Особливості гормонального і цитокінового статусу в жінок, які мали порушення менструальної функції у пубертатний період

Abstract

Deviations in the formation of reproductive function, and subsequently menstrual irregularities from the age of menarche, ovarian dysfunction and steroidogenesis disorders can be clinically manifested in remote periods after their direct action. The nature and depth of morphofunctional disorders in this case depends on the degree of maturity of the reproductive system, the initial functional state of the regulation centers (hypothalamus, pituitary gland) and ovaries, and the duration of the action of adverse factors. The accumulated specific research experience indicates that in addition to the pituitary gonadotropin hormones, cytokines (interleukins), which can simulate ovarian function and play an important role in ovulation, are of great importance in the normal functioning of the ovaries. The objective: аccording to laboratory and instrumental methods of research, to study the characteristics of hormonal status and the relationship of ovarian hormones with interleukins (IL) in women with menstrual dysfunction in the puberty. Materials and methods. According to the nature of the violations, the main group of women (n=90) who had a pathology of menstrual function in the puberty period was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included women (n=30) with the correct rhythm of menstruation in puberty. Results. A clinical study found a decrease in the concentration of progesterone in women with a history of primary oligomenorrhea, a decrease in estradiol in the preovulatory period in women with late menarche. When assessing the concentration of follicle-stimulating hormone in the subgroups, an increase was noted in patients with puberty bleeding compared with the control group, due to the low level of antimuller hormone in the blood serum. The correlation between the indicators of these hormones and interleukins (IL-4, IL-8) indicates the influence of cytokines on folliculogenesis and the formation of the corpus luteum. Ovarian reserve parameters are not reduced. Conclusion. An analysis of the hormonal and cytokine status in women with menstrual dysfunction in the puberty allows us to draw an analogy between the processes of ovulation and the inflammatory response. The cytokines produced by certain immune cells are signaling molecules that affect cell proliferation and apoptosis of ovarian cells, folliculogenesis, hormone secretion and thus play an important role in ovulation. Therefore, the immune system may be an additional local regulator of ovarian function. Estradiol and progesterone are of great importance in the secretory transformation of the endometrium, especially during the «implantation window». Keywords: puberty, menarche, oligomenorrhea, pubertal bleeding, folliculogenesis, progesterone, estradiol, interleukins, pituitary gland, anti-varial antibodies.