Abstract

Objective — to identify the relationship between changes in the concentration of vitamins A, E, D, magnesium content, and comorbid pathology in adolescent girls with menstrual function disorders. Materials and methods. Examinations involved 237 girls with menstrual function disorders aged 11—18 years. Oligomenorrhea (OM) was diagnosed in 103 patients, and abnormal uterine bleeding (AUB) in 134 girls. Results and discussion. Comorbid pathology was revealed in most patients, regardless of the type of menstrual function disorder. Endocrine system disorders were the most frequent comorbidities. In girls with OM, comorbid endocrine disorders were accompanied by a decrease in the levels of vitamins A (pu < 0.01) and E, due to decrease in the frequency of their elevated indicators (pφ < 0.03). At the same time, mostly normal magnesium levels were registered (pφ < 0.001) due to a decrease in the frequency of its reduced and elevated levels compared to patients without pathology. In girls with AUB, comorbid endocrine system pathology was accompanied by decrease in the frequency of optimal levels of 25(OH)D3 (pφ < 0.03), and comorbid pathology of the neuro-­psychiatric sphere was accompanied by decrease in the frequency of elevated levels of vitamins A (pφ < 0.01) and E (pφ < 0.03) compared to girls without pathology. Regardless of the type of menstrual disorder, the greatest number of changes in the vitamin status were found in girls with comorbid pathology of the endocrine system. In patients with OM, the retinol levels were lower than in girls with AUB (pφ < 0.01), and a decrease in tocopherol levels was observed (pφ > 0.05). In girls with AUB, elevated levels of vitamin A (pφ < 0.03), vitamin E (pφ < 0.04), and moderate vitamin D deficiency (pφ < 0.03) were more frequently registered compared to girls with OM. Vitamin D deficiency in girls with abnormal uterine bleeding was less frequently registered compared to patients with oligomenorrhea (pφ < 0.05). It should be noted that comorbid pathology of the digestive system in abnormal uterine bleeding was mostly often accompanied by the decreased tocopherol levels (pφ < 0.05) and normal magnesium values (pφ < 0.04) compared to patients with oligomenorrhea. Conclusions. The study revealed a correlation between fluctuations in the content of vitamin status components and comorbid pathology in girls with menstrual disorders. The most pronounced changes in oligomenorrhea were found under conditions of concomitant pathology of the endocrine system, while in abnormal uterine bleeding, they were identified in the presence of endocrine disorders and disturbances in the neuro­psychiatric sphere. The combination of oligomenorrhea and endocrine pathology, as well as abnormal uterine bleeding and nervous disorders, is accompanied by a decrease in retinol and tocopherol reserves, creating conditions for the deterioration of compensatory­adaptive reactions of the body by suppressing the low-­molecular-­weight link of the antioxidant defense system. Abnormal uterine bleeding and concomitant endocrine disorders are associated with more pronounced moderate vitamin D deficiency.

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