Journal of Capital Medical University ›› 2024, Vol. 45 ›› Issue (4): 583-588.doi: 10.3969/j.issn.1006-7795.2024.04.004

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

Wang Zecheng1, Ruan Xiangyan1,2*, Yang Yu1,Li Jing1, Alfred O. Mueck1,2   

  1. 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).

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

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