Urine steroid profile in pregnant women with isthmic-cervical insufficiency and hyperandrogenism

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Objective: To evaluate the features of urine steroid profile and quantification of urinary steroids in pregnant women with isthmic-cervical insufficiency (ICI) and hyperandrogenism (HA).

Materials and methods: A prospective cohort controlled study was conducted from 2014 to 2019 in Maternity hospital No. 1, a branch of the City Clinical Hospital No. 67 named after L.A. Vorokhobov (Moscow). The study included 98 women. The main group consisted of 63 women with ICI. The control group included 35 women without ICI. HA was assessed by determination of the steroid profile and quantification of urinary steroids using high-performance liquid chromatography. Statistical data processing and analysis was performed using Microsoft Excel 2007, Statistica 12.0. Specific characteristics of urine steroid profile in pregnant women with isthmic-cervical insufficiency and hyperandrogenism were evaluated.

Results: The women with ICI, regardless of the presence or absence of HA, were characterized by monomarkers of the steroid profile of urine – higher levels of androsterone (abs.) (p<0.001), total 17-ketosteroids (17-CS) (p=0.02), van de Calseide discriminants (p<0.001), delta-5-pregnandiol (p=0.03), but low levels of 16-alpha-Hydroxy-Et (p<0.001), 16-alpha-Hydroxy-An (p<0.001) and 16-alpha-hydroxy-DHEA (p=0.02); a combination of markers – van de Kalseide discriminant, 16-alpha-Hydroxy-An, allo-Pd, cholesterol and estrone (OR=19.5). In women with ICI associatade with HA are characterized by the markers: higher values of An, abs. (p=0.001), van de Calseide (p=0.002), Et/Ch (p=0.0003) and estrone (p=0.03) discriminants, and lower ones – 11-Keto-Et, abs. (p=0.005) and % of the sum of 17-KS (p=0.001), 16-alpha-Hydroxy-Et (p=0.04). An association between ICI and HA was established (OR=3.48, 95% CI 1.37–8.84). A trend of greater association of GA of ovarian origin with ICI was revealed in comparison with mixed origin (OR=1.62 (95% CI 0.17–15.72).

Conclusion: HA may lead to changes in metabolic processes, that are manifested by urine steroid profile, since urine composition reflects a general metabolic state and contains metabolites. Based on the stratification data, it is possible to identify specific metabolic patterns that indicate an association between GA and the potential risk of developing ICI.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Artur Mokh

Konchalovsky City Clinical Hospital, Moscow Healthcare Department, Perinatal Center

Хат алмасуға жауапты Автор.
Email: mohar2205@mail.ru

Head of the Maternity Department

Ресей, Moscow

Sergey Levakov

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: levakoff@yandex.ru

Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology of the N.V. Sklifosovsky Institute of Clinical Medicine

Ресей, Mosow

Әдебиет тізімі

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Әрекет
1. JATS XML
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2. Fig. 1. Urine steroid profile marker values

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3. Fig. 2. Urine steroid profile markers that significantly differentiate women with SCI from controls

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4. Fig. 3. ROC curve. Differentiation of women with SCI from the control group based on a set of urinary steroid profile markers (van de Kalseide discriminant, 16-alpha-Hydroxy-Ap, DeltaZ-Pd, Ch)

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5. Fig. 4. ROC curves characterizing the accuracy of differentiation of women: A - women with SCI and control group with GA; B - women with SCI and control group without GA

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