urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.23.2.41IHMIGHurmj-1495Research ArticleОригинальные статьи | Original articlesOriginal articlesУровень мелатонина и активность районов ядрышковых организаторов в прогнозе бесплодия у женщин с эндометриозом яичниковMelatonin Level and Activity of Nucleolar Organizer Regions in the Prognosis of Infertility in Women with Ovarian EndometriosisКачуринаМ. С.KachurinaM. S.

Мария Станиславовна Качурина — акушер-гинеколог Клиники

Челябинск

Maria S. Kachurina — Obstetrician-Gynecologist of the Clinic

Chelyabisnk

masha.kachurina@mail.ruhttps://orcid.org/0000-0001-5256-843XЗайнетдиноваЛ. Ф.ZainetdinovaL. F.

Лариса Фоатовна Зайнетдинова — доктор медицинских наук, доцент, профессор кафедры акушерства и гинекологии

Челябинск

Larisa F. Zainetdinova — Doctor of Sciences (Medicine), Professor, Professor of the Department of Obstetrics and Gynecology

Chelyabisnk

sea-gull6@yandex.ruКуренковЕ. Л.KurenkovYe. L.

Евгений Леонидович Куренков — доктор медицинских наук, профессор, заведующий кафедрой анатомии и оперативной хирургии

Челябинск

Yevgeny L. Kurenkov — Doctor of Sciences (Medicine), Professor, Head of the Department of Anatomy and Operative Surgery

Chelyabisnk

kurenkovel@chelsma.ruМедведевБ. И.MedvedevB. I.

Борис Иванович Медведев — доктор медицинских наук, профессор, профессор кафедры акушерства и гинекологии

Челябинск

Boris I. Medvedev — Doctor of Sciences (Medicine), Professor, Professor of the Department of Obstetrics and Gynecology

Chelyabisnk

sea-gull6@yandex.ruШамаеваТ. Н.ShamaevaT. N.

Татьяна Николаевна Шамаева — кандидат педагогических наук, доцент кафедры математики, медицинской информатики, информатики и статистики, физики

Челябинск

Tatyana N. Shamaeva — Candidate of Sciences (Pedagogy), Associate Professor of the Department of Mathematics, Medical Informatics, Computer Science and Statistics, Physics

Chelyabisnk

shamtan@rambler.ruhttps://orcid.org/0000-0002-7884-9675ТелешеваЛ. Ф.TeleshevaL. F.

Лариса Фёдоровна Телешева — доктор медицинских наук, профессор, профессор кафедры микробиологии, вирусологии и иммунологии

Челябинск

Larisa F. Telesheva — Doctor of Sciences (Medicine), Professor, Professor of the Department of Microbiology, Virology and Immunology

Chelyabisnk

teleshevalarisa@mail.ruКанайкинаА. Ю.KanaykinaA. Yu.

Анна Юрьевна Канайкина — акушер-гинеколог, 

Челябинск

Anna Yu. Kanaykina — Obstetrician-Gynecologist

Chelyabinsk

kanaikinaayu@mail.ruЮжно-Уральский государственный медицинский университетРоссияSouth Ural State Medical UniversityRussian FederationОбластной перинатальный центрРоссияRegional Perinatal CenterRussian Federation2024080520242324154Copyright © Качурина М.С., Зайнетдинова Л.Ф., Куренков Е.Л., Медведев Б.И., Шамаева Т.Н., Телешева Л.Ф., Канайкина А.Ю., 20242024Качурина М.С., Зайнетдинова Л.Ф., Куренков Е.Л., Медведев Б.И., Шамаева Т.Н., Телешева Л.Ф., Канайкина А.Ю.Kachurina M.S., Zainetdinova L.F., Kurenkov Y.L., Medvedev B.I., Shamaeva T.N., Telesheva L.F., Kanaykina A.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1495Введение

Введение. Эндометриоз — многофакторное заболевание, которым страдает около 10 % женщин репродуктивного возраста.

Цель работы — прогнозирование развития бесплодия у женщин с эндометриозом яичников с помощью определения уровня мелатонина мочи ипоказателей активности районов ядрышковых организаторов в эндометриоидных гетеротопиях яичников.

