Влияние ожирения и дислипидемии на выработку грелина и лептина у женщин репродуктивного возраста

Abstract

Adipose tissue fulfills different functions, related to homeostasis, consequently, excess of adipose tissue may have a negative influence on endocrine and metabolic parameters. The relationship of separate components of metabolic disorders with reproductive disturbance remains under-investigated. Notably, the role of dyslipidemia (DL) as an independent risk factor of menstrual function and fertility disorders remains unknown. Objective. To evaluate fertility and menstrual disturbance in women with obesity and/or DL. Patients and methods. 150 women aged 18-37 years were divided into 3 groups: 1st - 50 women with body mass index (BMI)>24.9 kg/m2 and DL, 2nd - 46 women with BMI>24.9 kg/m2 and normal blood lipids; 3rd - 54 women with BMI<25 kg/m2 and DL; control group - 20 healthy women with normal BMI. All women underwent the evaluation of menstrual and reproductive function, standard clinical and laboratory evaluation and assessment of ghrelin and leptin levels. Results. Fertility disorders were found in 69 (75.0%) women: 31 (44.9%) patients in group 1, 13 (18.8%) patients in group 2 and 25 (36.3%) patients in group 3. Menstrual cycle disorders, including oligo/amenorrhea and abnormal uterine bleeding were found in 35 (70.0%) patients in group 1, 13 (28.3%) patients in group 2 and 45 (83.3%) patients in group 3. An increased prevalence of cholelithiasis in patients with dyslipidemia was demonstrated. There was an inverse correlation of ghrelin and leptin levels (r=-0.285; p<0.05) and BMI. Conclusions. A high level of menstrual cycle and fertility disorders is observed in women of childbearing age with DL. DL is a significant risk factor of menstrual cycle disorders and infertility independent of BMI. Obesity promotes an increase of leptin level and decrease of ghrelin level.