Primary Ovarian Insufficiency due to Steroidogenic Cell Autoimmunity Is Associated with a Preserved Pool of Functioning Follicles
Primary Ovarian Insufficiency due to Steroidogenic Cell Autoimmunity Is Associated with a Preserved Pool of Functioning Follicles
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DOI：
10.1210/jc.2009-0817
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发表时间：
2009-10-01
影响因子：
5.8
通讯作者：
Falorni, Alberto
中科院分区：
文献类型：
--
作者：
La Marca, Antonio;Marzotti, Stefania;Falorni, Alberto
原发性卵巢功能不全是指40岁以前的高促性腺激素性闭经。在4-5%的POI患者中，卵巢自身免疫过程是present.Design：血清中的抗苗勒管激素（AMH）的浓度已被确定在26名妇女与POI由于类固醇生成细胞自身免疫（SCA-POI），66与非自身免疫性特发性POI（iPOI），40绝经后妇女（PMW），和44名健康的生育妇女（HW）。结果：SCA-POI患者AMH浓度显著高于iPOI（P = 0.018）或PMW（P = 0.03），但显著低于HW（P < 0.0001）。26例SCA-POI患者中有11例（42%）和66例iPOI患者中有7例（11%）检测到AMH（P = 0.002）。在26名SCA-POI女性中有9名（35%）和66名iPOI女性中有4名（6%）检测到血清浓度高于正常范围的第五百分位数（0.6 ng/ml）（P = 0.001）。12名SCA-POI患者中，年龄小于5年的8名（67%）和14名病程较长的患者中的1名（7%）AMH浓度在正常范围内（P = 0.003）。SCA-POI女性患者AMH浓度与病程呈负相关（rho =-0.563，P = 0.003），但iPOI女性患者AMH浓度与病程无关。HW组AMH与FSH血清浓度呈负相关（rho =-0.584，P < 0.001），而PMW组和POI组AMH与FSH血清浓度无相关性（P> 0.05）。SCA-POI的女性，与iPOI的女性不同，在诊断卵巢功能不全后几年内存在保留的卵泡池。（临床内分泌代谢杂志94：3816-3823，2009）
Context: Primary ovarian insufficiency (POI) is defined as hypergonadotropic amenorrhea before the age of 40 yr. In 4-5% of patients with POI, an ovarian autoimmune process is present.Design: Serum concentrations of antimullerian hormone (AMH) have been determined in 26 women with POI due to steroidogenic cell autoimmunity (SCA-POI), 66 with nonautoimmune idiopathic POI (iPOI), 40 postmenopausal women (PMW), and 44 healthy fertile women (HW). SCA-POI was diagnosed according to presence of steroidogenic enzyme autoantibodies (17 alpha-hydroxylase, side chain cleavage, and 21-hydroxylase autoantibodies).Results: AMH concentrations were significantly higher in women with SCA-POI than women with iPOI (P = 0.018) or PMW (P = 0.03) but significantly lower than HW (P < 0.0001). AMH was detected in 11 of 26 women with SCA-POI (42%) and seven of 66 with iPOI (11%) (P = 0.002). Serum concentrations above the fifth percentile of the normal range (0.6 ng/ml) were detected in nine of 26 women with SCA-POI (35%) and four of 66 with iPOI (6%) (P = 0.001). Eight of 12 women with SCA-POI with less than 5 yr (67%) and one of 14 with longer disease duration (7%) had AMH concentrations within the normal range (P = 0.003). AMH concentrations correlated inversely with disease duration in women with SCA-POI (rho = -0.563, P = 0.003) but not women with iPOI. AMH correlated inversely with FSH serum concentrations in HW(rho = -0.584, P < 0.001) but not PMW or women with POI.Conclusions: Two thirds of women with recent-onset SCA-POI had normal AMH concentrations. Women with SCA-POI, differently from those with iPOI, present a preserved ovarian follicle pool for several years after diagnosis of ovarian insufficiency. (J Clin Endocrinol Metab 94: 3816-3823, 2009)