Role of inflammation and oxidative stress in the etiology of primary ovarian insufficiency.

Elif Ağaçayak,Sevgi Kalkanlı,Senem Yaman Tunç,Ahmet Yıldızbakan,Neval Yaman Görük,Serdar Başaranoğlu,Hakan Küsen,Mehmet Sait İçen,Hatice Yüksel,Talip Gül

doi:10.4274/tjod.00334

Abstract

Objective:The aim of this study was to elucidate the etiology and treatment of primary ovarian insufficiency, which is of unknown cause in 95% of the cases.Materials and Methods:Thirty patients aged 18-40 years who presented to Dicle University Faculty of Medicine Clinic of Obstetrics and Gynecology between June 2012 and January 2014 and were diagnosed as having primary ovarian insufficiency based on their clinical and endocrinologic data, and 30 healthy controls were included in this study.Results:No significant differences were found between patients with primary ovarian insufficiency and control subjects in demographic data and lipid profile levels, thyroid- stimulating hormone, prolactin, and glucose. However, the neutrophil to lymphocyte ratio and levels of follicle-stimulating hormone, luteinizing hormone, total antioxidant status, total oxidant status, and oxidative stress index were significantly higher in patients with primary ovarian insufficiency than in control subjects. In the correlation analysis, follicle-stimulating hormone exhibited a positive correlation with total oxidant status, oxidative stress index, and the neutrophil to lymphocyte ratio (r=0.573** p<0.001, r=0.584** p<0.001, r=0.541 p<0.001, respectively) and correlated negatively with total antioxidant status (r=-0.437** p<0.001).Conclusion:The neutrophil to lymphocyte ratio, total oxidant status, and oxidative stress index levels are elevated in primary ovarian insufficiency. Therefore, anti-oxidative and anti-inflammatory treatment might be administered to patients in the early stage of primary ovarian insufficiency. However, larger studies are needed to clarify whether these elevated levels are a cause or a consequence of primary ovarian insufficiency.

Highlights

The age of normal menopause, which occurs as a result of the depletion of functional primordial follicles in ovaries, is 50±4 years[1]
There are many rat studies in the literature regarding antiinflammatory treatments in the treatment of premature ovarian failure (POF)[14]. This is the first study in the literature to investigate neutrophil to lymphocyte ratio (NLR), total antioxidant status (TAS), and total oxidant status (TOS) in primary ovarian insufficiency (POI), which is of unknown cause in 95% of the cases
NLR and levels of follicle-stimulating hormone (FSH), LH, TOS, and oxidative stress index (OSI) were higher in patients with POI than in the control subjects (Table 3) (Figure 1)

Summary

Introduction

The age of normal menopause, which occurs as a result of the depletion of functional primordial follicles in ovaries, is 50±4 years[1]. POI comprises various diseases with a wide variety of pathogenesis such as genetic chromosomal, mitochondrial, enzymatic, iatrogenic, and immunologic aberrations, or infections[8] These causes may effect the ovary at each period of life, including prepubertal, pubertal, and reproductive periods[9]. There are many rat studies in the literature regarding antiinflammatory treatments in the treatment of POF[14] This is the first study in the literature to investigate NLR, total antioxidant status (TAS), and total oxidant status (TOS) in POI, which is of unknown cause in 95% of the cases. The purpose of this study was to elucidate the etiology and therapeutic approaches of POI

Materials and Methods

Results

Discussion

Study Limitations