评估不同血糖特征的 1 型糖尿病女性的卵泡生成和氧化应激参数。

IF 3.7 3区 医学 Q2 Medicine Endocrine Pub Date : 2024-09-01 Epub Date: 2024-06-06 DOI:10.1007/s12020-024-03805-4
A V Tiselko, E V Misharina, M I Yarmolinskaya, Y P Milyutina, I V Zalozniaia, A V Korenevsky
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引用次数: 0

摘要

背景:尽管糖尿病治疗取得了巨大进步,但与未患糖尿病的妇女相比,患有1型糖尿病(DM)的妇女仍会出现初潮推迟、月经不调、怀孕次数减少以及死胎率高等问题。目的:本研究旨在评估 1 型糖尿病育龄期患者不同血糖谱与促氧化剂-抗氧化剂平衡和卵巢卵泡器变化之间的关系:我们研究了50名育龄期(19-38岁)1型DM女性患者,她们的病程至少有10年。通过连续血糖监测(CGM)系统和糖化血红蛋白(HbA1c)浓度测量对碳水化合物代谢进行了评估。CGM 使用 FreeStyle Libre 闪存葡萄糖监测系统(雅培糖尿病护理公司,英国威特尼)进行。对每位患者的血清中丙二醛水平、过氧化氢酶活性和 3-硝基酪氨酸水平进行了测定。为了评估卵巢功能,我们测量了卵巢体积、前卵泡计数以及血清中抗苗勒氏管激素和卵泡刺激素的水平。根据 CGM 的结果,所有患者被分为四组(血糖分型)。第 1 组包括碳水化合物代谢代偿令人满意的 1 型糖尿病患者;第 2 组包括经常出现低血糖和病理性血糖变异的患者;第 3 组包括长期高血糖和 HbA1c 水平最高的患者;第 4 组包括血糖状况以所有出现的血糖异常类型(间歇性血糖)为特征的患者:根据 CGM 的结果,我们发现 1 型糖尿病患者的血清过氧化氢酶活性与低血糖时间呈负相关(rs = -0.47,p s = -0.82,p s = 0.68,p s = 0.88,p 结论:血清过氧化氢酶活性与低血糖时间呈负相关(rs = -0.47,p s = -0.82,p s = 0.68,p s = 0.88):所获得的数据表明,卵巢体积、血清抗缪勒氏管激素水平、前卵泡数和氧化应激参数之间不仅与高血糖患者有关,而且与低血糖患者以及病理血糖变异有关。
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Evaluation of folliculogenesis and oxidative stress parameters in type 1 diabetes mellitus women with different glycemic profiles.

Background: Despite enormous advances in diabetes treatment, women with type 1 diabetes mellitus (DM) still experience delayed menarche, menstrual irregularities, fewer pregnancies, and a higher rate of stillbirths compared to women without the disease. Due to the fact that type 1 DM occurs at a young age, the preservation of reproductive health is one of the most important goals of treatment.

Aims: The aim of this study was to evaluate the relationship between different glycemic profiles and changes in the pro-oxidant-antioxidant balance and ovarian follicular apparatus in reproductive-age patients with type 1 DM.

Methods: We examined 50 reproductive-age (19-38 years) women with type 1 DM with a disease duration of at least ten years. Carbohydrate metabolism was assessed with the continuous glucose monitoring (CGM) system and glycated hemoglobin (HbA1c) concentration measurement. CGM was performed using the FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, UK). In each patient, malondialdehyde level, catalase activity and 3-nitrotyrosine level in the blood serum were determined. To assess the ovarian function, we measured the ovarian volume, the antral follicle count, and the serum levels of anti-Müllerian hormone and follicle-stimulating hormone. All patients were divided into four groups (glucotypes) based on the CGM results. Group 1 included type 1 DM patients with satisfactory compensation of carbohydrate metabolism; group 2 consisted of patients with frequent hypoglycemic conditions and pathological glucose variability; group 3 included individuals with prolonged hyperglycemic conditions and maximum HbA1c levels; and group 4 comprised patients with the glycemic profile characterized by all the presented types of dysglycemia (intermittent glycemia).

Results: We revealed a negative correlation between serum catalase activity and time of hypoglycemic conditions in patients with type 1 DM based on the CGM results (rs = -0.47, p < 0.01). In group 4 (intermittent glycemia), patients demonstrated the lowest serum catalase activity and increased serum 3-nitrotyrosine level, while in group 3, women with chronic hyperglycemia (HbA1c 8.4 [8.1; 9.9]%; 68 [65; 85] mmol/mol) had a moderate change in antioxidant defense and oxidative stress parameters. Correlation analysis of ovarian volume, the antral follicle count, and the serum anti-Müllerian hormone level in type 1 DM women with different glycemic profiles established a negative relationship (rs = -0.82, p < 0.05) between the antral follicle count and glucose variability in group 1, a positive relationship (rs = 0.68, p < 0.05) between ovarian volume and glucose variability in group 2, and a positive relationship (rs = 0.88, p < 0.05) between ovarian volume and time of hypoglycemic conditions, which, according to the CGM results, amounted to a critical value of 57.5 [40.0; 82.0]%.

Conclusions: The data obtained indicate the relationship between the ovarian volume, serum anti-Müllerian hormone level, the antral follicle count and oxidative stress parameters not only in patients with hyperglycemia, but also in those with hypoglycemic conditions, as well as with pathological glucose variability.

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来源期刊
Endocrine
Endocrine 医学-内分泌学与代谢
CiteScore
6.40
自引率
5.40%
发文量
0
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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