Clinical significance of anti-Mullerian hormone level in the evaluation of ovarian reserve function in child-bearing female patients with rheumatoid arthritis
- VernacularTitle:抗苗勒管激素水平评价生育期女性类风湿关节炎患者卵巢储备功能的临床意义
- Author:
Zhaomeng GAO
1
;
Jian XU
;
Lei ZHANG
;
Qi ZHANG
Author Information
1. 胜利油田中心医院风湿免疫科
- Keywords:
Arthritis;
RA;
Anti-Mullerian hormone;
Ovarian insufficiency
- From:
China Modern Doctor
2018;56(14):21-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical application value of anti-Mullerian hormone in the evaluation of ovarian reserve function in the child-bearing female patients with RA. Methods A total of 90 child-bearing patients with RA aged from 20 to 50 years of age who were hospitalized from December 5, 2015 to April 30, 2017 were enrolled and healthy females with matched ages were enrolled as the control group. Electrochemiluminescence assay was used to determine the anti-Mullerian hormone (AMH) and the clinical data of all patients were retrospectively analyzed. SPSS software was applied to draw the ROC curve and calculate the area under the AMH curve. Risk factors were statistically analyzed using Logistic regression method. Results (1)A total of 90 patients with RA were included in the analysis[mean age (32. 2±6. 87) years, duration of disease (3. 03±2. 03) years]. AMH levels in RA patients [(2. 74±0. 16) ng/mL] were significantly lower than those in the control group [(3. 75±0. 17) ng/mL]. (2)Pearson correlation analysis showed that the increase of age (r=0. 965, P＜0. 001) and bFSH (r=0. 664, P＜0. 001) were associated with low AMH levels. The ROC curve analysis showed that the predictive sensitivity to the ovarian reserve reduction (DOR) was 0. 828 and the specifici ty was 0. 727 when AMH was 2. 27 ng/mL. (3)AMH levels in the patients with RA exposed to Tripterygium wilfordii preparation[(1. 86±0. 16) ng/mL] were significantly lower than those in unexposed patients [(3. 27±0. 14) ng/mL]. There was no statistically significant difference in AMH levels among the patients receiving other immunosuppressive agents(including methotrexate, leflunomide, hydroxychloroquine). (4)Logistic regression analysis indicated that the use of Tripterygium wilfordii preparation was the risk factor for DOR (OR=7. 31, P=0. 019, 95％ CI 1. 39 to 38. 54). Conclusion AMH levels can be used to evaluate ovarian function in child-bearing female patients with RA. Ovarian toxicity of Tripterygium wilfordii preparations should be alerted in the its clinical application in the treatment of RA.
