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DOI: 10.1055/s-2003-42740
Georg Thieme Verlag Stuttgart · New York
Altersabhängige Serumkonzentrationen von Inhibin A, Inhibin B und Aktivin A bei jüngeren und älteren fertilen Frauen
Age-Related Serum Concentrations of Inhibin A, Inhibin B and Activin A in Younger and Elder Fertile WomenPublication History
Eingang Manuskript: 21. Mai 2003
Eingang revidiertes Manuskript: 21. August 2003
Akzeptiert: 24. August 2003
Publication Date:
10 October 2003 (online)
Zusammenfassung
Fragestellung
Ziel der vorliegenden prospektiven Studie war es zu überprüfen, ob es einen altersabhängigen Effekt bezüglich der Serumkonzentrationen von Inhibin A, Inhibin B sowie Aktivin A zu verschiedenen Zeitpunkten des Menstruationszyklus bei jüngeren und älteren fertilen Frauen gibt. Die Serumkonzentrationen von Inhibin A, Inhibin B und Aktivin A wurden mit den LH-, FSH-, Östradiol- und Progesteronkonzentrationen verglichen.
Patientinnen und Methodik
52 gesunde Frauen mit regelmäßigem Menstruationszyklus im Alter von 18 - 45 Jahren wurden im Rahmen der Studie untersucht. Gruppe I bestand aus 28 Frauen (medianes Alter: 23,6 Jahre) und Gruppe II bestand aus 24 Frauen (medianes Alter: 39,4 Jahre). Es wurde am 3., 8. und 22. Zyklustag Inhibin A, Inhibin B, Aktivin A, FSH, LH, Östradiol sowie Progesteron bestimmt.
Ergebnisse
Es lag ein statistisch auffälliger Unterschied in Bezug auf die FSH-Konzentrationen in beiden Studiengruppen vor (p-Wert < 0,05). LH, Östradiol, Progesteron und Aktivin A zeigten keine statistisch auffälligen Konzentrationsänderungen. Die Serumkonzentrationen von Inhibin A und Inhibin B waren bei den älteren fertilen Frauen statistisch auffällig tiefer als bei den jüngeren fertilen Frauen (p-Wert < 0,05).
Schlussfolgerung
Aus unseren Daten lässt sich über die endokrine Rolle von Aktivin A keine eindeutige Aussage ableiten. Im Gegensatz dazu können die reduzierten Serumkonzentrationen von Inhibin A und Inhibin B bei älteren fertilen Frauen als biologischer Frühmarker der nachlassenden ovariellen Aktivität interpretiert werden.
Abstract
Purpose
The aim of this prospective study was to evaluate the age-related effect on the cyclical patterns of serum inhibin A, inhibin B and activin A in younger and elder fertile women and to compare them with concentrations of LH, FSH, estradiol and progesterone.
Patients and Methods
52 healthy women aged 18 - 45 years experiencing regular cycles participated in the study. Group I consisted of 28 women (median age: 23.6 years), group II consisted of 24 women (median age: 39.4 years). Serum inhibin A, inhibin B, activin A, LH, FSH, estradiol and progesterone were measured on day 3, 8 and 22 of the cycle.
Results
There was a statistically significant difference in the concentration of FSH in both groups (p-value < 0.05). The concentrations of LH, estradiol, progesterone and activin A did not change significantly between the younger and elder fertile women. The serum concentrations of inhibin A, inhibin B in the elder fertile women were significantly lower than those in the younger fertile women (p-value < 0.05).
Conclusion
Activin A appears to play a unclear role in characterizing ovarian activity. In contrast, the decreased patterns of circulating inhibin A and inhibin B concentrations in elder fertile women observed during the menstrual cycle suggest that these hormones are early biological markers of the decline in ovarian activity.
Schlüsselwörter
Inhibin A - Inhibin B - Aktivin A - altersabhängige Serumkonzentration - ovarielle Aktivität
Key words
Inhibin A - inhibin B - activin A - age-related serum concentration - ovarian activity
Literatur
- 1 Metcalf M G, Livesey J H. Gonadotrophin excretion in fertile women: effect of age and the onset of the menopausal transition. J Endocrinol. 1985; 105 357-362
- 2 Lee S J, Lenton E A, Sexton L, Cooke I D. The effect of age on the cyclical patterns of plasma LH, FSH, oestradiol and progesterone in women with regular menstrual cycles. Hum Reprod. 1988; 3 851-855
- 3 Fitzgerald C T, Seif M W, Killick S R, Elstein M. Age related changes in the female reproductive cycle. Br J Obstet Gynaecol. 1994; 101 229-233
- 4 Muttukrishna S, Knight P G. Effects of crude and highly purified bovine inhibin (Mr 32, 000 form) on gonadotrophin production by ovine pituitary cells in vitro: inhibin enhances gonadotrophin-releasing hormone-induced release of LH. J Endocrinol. 1990; 127 149-159
- 5 Klein N A, Illingworth P J, Groome N P, McNeilly A S, Battaglia D E, Soules M R. Decreased inhibin B secretion is associated with the monotropic FSH rise in older, ovulatory women: a study of serum and follicular fluid levels of dimeric inhibin A and B in spontaneous menstrual cycles. J Clin Endocrinol Metab. 1996; 81 2742-2745
- 6 Woodruff T K, Besecke L M, Groome N, Draper L B, Schwartz N B, Weiss J. Inhibin A and inhibin B are inversely correlated to follicle-stimulating hormone, yet are discordant during the follicular phase of the rat estrous cycle, and inhibin A is expressed in a sexually dimorphic manner. Endocrinology. 1996; 137 5463-5467
