医源性早发性卵巢功能不全性激素水平的变化及对糖代谢的影响

doi:10.3969/j.issn.1006-7795.2024.04.004

首都医科大学学报 ›› 2024, Vol. 45 ›› Issue (4): 583-588.doi: 10.3969/j.issn.1006-7795.2024.04.004

• 更年期生殖内分泌与生育力保护 • 上一篇下一篇

医源性早发性卵巢功能不全性激素水平的变化及对糖代谢的影响

王泽铖¹, 阮祥燕^1，2*, 杨瑜¹, 李婧¹, Alfred O. Mueck^1，2

1.首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科，北京 100026； 2.德国图宾根大学妇产医院妇女健康部与妇女健康研究中心，图宾根 D-72076

收稿日期:2024-04-30 出版日期:2024-08-21 发布日期:2024-07-08
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
北京市卫生健康委员会北京市研究型病房示范建设项目（BCRW202109)，北京市医院管理中心“登峰”计划专项(DFL20181401)，中国人体健康科技促进会科研专项（JKHY202003）。

Changes in sexual hormone levels of iatrogenic premature ovarian insufficiency and its impact on glucose metabolism

Wang Zecheng¹， Ruan Xiangyan^1，2*， Yang Yu¹，Li Jing¹， Alfred O. Mueck^1，2

1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing 100026, China; 2.Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University Hospitals of Tuebingen, Tuebingen D-72076, Germany

Received:2024-04-30 Online:2024-08-21 Published:2024-07-08
Supported by:
This study was supported by Beijing Municipal Health Commission, Demonstration Construction Project of Clinical Research Ward (BCRW202109), Beijing Municipal Administration of Hospitals' Ascent Plan (DFL20181401)，China Association for Promotion of Health Science and Technology Special Fund Project for Scientific Research (JKHY202003).

摘要/Abstract

摘要： 目的研究医源性早发性卵巢功能不全（premature ovarian insufficiency,POI）性激素水平的变化及对糖代谢的影响。方法募集2022年1月到2024年4月就诊于首都医科大学附属北京妇产医院内分泌科的20~40岁的60例因造血干细胞移植（hematopoietic stem cell transplantation, HSCT）导致的医源性POI患者和60例特发性POI患者，一般资料包括身高、体质量、年龄，并计算体质量指数(body mass index，BMI)，实验检测指标包括卵泡刺激素(follicle stimulating hormone，FSH)、黄体生成素(luteinizing hormone，LH)、雌二醇（estradiol，E₂）、皮质醇（cortisol,F)、总睾酮（total testosterone，TT）、游离睾酮（free testosterone，FT）、空腹血糖（fasting plasma glucose, FPG）及空腹胰岛素（fasting insulin, FINS）。结果医源性POI患者体质量、BMI、E₂、TT、FT低于特发性POI患者，差异有统计学意义（P均＜0.05）。医源性POI患者的FSH、LH、FINS、FPG高于特发性POI患者，差异有统计学意义（P均＜0.05）。医源性POI患者与特发性POI患者的年龄、身高和皮质醇相比，差异无统计学意义（P均＞0.05）。医源性POI患者高胰岛素血症的比例明显高于特发性POI患者（P=0.025）。结论医源性POI患者性激素水平的降低和糖代谢异常均比特发性POI患者更加严重，可能原因是疾病治疗对卵巢功能的损伤更大。但医源性POI是可以预防的。卵巢组织冻存（ovarian tissue cryopreservation， OTC）可以同时保护生育力和卵巢内分泌功能，使医源性POI的防治从不可能变为可能，因此在接受放射治疗和化学药物治疗之前进行OTC十分有必要。

关键词: 医源性, 特发性, 早发性卵巢功能不全, 性激素, 卵巢组织冻存, 糖代谢

Abstract: Objective To investigate the changes in sex hormone levels and their effects on glucose metabolism in patients with iatrogenic premature ovarian insufficiency (POI). Methods This study recruited 60 patients aged 20-40 years with iatrogenic POI due to hematopoietic stem cell transplantation (HSCT) and 60 patients with idiopathic POI who visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2022 to April 2024. General information collected included height, weight, age, and body mass index (BMI). Laboratory measurements included follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E₂), cortisol (F), total testosterone (TT), free testosterone (FT), fasting plasma glucose (FPG), and fasting insulin (FINS). Results Body weight, BMI, E₂, TT and FT levels were significantly lower in iatrogenic POI patients compared to idiopathic POI patients (all P<0.05). FSH, LH, FINS, and FPG levels were significantly higher in iatrogenic POI patients compared to idiopathic POI patients (all P<0.05). There were no significant differences in age, height, and cortisol levels between iatrogenic and idiopathic POI patients (all P>0.05). The proportion of iatrogenic POI patients with hyperinsulinemia was significantly higher than that of idiopathic POI patients (P=0.025).Conclusions Patients with iatrogenic POI exhibited more severe decreases in sex hormone levels and abnormalities in glucose metabolism compared to those with idiopathic POI, possibly due to greater damage to ovarian function from disease treatment. However, iatrogenic POI can be prevented by ovarian tissue cryopreservation (OTC) which can simultaneously preserve fertility and ovarian endocrine function. Therefore, it is highly necessary for patients undergoing OTC before receiving radiotherapy and chemotherapy.

Key words: iatrogenic, idiopathic, premature ovarian insufficiency, sexual hormones, ovarian tissue cryopreservation, glucose metabolism

中图分类号:

R711

王泽铖, 阮祥燕, 杨瑜, 李婧, Alfred O. Mueck. 医源性早发性卵巢功能不全性激素水平的变化及对糖代谢的影响[J]. 首都医科大学学报, 2024, 45(4): 583-588.

Wang Zecheng, Ruan Xiangyan, Yang Yu, Li Jing, Alfred O. Mueck. Changes in sexual hormone levels of iatrogenic premature ovarian insufficiency and its impact on glucose metabolism[J]. Journal of Capital Medical University, 2024, 45(4): 583-588.

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医源性早发性卵巢功能不全性激素水平的变化及对糖代谢的影响

Changes in sexual hormone levels of iatrogenic premature ovarian insufficiency and its impact on glucose metabolism

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