血清镉水平在卵巢早衰病因学中的作用:一项病例对照研究

Sevil Cicek, P. Kırıcı, A. Karaer
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摘要

卵巢早衰(POF)是一种临床综合征,已知影响约1%的育龄妇女。许多遗传、自身免疫、代谢、感染和环境因素已被确定为POF的病因。镉是一种有毒金属,可在卵巢中积累,并导致颗粒细胞中调节类固醇生成酶活性的促性腺激素结合显著减少。我们的目的是研究镉在POF病因学中的作用。35例POF患者被纳入第一组,即研究组。两个对照组由健康的参与者组成。35名年龄匹配、月经规律的年轻女性被纳入第二组。35名健康绝经后妇女被纳入第三组。记录患者的人口统计数据。测定血清促卵泡激素(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)、甲状腺素(T4)和镉水平。妊娠、胎次、活儿组间差异有统计学意义(p<0.001),流产组间差异无统计学意义(p=0.430)。两组间血清FSH、LH、E2水平差异有统计学意义(p<0.001), T3、T4、TSH水平差异无统计学意义。与2、3组相比,1组血清镉水平显著降低(p<0.001)。本研究表明,镉对POF的发展没有直接影响,但需要注意的是,金属的协同和拮抗作用可能会影响这一结果。
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The Role of Serum Cadmium Levels in the Etiology of Premature Ovarian Failure: A Case-Control Study
Premature ovarian failure (POF) is a clinical syndrome known to affect approximately 1% of women of reproductive age. A number of genetic, autoimmune, metabolic, infectious and environmental causes have been identified in the etiology of POF. Cadmium is a toxic metal which can accumulate in ovaries and causes a significant decrease in the binding of gonadotropins that regulate steroidogenic enzyme activity in granulosa cells. We aimed to investigate the role of cadmium in the etiology of POF. Thirty-five patients with POF were enrolled in group 1 which was the study group. Two control groups were formed from healthy participants. Thirty-fiveparticipants who were age-matched young women with regular menstruation were included in group 2.Thirty-fivehealthy postmenopausal women were included in group 3. Patients' demographic data were recorded. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and cadmium levels were measured. There was a statistically significant difference between the groups for gravida, parity and living children (p<0.001), but no difference was found for abortion (p=0.430). While there was a statistically significant difference between the groups for serum FSH, LH and E2 levels (p<0.001), no statistically significant difference was found for T3, T4 and TSH. Serum cadmium levels were found to be statistically significantly decreased in group 1 compared to g roups 2 and 3 (p<0.001). This study revealed that cadmium had no direct effect on the development of POF, but it should be kept in mind that the synergistic and antagonistic effects of metals may affect this result.
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