Context: Primary ovarian insufficiency (POI) is defined by hypergonadotropic amenorrhea occurring before the age of 40 yr. In 4-5% of women with POI, an ovarian autoimmune process can be demonstrated. Design: We have determined the serum concentrations of total inhibin and inhibin B by sensitive ELISAs in 22womenwith autoimmune POI (aPOI), 71womenwith non-autoimmune idiopathic POI (iPOI), 77 postmenopausal women, and 90 healthy, fertile women (HW). Diagnosis of aPOI was made according to the presence of steroid cell autoantibodies and/or 17α-hydroxylase autoantibodies and/or cytochrome P450 side-chain cleavage autoantibodies. All aPOI patients were also positive for adrenal autoantibodies. Results: Total inhibin levels were significantly higher inwomenwith aPOI (median, 281 pg/ml) than in women with iPOI (median, 74 pg/ml) or HW (median, 133.5 pg/ml) (P < 0.001). Levels of inhibin B were also significantly higher in women with aPOI (median, 109 pg/ml) than in women with iPOI (median, 18 pg/ml) (P < 0.001) or HW (median, 39 pg/ml) (P < 0.05). Serum concentrations of total inhibin and inhibin B were significantly higher inwomenwith POI than in postmenopausal women (P < 0.001), irrespective of the presence/absence of autoantibodies. At receiver-operating characteristic analysis, cutoff values of 133 pg/ml for total inhibin and 60.5 pg/ml for inhibin B ensured 86.4% sensitivity and 81-84.5% specificity for aPOI vs. iPOI. Conclusions: We conclude that a variable degree of ovarian function is preserved in women with POI and that aPOI is characterized by increased inhibin production resulting from a selective theca cell destruction, with initial preservation of granulosa cells. Copyright © 2008 by The Endocrine Society.

Tsigkou, A., Marzotti, S., Borges, L., Brozzetti, A., Reis, F.M., Candeloro, P., et al. (2008). High serum inhibin concentration discriminates autoimmune oophoritis from other forms of primary ovarian insufficiency. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM, 93(4), 1263-1269 [10.1210/jc.2007-1675].

High serum inhibin concentration discriminates autoimmune oophoritis from other forms of primary ovarian insufficiency

TSIGKOU, A.;MARZOTTI, S.;BINI, V.;PETRAGLIA, F.;FALORNI, A.
2008

Abstract

Context: Primary ovarian insufficiency (POI) is defined by hypergonadotropic amenorrhea occurring before the age of 40 yr. In 4-5% of women with POI, an ovarian autoimmune process can be demonstrated. Design: We have determined the serum concentrations of total inhibin and inhibin B by sensitive ELISAs in 22womenwith autoimmune POI (aPOI), 71womenwith non-autoimmune idiopathic POI (iPOI), 77 postmenopausal women, and 90 healthy, fertile women (HW). Diagnosis of aPOI was made according to the presence of steroid cell autoantibodies and/or 17α-hydroxylase autoantibodies and/or cytochrome P450 side-chain cleavage autoantibodies. All aPOI patients were also positive for adrenal autoantibodies. Results: Total inhibin levels were significantly higher inwomenwith aPOI (median, 281 pg/ml) than in women with iPOI (median, 74 pg/ml) or HW (median, 133.5 pg/ml) (P < 0.001). Levels of inhibin B were also significantly higher in women with aPOI (median, 109 pg/ml) than in women with iPOI (median, 18 pg/ml) (P < 0.001) or HW (median, 39 pg/ml) (P < 0.05). Serum concentrations of total inhibin and inhibin B were significantly higher inwomenwith POI than in postmenopausal women (P < 0.001), irrespective of the presence/absence of autoantibodies. At receiver-operating characteristic analysis, cutoff values of 133 pg/ml for total inhibin and 60.5 pg/ml for inhibin B ensured 86.4% sensitivity and 81-84.5% specificity for aPOI vs. iPOI. Conclusions: We conclude that a variable degree of ovarian function is preserved in women with POI and that aPOI is characterized by increased inhibin production resulting from a selective theca cell destruction, with initial preservation of granulosa cells. Copyright © 2008 by The Endocrine Society.
Tsigkou, A., Marzotti, S., Borges, L., Brozzetti, A., Reis, F.M., Candeloro, P., et al. (2008). High serum inhibin concentration discriminates autoimmune oophoritis from other forms of primary ovarian insufficiency. THE JOURNAL OF CLINICAL ENDOCRINOLOGY AND METABOLISM, 93(4), 1263-1269 [10.1210/jc.2007-1675].
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11365/22779
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