Материалы и методы

Материалы и методы. В Клинике ЮУГМУ с 2018 по 2020 г. исследовано 2 группы женщин с эндометриозом яичников: 1 группа — с бесплодием (n = 22); 2 группа — без него (n = 27). Определяли уровень 6-СОМТ мочи и активность рибосомального синтеза.

Результаты

Результаты. Уровень 6-СОМТ снижен у пациенток с I стадией эндометриоза яичников. При II и III стадиях уровень 6-СОМТ ниже у женщин с бесплодием, чем без него: II стадия — (38,82±1,49) нг/мл и (93,04±3,64) нг/мл (р < 0,001); III стадия — (42,84±1,85) нг/мл и (58,06±1,65) нг/мл (р = 0,340). Активность рибосомального синтеза в эпителиоцитах эндометриоидных гетеротопий повышается при III стадии. В фибробластах стромы эндометриоидных гетеротопий активность рибосомального синтеза выше у женщин с бесплодием при III стадии, а в гистиоцитах — у женщин с бесплодием при II стадии. Проведен логистический пошаговый регрессионный анализ, определены наиболее важные предикторы, влияющие на развитие бесплодия.

Обсуждение

Обсуждение. Снижение мелатонина у женщин с эндометриозом яичников, страдающих бесплодием, а также при I стадии эндометриоза яичников согласуется с исследованиями М. И. Ярмолинской и др. (2019). При наличии бесплодия активация гистиоцитов соединительной ткани начинается с ранних стадий. Полученные результаты, возможно, отражают иммуномодулирующий эффект мелатонина, который выражается в усилении функциональной активности соединительнотканных гистиоцитов и фибробластов.

Заключение

Заключение. С помощью математического анализа определены наиболее важные показатели, влияющие на репродуктивный прогноз у женщин с эндометриозом яичников (активность районов ядрышковых организаторов, уровень 6-СОМТ мочи), что позволяет составить модель для расчета индивидуально репродуктивного прогноза.

Introduction

Introduction. Endometriosis is a multifactorial disease, affecting about 10 % of women of reproductive age. The purpose of the work is predicting the development of infertility in women with ovarian endometriosis by determining urine melatonin levels and activity indicators of nucleolar organizer regions in endometrioid ovarian heterotopias.

Materials and methods

Materials and methods. In the Clinic of South Ural State Medical University from 2018 to 2020, 2 groups of women with ovarian endometriosis were studied: group 1 — with infertility (n = 22); group 2 — without it (n = 27). The level of urinary 6-SMT and the activity of ribosomal synthesis were determined.

Results

Results. The level of 6-SMT is reduced in patients with stage I ovarian endometriosis. At stagesII and III, the level of 6-SMTis lower in women with infertility than without it: Stage II — (38.82±1.49) ng/ml and (93.04±3.64) ng/ml (p < 0.001); Stage III — (42.84±1.85) ng/ml and (58.06±1.65) ng/ml (p = 0.340). The activity of ribosomal synthesis in epithelial cells of endometrioid heterotopias increases at stage III. In fibroblasts of the stroma of endometrioid heterotopias, the activity of ribosomal synthesis is higherin women with stage III infertility, and in histiocytes— in women with stage II infertility. A logistic stepwise regression analysis was carried out and the most important predictors influencing the development of infertility were identified.

Discussion

Discussion. The decrease in melatonin in women with ovarian endometriosis, suffering from infertility, as well as in stage I ovarian endometriosis is consistent with the research of M. I. Yarmolinskaya et al. (2019). In the presence of infertility, activation of connective tissue histiocytes begins in the early stages. The results obtained may reflect the immunomodulatory effect of melatonin, which is expressed inincreased functional activity of connective tissue histiocytes and fibroblasts.

Conclusion

Conclusion. Using mathematical analysis, the most important indicators that influence the reproductive prognosis in women with ovarian endometriosis (activity of nucleolar organizer regions, urine 6-SMT level) were determined, which makes it possible to create a model for calculating an individual reproductive prognosis.

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The authors declare that there are no conflicts of interest present.