妇女缺乏维生素和微量营养素与生殖健康

E. Kudinova
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Group 1 (n=53) consisted of female patients with MD, group 2 (n=44) — women with manifestations of hyperandrogenism (HA; acne and post-acne, alopecia, seborrhea) and MD, group 3 (n=9) — female patients with HA manifestations without MD, group 4 (n=27) — female patients without HA and MD (conditionally healthy). 41% of female patients of the 1st and 2nd groups and 44% of the 3rd group showed signs of an increase in the ovarian volume and changes in their structure (multifollicular or polycystic ovaries). Echographic signs of anovulation were detected in 26.1, 32.3 and 35.0% of female patients in groups 1, 2 and 3, respectively. Comparison of the androgenic steroid level in the groups did not reveal statistically significant differences, however, there were borderline cortisol levels and higher values of plasma 17-OH progesterone (vs the group 1) in groups 2 and 3. Values of gonadotropins did not differ significantly, but the LH/FSH ratio was higher in group 2, although unreliable. Hyperprolactinemia was detected in every fourth female patient of groups 1, 2, 3 (value range from 737 to 1079 mIU/L). 25(OH)D content was reduced in all three groups, amounting to 16.4±8.4, 24.7±13.2 and 11.4±4.5 ng/mL, respectively. Although homocysteine levels were borderline (11.5±2.9, 9.7±2.8 and 9.4±2.7 μmol/L), they differed statistically significantly (p<0.0002) in the groups. Besides, borderline low levels of folic acid, vitamin B12 and serum ferritin were found in groups 1, 2 and 3. Conclusion: the disorders detected in women with MD and HA should be taken into account when forming the treatment tactics. KEYWORDS: menstrual disorders, hyperandrogenism, homocysteine, ferritin, vitamin D, B vitamins. FOR CITATION: Kudinova E.G. Deficiency of vitamins and micronutrients and reproductive health in women. Russian Journal of Woman and Child Health. 2022;5(3):182–187 (in Russ.). 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引用次数: 0

摘要

目的:测定年轻女性患者血液中维生素和微量营养素的含量。患者和方法:一项前瞻性单中心研究纳入了年龄在18-24岁的年轻女性患者,她们有月经失调(MD)或雄激素依赖性皮肤病(痤疮、皮脂漏、脱发)的表现。评估临床、记忆和人体测量参数、参与生殖功能实现的激素谱、多项血液生化参数和盆腔超声数据。结果:纳入133例女性患者,分为4组。组1 (n=53)为女性MD患者,组2 (n=44)为表现为高雄激素症(HA;痤疮及痤疮后、脱发、皮脂漏)和MD,第3组(n=9) -有HA表现但无MD的女性患者,第4组(n=27) -无HA和MD的女性患者(条件健康)。第一组和第二组女性患者中41%和第三组女性患者中44%表现为卵巢体积增大和结构改变(多卵泡或多囊卵巢)。1、2、3组女性患者无排卵的超声征象分别为26.1%、32.3%、35.0%。各组雄激素水平比较无统计学差异,但2、3组皮质醇水平处于临界水平,血浆17-OH孕酮(与1组相比)较高。促性腺激素值无显著差异,但LH/FSH比值在2组较高,尽管不可靠。1、2、3组每4例女性患者中检测到高泌乳素血症(数值范围为737 ~ 1079 mIU/L)。25(OH)D含量在三组均降低,分别为16.4±8.4、24.7±13.2和11.4±4.5 ng/mL。虽然同型半胱氨酸水平处于交界水平(11.5±2.9、9.7±2.8和9.4±2.7 μmol/L),但各组间差异有统计学意义(p<0.0002)。此外,1、2和3组的叶酸、维生素B12和血清铁蛋白水平均处于临界低水平。结论:在制定治疗策略时应综合考虑女性MD和HA所发现的障碍。关键词:月经失调,高雄激素症,同型半胱氨酸,铁蛋白,维生素D, B族维生素。引文:库丁诺娃,例如:妇女维生素和微量营养素缺乏与生殖健康。俄罗斯妇幼卫生杂志,2022;5(3):182-187。DOI: 10.32364 / 2618-8430-2022-5-3-182-187。
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Deficiency of vitamins and micronutrients and reproductive health in women
Aim: to identify the content of vitamins and micronutrients in the blood of young female patients. Patients and Methods: a prospective single-center study included young female patients aged 18–24 years with complaints of menstrual disorders (MD) or manifestations of androgen-dependent dermopathy (acne, seborrhea, alopecia). Clinical, anamnestic and anthropometric parameters, hormonal profile involved in the realization of reproductive function, a number of biochemical blood parameters, and pelvic ultrasound data were evaluated. Results: the study included 133 female patients divided into 4 groups. Group 1 (n=53) consisted of female patients with MD, group 2 (n=44) — women with manifestations of hyperandrogenism (HA; acne and post-acne, alopecia, seborrhea) and MD, group 3 (n=9) — female patients with HA manifestations without MD, group 4 (n=27) — female patients without HA and MD (conditionally healthy). 41% of female patients of the 1st and 2nd groups and 44% of the 3rd group showed signs of an increase in the ovarian volume and changes in their structure (multifollicular or polycystic ovaries). Echographic signs of anovulation were detected in 26.1, 32.3 and 35.0% of female patients in groups 1, 2 and 3, respectively. Comparison of the androgenic steroid level in the groups did not reveal statistically significant differences, however, there were borderline cortisol levels and higher values of plasma 17-OH progesterone (vs the group 1) in groups 2 and 3. Values of gonadotropins did not differ significantly, but the LH/FSH ratio was higher in group 2, although unreliable. Hyperprolactinemia was detected in every fourth female patient of groups 1, 2, 3 (value range from 737 to 1079 mIU/L). 25(OH)D content was reduced in all three groups, amounting to 16.4±8.4, 24.7±13.2 and 11.4±4.5 ng/mL, respectively. Although homocysteine levels were borderline (11.5±2.9, 9.7±2.8 and 9.4±2.7 μmol/L), they differed statistically significantly (p<0.0002) in the groups. Besides, borderline low levels of folic acid, vitamin B12 and serum ferritin were found in groups 1, 2 and 3. Conclusion: the disorders detected in women with MD and HA should be taken into account when forming the treatment tactics. KEYWORDS: menstrual disorders, hyperandrogenism, homocysteine, ferritin, vitamin D, B vitamins. FOR CITATION: Kudinova E.G. Deficiency of vitamins and micronutrients and reproductive health in women. Russian Journal of Woman and Child Health. 2022;5(3):182–187 (in Russ.). DOI: 10.32364/2618-8430-2022-5-3-182-187.
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0.60
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14
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