FEATURES OF THE ENDOTHELIAL FUNCTIONAL STATE AND THE FEASIBILITY OF ITS CORRECTION IN PREMATURE OVARIAN FAILURE


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Objective. To investigate whether there is an association between the hormonal indicators specific for premature ovarian failure (POF) and the predictors of cardiovascular diseases (CVD) (the biochemical and functional markers of endothelial dysfunction). Subjects and methods. The study enrolled 85 women with POF and 85 women with a regular menstrual cycle. All the study participants were examined for hormonal profiles, the levels of biochemical and functional endothelial dysfunction markers (total cholesterol, triglycerides, low-density lipoproteins (LDL), high-density lipoproteins (HDL), atherogenic coefficient (AC), apolipoproteins (apo) A1 and B, uric acid, glucose, high-sensitivity C-reactive protein (hs-CRP), right and left carotid intima-media thickness (IMT), and endothelium-dependent vasodilation (EDVD) in the brachial artery (BA). After hormone replacement therapy (HRT), 52 women with POF underwent control examinations. Results. Comparative analysis of the biochemical and functional markers of endothelial dysfunction showed significant differences between the levels of cholesterol, LDL, AC, hs-CRP, uric acid, IMT, and EDVD in women with POF compared to those with regular menstrual cycles (p < 0.05). When introducing corrections for the presence of traditional cardiovascular risk factors (smoking, obesity, hypertension, a family history of CVD), there were also still differences between the groups in the levels of cholesterol, LDL, EDVD, and IMT on both sides. There was a positive correlation between the level of follicle-stimulating hormone (FSH) and that of cholesterol, LDL, AC, hs- CRP, right and left carotid IMT; in this case there was a negative correlation between these markers of endothelial dysfunction and the level of E2. There was an inverse correlation between EDVD and FSH and a direct correlation between EDVD and E2. During the therapy performed, the patients with POF showed a significant increase in estradiol levels by 118%, a simultaneous reduction in the levels of cholesterol by 9.3%, LDL by 10.8%, and apoB by 12.9%, and an improvement in EDVD by 17% of the baseline values (p < 0.05). Conclusion. The women with POF versus those with regular menstrual cycles are noted to have a significant increase in the level of biochemical and functional markers of endothelial dysfunction. HRT leads to improvements in these indicators, which may suggest that HRT is first-line treatment for patients with POF, contributes to the normalization of the lipid profile and the endothelial functional status and demonstrates the need for its mandatory implementation as primary prevention of cardiovascular diseases in women with POF.

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作者简介

Anna Pozdnyakova

the graduate student of office of gynecologic endocrinology of Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Rossiа 117997, Russia, Moscow, Ac. Oparina str. 4

Natalia Sharashkina

Email: sharashkina@inbox.ru
PhD, Senior Researcher, Laboratory of Geriatrics, Russian Gerontology Research and Clinical Center, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 129226, Russia, Moscow, 1st Leonova str. 16

Tatiana Ivanets

Email: t_ivanetz@oparina4.ru
PhD, Head of Research and diagnostic laboratory, Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Rossiа. 117997, Russia, Moscow, Ac. Oparina str. 4

Larisa Butareva

Email: l.a.marchenko@yandex.ru
MD, obstetrician-gynecologist, gynecological endocrinology department, Research Center of Obstetrics, Gynecology and Perinatology Ministry of Health of Rossiа. 117997, Russia, Moscow, Ac. Oparina str. 4

Nadezhda Runikhina

Email: runishi@rambler.ru
MD, Deputy Director, Russian Gerontology Research and Clinical Center, N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia. 129226, Russia, Moscow, 1st Leonova str. 16

Larisa Marchenko

Email: l.a.marchenko@yandex.ru
the doctor of medical sciences, the professor, the leading researcher of the department of gynecologic endocrinology of Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russiа. 117997, Russia, Moscow, Ac. Oparina str. 4

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