipidogram readings, venous plasma glucose levels, and blood pressure, were estimated in relation to the type of MHT. In the prospective part of the investigation, an angioscan was used to estimate vessel characteristics (stiffness, wall tone, endothelial function (EF)), by using the examination data. RESULTS: 90% of the patients with STS were found to have risk factors for CVEs: atherogenic dyslipidemia (85%; 51% in the general female population of the same age), diastolic hypertension (36%; no more than 5% that is not typical for age-matched healthy general female population). In addition to increased arterial wall stiffness (AWS), obvious EF disorder is typical for STS patients. MHT was accompanied by a dose-dependent (estradiol, at least 2 mg) reduction in diastolic blood pressure by an average of 13% over 24 months, an increase in high density lipoprotein levels by more than 10% over 24 months and also contributedto a decrease in AWS and an improvement in EF. CONCLUSION: By favorably affecting the EF of vessels and reducing the severity of atherogenic dyslipidemia, MHT potentially enables a reduction in CV risk in patients with STS.
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Determinación de la Presión Sanguínea , Enfermedades Cardiovasculares , Endotelio Vascular/efectos de los fármacos , Estradiol/administración & dosificación , Terapia de Reemplazo de Estrógeno/métodos , Síndrome de Turner , Adulto , Algoritmos , Aterosclerosis/metabolismo , Aterosclerosis/prevención & control , Determinación de la Presión Sanguínea/métodos , Determinación de la Presión Sanguínea/estadística & datos numéricos , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , HDL-Colesterol/sangre , Relación Dosis-Respuesta a Droga , Estrógenos/administración & dosificación , Femenino , Humanos , Administración del Tratamiento Farmacológico , Evaluación de Procesos y Resultados en Atención de Salud , Federación de Rusia/epidemiología , Síndrome de Turner/diagnóstico , Síndrome de Turner/metabolismo , Síndrome de Turner/terapia , Rigidez Vascular/efectos de los fármacosRESUMEN
Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disease in women. The prevailing complaints at a young age are menstrual irregularities, infertility, and hyperandrogenism-related problems. However, metabolic disorder-induced complications have been in the foreground over years. The review gives the current ideas on a change of clinical manifestations in the natural course of PCOS, as well as the pathogenetically grounded prevention of complications in patients.