- 7 Pangas S A, Woodruff T K. Activin signal transduction pathways. Trends Endocrinol Metab. 2000; 11 309-314
- 8 Groome N P, Illingworth P J, O'Brien M, Priddle J, Weaver K, Mc Neilly A S. Quantification of inhibin pro-alpha C-containing forms in human serum by a new ultrasensitive two-site enzyme-linked immunosorbent assay. J Clin Endocrinol Metab. 1995; 80 2926-2932
- 9 Knight P G, Muttukrishna S, Groome N P. Development and application of a two-site enzyme immunoassay for the determination of “total” activin-A concentrations in serum and follicular fluid. J Endocrinol. 1996; 148 267-279
- 10 Groome N P, Illingworth P J, O'Brien M, Pai R, Rodger F E, Mather J P, McNeilly A S. Measurement of dimeric inhibin B throughout the human menstrual cycle. J Clin Endocrinol Metab. 1996; 81 1401-1405
- 11 Welt C K, Martin K A, Taylor A E, Lambert-Messerlian G M, Crowley Jr W F, Smith J A, Schoenfeld D A, Hall J E. Frequency modulation of follicle-stimulating hormone (FSH) during the luteal-follicular transition: evidence for FSH control of inhibin B in normal women. J Clin Endocrinol Metab. 1997; 82 2645-2652
- 12 Petraglia F, Zanin E, Faletti A, Reis F M. Inhibins: paracrine and endocrine effects in female reproductive function. Curr Opin Obstet Gynecol. 1999; 11 241-247
- 13 Muttukrishna S, Fowler P A, George L, Groome N P, Knight P G. Changes in peripheral serum levels of total activin A during the human menstrual cycle and pregnancy. J Clin Endocrinol Metab. 1996; 81 3328-3334
- 14 Reame N E, Wyman T L, Phillips D J, de Kretser D M, Padmanabhan V. Net increase in stimulatory input resulting from a decrease in inhibin B and an increase in activin A may contribute in part to the rise in follicular phase follicle-stimulating hormone of aging cycling women. J Clin Endocrinol Metab. 1998; 83 3302-3307
- 15 Welt C K, McNicholl D J, Taylor A E, Hall J E. Female reproductive aging is marked by decreased secretion of dimeric inhibin. J Clin Endocrinol Metab. 1999; 84 105-111
- 16 Burger H G, Dudley E C, Hopper J L, Shelly J M, Green A, Smith A, Dennerstein L, Morse C. The endocrinology of the menopausal transition: a cross-sectional study of a population-based sample. J Clin Endocrinol Metab. 1995; 80 3537-3345
- 17 Petraglia F, Hartmann B, Luisi S, Florio P, Kirchengast S, Santuz M, Genazzani A D, Genazzani A. Low levels of serum inhibin A and inhibin B in women with hypergonadotropic amenorrhea and evidence of high levels of activin A in women with hypothalamic amenorrhea. Fertil Steril. 1998; 70 907-912
- 18 Muttukrishna S, Child T, Lockwood G M, Groome N P, Barlow D H, Ledger W L. Serum concentrations of dimeric inhibins, activin A, gonadotrophins and ovarian steroids during the menstrual cycle in older women. Hum Reprod. 2000; 15 549-556
- 19 Klein N A, Illingworth P J, Groome N P, McNeilly A S, Battaglia D E, Soules M R. Decreased inhibin B secretion is associated with the monotropic FSH rise in older, ovulatory women: a study of serum and follicular fluid levels of dimeric inhibin A and B in spontaneous menstrual cycles. J Clin Endocrinol Metab. 1996; 81 2742-2745
- 20 Seifer D B, Gardiner A C, Lambert-Messerlian G, Schneyer A L. Differential secretion of dimeric inhibin in cultured luteinized granulosa cells as a function of ovarian reserve. J Clin Endocrinol Metab. 1996; 81 736-739
- 21 Burger H G, Cahir N, Robertson D M, Groome N P, Dudley E, Green A, Dennerstein L. Serum inhibin A and B fall differentially as FSH rises in perimenopausal women. Clin Endocrinol. 1998; 48 809-813
- 22 Schipper I, de Jong F H, Fauser B C. Lack of correlation between maximum early follicular phase serum follicle stimulating hormone concentrations and menstrual cycle characteristics in women under the age of 35 years. Hum Reprod. 1998; 13 1442-1448
- 23 Welt C K, Pagan Y L, Smith P C, Rado K B, Hall J E. Control of follicle-stimulating hormone by estradiol and the inhibins: critical role of estradiol at the hypothalamus during the luteal-follicular transition. J Clin Endocrinol Metab. 2003; 88 1766-1771
- 24 Hall J E, Welt C K, Cramer D W. Inhibin A and inhibin B reflect ovarian function in assisted reproduction but are less useful at predicting outcome. Hum Reprod. 1999; 14 409-415
- 25 Creus M, Peńarrubia J, Fábregues F, Vidal E, Carmona F, Casamitjana R, Vanrell J A, Balasch J. Day 3 serum inhibin B and FSH and age as predictors of assisted reproduction treatment outcome. Hum Reprod. 2000; 15 2341-2346
- 26 Casper F W, Seufert R J, Schaffrath M, Pollow K. Concentrations of inhibins and activin in women undergoing stimulation with recombinant follicle-stimulating hormone for in vitro fertilization treatment. Fertil Steril. 2001; 75 32-37
Dr. med. Winfried Munz
Universitäts-Frauenklinik
Johannes-Gutenberg-Universität Mainz
Langenbeckstraße 1
55101 Mainz
Email: wmunz@uni-mainz.de