Changes in sexual hormone levels of iatrogenic premature ovarian insufficiency and its impact on glucose metabolism
Objective To investigate the changes in sex hormone levels and their effects on glucose metabolism in patients with iatrogenic premature ovarian insufficiency(POI).Methods This study recruited 60 patients aged 20-40 years with iatrogenic POI due to hematopoietic stem cell transplantation(HSCT)and 60 patients with idiopathic POI who visited the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2022 to April 2024.General information collected included height,weight,age,and body mass index(BMI).Laboratory measurements included follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),cortisol(F),total testosterone(TT),free testosterone(FT),fasting plasma glucose(FPG),and fasting insulin(FINS).Results Body weight,BMI,E2,TT and FT levels were significantly lower in iatrogenic POI patients compared to idiopathic POI patients(all P<0.05).FSH,LH,FINS,and FPG levels were significantly higher in iatrogenic POI patients compared to idiopathic POI patients(all P<0.05).There were no significant differences in age,height,and cortisol levels between iatrogenic and idiopathic POI patients(all P>0.05).The proportion of iatrogenic POI patients with hyperinsulinemia was significantly higher than that of idiopathic POI patients(P=0.025).Conclusions Patients with iatrogenic POI exhibited more severe decreases in sex hormone levels and abnormalities in glucose metabolism compared to those with idiopathic POI,possibly due to greater damage to ovarian function from disease treatment.However,iatrogenic POI can be prevented by ovarian tissue cryopreservation(OTC)which can simultaneously preserve fertility and ovarian endocrine function.Therefore,it is highly necessary for patients undergoing OTC before receiving radiotherapy and chemotherapy.
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