The relationship between metabolic stress and Anti- Müllerian hormone (AMH) in women hospitalized in intensive care units

Ş. Aksin, Mehmet Yılmaz
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Abstract

Objective: Our study aimed to investigate the levels of anti-Müllerian hormone (AMH) to determine ovarian reserve in women in intensive care units experiencing metabolic and physiological stress. Materials and Methods: For this purpose, 37 women were hospitalized in the intensive care unit (ICU) of Siirt Training and Research Hospital between November 2022 and February 2023. The same number of healthy control groups were included in the study. Patient selection was based on acute physiology and chronic health assessment (APACHI II) score and injury severity score (ISS).Anti-müllerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) thyroid stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine (T4), adrenocorticotropic hormone (ACTH), cortisol. , prolactin, C-reactive hormone (CRP) serum levels were examined Results: There was no significant difference in mean age between intensive care patients (29.3±8.3 , n=37) and control group (28.0±0.0, n=37) (p=0.349). A statistically significant difference was found between the AMH values between the patients hospitalized in the intensive care unit and the control group (p=0.012).AMH values were significantly lower in ICU patients. However, the T3 value was observed to be significantly lower in ICU patients compared to the control group (p < 0.0001). Additionally, prolactin, CRP, and cortisol values were found to be statistically significantly higher. Conclusion: This study revealed a significant decrease in anti-Müllerian hormone (AMH) levels among women experiencing metabolic and physiological stress in intensive care units. The lowered AMH levels suggest a potential impact on ovarian reserve in such conditions. Additionally, the observation of reduced T3 levels in ICU patients could indicate thyroid function alterations during times of stress. The elevated prolactin, CRP, and cortisol levels further underscore the physiological disruptions experienced by ICU patients. These findings emphasize the importance of considering hormonal and metabolic changes in critically ill women, particularly in relation to their ovarian health. Further research is warranted to elucidate the intricate mechanisms underlying these hormonal alterations and their potential long-term implications.
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重症监护室住院妇女代谢应激与抗勒氏杆菌激素(AMH)的关系
目的:我们的研究旨在研究抗勒氏激素(AMH)水平,以确定在重症监护病房经历代谢和生理应激的妇女卵巢储备。材料和方法:为此目的,在2022年11月至2023年2月期间,在Siirt培训与研究医院重症监护病房(ICU)住院的37名妇女。同样数量的健康对照组也被纳入研究。患者的选择基于急性生理和慢性健康评估(APACHI II)评分和损伤严重程度评分(ISS)。抗勒氏激素(AMH)、促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E2)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)、四碘甲状腺原氨酸(T4)、促肾上腺皮质激素(ACTH)、皮质醇。结果:重症监护组患者(29.3±8.3,n=37)与对照组(28.0±0.0,n=37)的平均年龄差异无统计学意义(p=0.349)。重症监护室住院患者与对照组AMH值比较,差异有统计学意义(p=0.012)。ICU患者AMH值明显降低。而ICU患者T3值明显低于对照组(p < 0.0001)。此外,催乳素、CRP和皮质醇值也有统计学意义上的显著升高。结论:本研究揭示了在重症监护病房经历代谢和生理应激的妇女中抗勒氏杆菌激素(AMH)水平显著降低。AMH水平的降低表明在这种情况下对卵巢储备的潜在影响。此外,观察到ICU患者T3水平的降低可能表明应激时期甲状腺功能的改变。催乳素、CRP和皮质醇水平的升高进一步强调了ICU患者所经历的生理破坏。这些发现强调了考虑危重妇女的激素和代谢变化的重要性,特别是与她们的卵巢健康有关。需要进一步的研究来阐明这些激素变化背后的复杂机制及其潜在的长期影响。
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