Менопауза и преждевременная недостаточность яичников при ревматических заболеваниях

Паневин Т.С., Ледина А.В., Зоткин Е.Г. Менопауза и преждевременная недостаточность яичников при ревматических заболеваниях. Гинекология. 2023;25(4):428–434. DOI: 10.26442/20795696.2023.4.202366

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

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Panevin TS, Ledina AV, Zotkin EG. Menopause and premature ovarian insufficiency in rheumatic diseases: A review. Gynecology. 2023;25(4):428–434. DOI: 10.26442/20795696.2023.4.202366

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Аннотация

Преждевременная недостаточность яичников (ПНЯ) – это клинический синдром, определяемый как потеря функции яичников в возрасте до 40 лет. Среди причин ПНЯ – генетические, обменные нарушения, а также инфекционный или ятрогенный факторы, однако в ряде случаев точную причину установить не удается. Учитывая возможную ассоциацию недостаточности яичников с аутоиммунными нарушениями, а также обнаружение антител к нормальной ткани яичников в сыворотке крови пациенток с ПНЯ, предполагается, что аутоиммунный механизм является значимой причиной синдрома. Принимая во внимание взаимосвязь между ПНЯ и аутоиммунными заболеваниями, представляется актуальным освещение вопросов взаимовлияния овариальной функции женщин с ПНЯ и ревматических заболеваний (в частности, системной красной волчанки, ревматоидного артрита и системной склеродермии), что представлено в обзоре. Заместительная гормональная терапия может быть рекомендована женщинам с ПНЯ для повышения качества их жизни.

Ключевые слова: преждевременная недостаточность яичников, менопауза, антиовариальные антитела, системная красная волчанка, ревматоидный артрит, системная склеродермия, ревматические заболевания, заместительная гормональная терапия

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Premature ovarian insufficiency (POI) is a clinical syndrome defined as loss of ovarian function before the age of 40 years. Among the causes of POI are genetic, metabolic disorders, as well as infectious or iatrogenic factors, but in some cases the exact cause cannot be established. Given the possible association of ovarian failure with autoimmune disorders, as well as the detection of antibodies to normal ovarian tissue in the serum of patients with POI, it is assumed that an autoimmune mechanism is a significant cause of the syndrome. Taking into account the relationship between POI and autoimmune diseases, it seems relevant to address the issues of mutual influence of the ovarian function of women with POI and rheumatic diseases (in particular, systemic lupus erythematosus, rheumatoid arthritis and systemic scleroderma), which is presented in this review. Hormone replacement therapy may be recommended for women with POI to improve their quality of life.

Keywords: premature ovarian insufficiency, menopause, anti-ovarian antibodies, systemic lupus erythematosus, rheumatoid arthritis, systemic scleroderma, rheumatic diseases, hormone replacement therapy

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1. European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI; Webber L, Davies M, Anderson R, et al. ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016;31(5):926-37. DOI:10.1093/humrep/dew027
2. Adamyan LV, Pivazyan LG, Antonova AA. Autoimmunity and premature ovarian insufficiency – up-to-date. Russian Journal of Human Reproduction. 2022;28(6):116-24 (in Russian). DOI:10.17116/repro202228061116
3. Chon SJ, Umair Z, Yoon MS. Premature Ovarian Insufficiency: Past, Present, and Future. Front Cell Dev Biol. 2021;9:672890. DOI:10.3389/fcell.2021.672890
4. Adamian LV, Andreeva EN, Artymuk NV, et al. Amenoreia i oligomenoreia. Klinicheskiie rekomendatsii. Moscow: Rossiiskoie obshchestvo akusherov-ginekologov, 2021 (in Russian).
5. Kravchenko EN, Vorontsova MS. Premature ovarian insufficiency: modern view of the problem. Mat’ i ditia v Kuzbasse. 2022;88(1):4-10 (in Russian).
DOI:10.24412/2686-7338-2022-1-4-10
6. Ishizuka B. Current Understanding of the Etiology, Symptomatology, and Treatment Options in Premature Ovarian Insufficiency (POI). Front Endocrinol (Lausanne). 2021;12:626924. DOI:10.3389/fendo.2021.626924.
7. Christin-Maitre S, Givony M, Albarel F, et al. Position statement on the diagnosis and management of premature/primary ovarian insufficiency (except Turner Syndrome). Ann Endocrinol (Paris). 2021;82(6):555-71. DOI:10.1016/j.ando.2021.09.001.
8. Adamyan LV, Pivazyan LG. Interdisciplinary approach and the current state of the issue of premature ovarian aging (literature review). Russian Journal of Human Reproduction. 2023;29(1):94-103 (in Russian). DOI:10.17116/repro20232901194
9. Andreeva EN, Absatarova YS, Akhmatova RR, et al. Primary ovarian insufficiency: from basis of pathogenesis to treatment perspectives. Gynecology, Obstetrics and Perinatology. 2021;20(5):100-7 (in Russian). DOI:10.20953/1726-1678-2021-5-100-107
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Авторы

Т.С. Паневин*^1,2, А.В. Ледина^3–5, Е.Г. Зоткин¹

¹ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой», Москва, Россия;
²ФГБОУ ВО «Дальневосточный государственный медицинский университет» Минздрава России, Хабаровск, Россия;
³ФГАОУ ВО «Российский университет дружбы народов», Москва, Россия;
⁴Общероссийская общественная организация «Российская ассоциация по генитальным инфекциям и неоплазии», Москва, Россия; 5Клинический госпиталь Лапино «Мать и дитя», д. Лапино, Россия
*tarasel@list.ru

________________________________________________

Taras S. Panevin*^1,2, Antonina V. Ledina^3–5, Evgeniy G. Zotkin¹

¹Nasonova Research Institute of Rheumatology, Moscow, Russia;
²Far-East State Medical University, Khabarovsk, Russia;
³People’s Friendship University of Russia (RUDN University), Moscow, Russia;
⁴Russian Association of Genital Infections and Neoplasia, Moscow, Russia; 5Lapino Clinical Hospital “Mother and Child”, Lapino, Russia
*tarasel@list.ru

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