Роль білків теплового шоку в прогнозуванні перебігу клімактеричного синдрому

Abstract

The problem of menopause has been relevant for many decades. A pathogenetically justified method of treatment, taking into account the change in the hormonal background of a woman, is hormone replacement therapy. Determination of immune markers of cellular homeostasis is one of the promising directions, therefore, the study of changes in the levels of antibodies to HSP60 can become a reliable marker of both the course and compensation of disorders of the neurovegetative state in perimenopause. Purpose - to study the role of anti-Müllerian, follicle-stimulating, luteinizing, thyroid-stimulating hormones, antibodies (IgG) to human heat shock protein 60 (HSP60) and its bacterial homologue (GroEl), and obstetric history on the diagnosis and treatment of vasomotor symptoms in perimenopausal women. Materials and methods. 158 patients with climacteric syndrome in perimenopause were examined in the period October 2019 - March 2022. The Group 1 (main) included 80 patients who agreed to treatment and received it according to the standard scheme: combined treatment in a cyclical regimen - estrogens (17β-estradiol) + progestogens (dydrogesterone); the Group 2 (comparison) included 78 women who refused treatment due to estrogen deficiency. Results. Revealed a decrease (p<0.01) in the risk of not achieving a high treatment effect with vasomotor symptoms for treated patients, OR=0.04 (95% CI: 0.01-0.18) compared to the group of untreated patients. With the number of deliveries, the risk of not achieving a high treatment effect in women with vasomotor symptoms increases (p=0.01), OR=2.27 (95% CI: 1.2-4.27) for each delivery. A lower (p=0.039) risk of not achieving a high treatment effect was found in women with vasomotor symptoms at a higher GroEl level, ОR=0.994 (95% CI: 0.987-1.000) for each ng. When standardizing by the thyrotropin hormone and the manifestation of vasomotor symptoms before or without treatment, a decrease (p<0.001) in the risk of not achieving a high effect of treatment in women with vasomotor symptoms for treated patients was found, OR=0.04 (95% CI: 0.01-0.20). Conclusions. This study found that there is no informative indicator for predicting the effectiveness of treatment in women with vasomotor symptoms. It was established that the HSP60 indicator does not affect, and the GroEl indicator affects the effectiveness of the treatment of vasomotor clinical manifestations. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institutions. The informed consent of the women was obtained for conducting the studies. No conflict of interest was declared by the authors.