Hormonal Changes in Women with Uterine Leiomyomas
About the author:
Zaporozhchenko M. B.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
Introduction. One of the central points in the pathogenesis of uterine leiomyoma is given hormon- al status and features of the functional state of the reproductive system. Changes in the blood levels of lutein- izing hormone, folliculostimulating hormone are more dependent on the functional state of the reproductive sys- tem as a whole than on the presence of uterine tumors. One theory of the development of uterine leiomyoma is hyperestrogenemia, which develops due to progesterone deficiency. Raising the level of progesterone leads to a decrease of the estrogen and progesterone receptors. Violation ratio estrogen / progesterone are particularly hypoprogesteronemia role in the development of proliferative processes endo- and myometrium. Progesterone along with estrogen stimulates the growth of uterine leiomyoma. Leiomyoma actively proliferate in the secretory phase of the menstrual cycle. In the presence of leiomyoma have elevated blood levels of estradiol. Local hormonemiya is important in the pathogenesis of growth uterine node and hypertrophy myometrium. Estradiol induces the formation of their receptors in the uterus, stimulates hyperplastic process. The level of concentration of steroid hormones in the uterine artery in patients with uterine leiomyoma, developing on the background of the ovulatory cycle, can serve as a local stimulant hyperestrogenemia, which contributes to a vicious circle of the type «stimulating consumption». The content of estradiol and progesterone receptors in leiomyoma tissue higher than the unmodified myometrium. Estrone has a low hormonal activity compared to estradiol. Leiomyoma cells secrete prolactin, which, together with progesterone is one of the growth factors leyomatoz nodes. The purpose was to investigate the hormonal changes in a woman with uterine leiomyoma and their effect on the proliferation leiomyomatosis nodes. Materials and methods. It is investigated the content levels of estradiol, estrone, progesterone, folliculostimu- lating hormone, luteinizing hormone and prolactin in whey of the blood taken from an elbow vein, in 554 women with uterine leiomyomas of immunochemical method electrohemiluminiscentic detection (ECLIA) on analyzator Sobas 6000 (e 601 module). Test system: Roche Diagnostics (Switzerland). Hormonal studies were conducted on day 5-7 of the menstrual cycle, progesterone levels are determined on 20-21 day cycle. The blood to assess concentrations of sex steroids in the local uterine blood flow were taken during surgery in the ascending branch of the uterine artery after mobilization ligamentous apparatus and vascular bundles of the uterus. Results. Estradiol in patients with uterine leiomyoma proliferative type was 1.8 times higher in relation to the group of patients with simple leiomyoma. In the serum of patients with proliferative leiomyoma estrone level was 1. 5 times higher than in patients with simple leiomyoma, and in regional blood flow – 1.8 times greater (p < 0.01). The level of estrone was 1.3 times higher in the regional blood flow at proliferative leiomyomain relation to the systemic circulation, while a simple leiomyoma – 1.1 times. Indicators content of luteinizing hormone, folliculostimulating hormone in the serum of women with leiomyomas proliferative type were significantly higher (p < 0,001), than in pa- tients with simple leiomyoma. Prolactin level was 1.4 times higher in patients with leiomyoma proliferative type than the simple leiomyoma. In patients with proliferative leiomyoma reproductive age progesterone was 1.8 times lower than that of women of the same age with a simple leiomyoma. Conclusion. It is noted a direct correlation between the growth of myoma and a high concentration of estrogen in the system and local blood flow at the leiomyoma proliferative type. Changes in the blood levels of luteinizing hor- mone, folliculostimulating hormone and prolactin are more dependent on the functional state of the reproductive system than on the presence of uterine tumors.
Tags:
estradiol, estrone, progesterone, luteinizing hormone, folliculostimulating hormone, prolactin, uter- ine leiomyoma
Bibliography:
- Белых О. А. Гормоны и репродуктивная система / О. А. Белых, Е. А. Кочеткова, Б. И. Гельцер // Сибирский медицин- ский журнал: научно- практический рецензируемый журнал. – 2005. – Т. 20, № 3. – С. 56 – 61.
- Буянова С. Н. Современные представления об этиологии, патогенезе и морфогенезе миомы матки / С. Н. Буянова, М. В. Мгелиашвили, С. А. Петракова // Российский вестник акушера-гинеколога. – 2008. – Т, 8, № 6. – С. 45-51.
- Косей Н. В. Лейоміома матки (клініка, патогенез, діагностика та лікування) : автореф. дис. на соискание ученой степе- ни доктора мед. наук : спец. 14. 01. 01 «Акушерство і гінекологія» / Н. В. Косей. – К., 2009. – 36 с.
- Пролактин в реализации пролиферативного и морфологического действия эстрадиола на матку / В. А. Матвеева, А. А. Осипова, А. В. Самойлова [и др.] // Проблемы репродукции. – 2007. – Т. 13, № 6. – С. 45-50.
- Тихомиров А. Л. Миома матки / А. Л. Тихомиров, Д. М. Лубнин. – М.: МИА, 2006. – 174 с.
- Яворський П. В. Стан статевих стероїдів у жінок з фіброміомою матки та ожирінням / П. В. Яворський // Вісник ВНМУ. – 2010 – № 14(2). – С. 267 – 270.
- Bouchard P. Selective progesterone receptor modulators: future clinical applications / P. Bouchard, S. Ouzounian, N. Chabbert-Buffet // Bull. Acad. Natl. Med. – 2008. – Vol. 192, № 6. – P. 1159-1171.
- Kim J. J. The role of progesterone signaling in the pathogenesis of uterine leiomyoma / J. J. Kim, E. C. Sefton // Mol. Cell. Endocrinol. – 2012. – Vol. 358(2). – P. 223-231.
- Progesterone is essential for maintenance and growth of uterine leiomyoma / H. Ishikawa, K. Ishi, V. A. Serna [et al.] // Endo- crinology. – 2010. – Vol. 151. – P. 2433-2442. doi: 10. 1210/en. 2009 – 1225.
Publication of the article:
«Bulletin of problems biology and medicine» Issue 3 part 3 (112), 2014 year, 113-116 pages, index UDK 618. 14-006. 363. 03-06:612. 018