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Federación Mexicana de Ginecología y Obstetricia, A.C.

2013, Número 12

Ginecol Obstet Mex 2013; 81 (12)


Concentraciones en suero de hormona antimülleriana en mujeres con y sin miomatosis uterina

Carranza-Lira S, Bustamante-Mendoza JA, Leaños-Miranda A, Campos-Galicia I, Estrada-Moscoso I, Chan-Verdugo R, Ramos-Godínez MP, Moncada-Claudio G, Peña-Torres ML

Idioma: Español
Referencias bibliográficas: 18
Paginas: 700-705
Archivo PDF: 332.70 Kb.


RESUMEN

Antecedentes: la etiología de la miomatosis uterina es multifactorial y si existe relación entre ésta y la hormona hormona antimülleriana se desconoce.
Objetivo: determinar si existe diferencia en las concentraciones de hormona antimülleriana entre mujeres con y sin miomatosis uterina que explique la aparición de la miomatosis, y conocer la expresión de la hormona anti-mülleriana-RII en los miomas uterinos.
Material y métodos: estudio transversal, comparativo y descriptivo al que se incluyeron 60 mujeres (30 con y 30 sin miomatosis uterina). A las pacientes con miomatosis uterina se les realizó histerectomía total abdominal. El diagnóstico se confirmó por histopatología. Ambos grupos se parearon por edad y todas las concentraciones en suero de hormona antimülleriana se midieron por ELISA y se determinaron las de estradiol y progesterona. En el miometrio sano y en los miomas se realizó inmunohistoquímica.
Resultados: no se encontraron diferencias entre los grupos en edad (41.8 ± 5.6 años vs 41.4 ± 5.7 años), ni en peso, talla e índice de masa corporal. Las concentraciones en suero de hormona antimülleriana fueron menores en las mujeres con miomatosis uterina [0.21 (0-10.4) ng/mL vs 1.83 (0-6.38) ng/mL, p < 0.005]. No hubo diferencias entre los grupos en las concentraciones de estradiol y progesterona. El receptor de hormona antimülleriana no se expresó ni en el miometrio sano ni en los miomas.
Conclusiones: las mujeres con miomatosis uterina tuvieron menores concentraciones de hormona anti-mülleriana. Se requieren más estudios para determinar si existe alguna relación entre la hormona antimülleriana y los miomas. Palabras clave: miomatosis uterina, hormona antimülleriana.

REFERENCIAS (EN ESTE ARTÍCULO)

  1. Vigier B, Picard JY, Tran D, Legeai L, Josso N. Production of anti-müllerian hormone: another homology between Sertoli and granulose cells. Endocrinology 1984;114:1315-1320.

  2. Cohen-Haguenauer O, Picard JY, Mattei MG, Serero S, Nguyen VC, De Tand MF, et al. Mapping of the gene for antimüllerian hormone to the short arm of human chromosome 19. Cytogenet Cell Gener 1987;44:2-6.

  3. Jaffe RB. Disorders of sexual development. In: Yen SSC, Jaffe RB, Barbieri RL. Eds. Reproductive endocrinology. Physiology, pathophysiology and clinical management. 4th ed. Philadelphia: WB Saunders, 1999;367.

  4. Durlinger AL, Gruijters MJ, Kramer P, Karels B, Ingraham HA, Natchigal MW, et al. Anti-Müllerian hormone inhibits initiation of primordial follicle growth in the mouse ovary. Endocrinology 2002;143:1076-1084.

  5. Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod 2004;10:77-78.

  6. Baarends AR, Uilenbroek JT, Kramer P, Hoogerbrugge JW, vanLeeuwen EC, Themmen AP, et al. Anti-müllerian hormone and anti-müllerian hormone type II receptor messenger ribonucleic acid expression in rat ovaries during postnatal development, the estrous cycle, and gonadotropin-induce follicle growth. Endocrinology 1995;136:4951-4962.

  7. Fanchin R, Schonauer LM, Righini C, Frydman N, Frydman R, Taieb J. Serum anti-Müllerian hormone dynamics during controlled ovarian hyperstimulation. Hum Reprod 2003;18:323-327.

  8. Fanchin R, Méndez Lozano DH, Louafi N, Achour- Frydman N, Frydman R, Taieb J. Dynamics of serum anti-Mullerian hormone levels during the luteal phase of controlled ovarian hyperstimulation. Hum Reprod 2005;20:747-751.

  9. Soto N, Iñiguez G, López P, Larenas G, Mujica V, Rey RA, et al. Anti-Müllerian hormone and inhibin B levels as markers of premature ovarian aging and transition to menopause in type I diabetes mellitus. Human Reprod 2009;24:2838-2844.

  10. Freeman EW, Gracia CR, Sammel MD, Lin H, Chong-Leon LL, Strauss JF III. Association of anti-müllerian hormone levels with obesity in late reproductive-age women. Fertil Steril 2007;87:101-106.

  11. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol 1990;94:435-438.

  12. Mashal RD, Fejzo ML, Friedman AJ, Mitchner N, Nowak RA, Rein MS, et al. Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata. Genes Chromosomes Cancer 1994;11:1-6.

  13. Englund K, Blanck A, Gustavsson I, Lundkvist U, Sjoblom P, Norgren A, et al. Sex steroid receptors in human myometrium and fibroids: changes during the menstrual cycle and gonadotropin-releasing hormone treatment. J Clin Endocrinol Metab 1996;83:4092-4096.

  14. Otubu JA, Buttram VC, Besch NF, Besch PK. Unconjugated steroids in leiomyomas and tumor-bearing myometrium. Am J Obstet Gynecol 1982;143:130-133.

  15. Goldzieher JW, Maqueo M, Ricaud L, Aguilar JA, Canales E. Induction of degenerative changes in uterine myomas by high-dosage progestin therapy. Am J Obstet Gynecol 1966;96:1078-1087.

  16. Tiltman AJ. The effect of progestins on the mitotic activity of uterine fibromyomas. Int J Gynecol Pathol 1985;4:89-96.

  17. Carr BR, Marshburn PB, Weatherall PT, Bradshaw KD, Breslav NA, Byrd W, et al. An evaluation of the effect of gonadotropin-releasing hormone analogs and medroxyprogesterone acetate on uterine leiomyomata volume by magnetic resonance imaging: a prospective, randomized, double blind, placebo-controlled, crossover trial. J Clin Endocrinol Metab 1993;76:1217-1223.

  18. Steinauer J, Pritts EA, Jackson R, Jacoby AF. Systematic review of mifepristone for the treatment of uterine leiomyomata. Obstet Gynecol 2004;103:1331-1336.

  19. Vigier B, Picard JY, Tran D, Legeai L, Josso N. Production of anti-müllerian hormone: another homology between Sertoli and granulose cells. Endocrinology 1984;114:1315-1320.

  20. Cohen-Haguenauer O, Picard JY, Mattei MG, Serero S, Nguyen VC, De Tand MF, et al. Mapping of the gene for antimüllerian hormone to the short arm of human chromosome 19. Cytogenet Cell Gener 1987;44:2-6.

  21. Jaffe RB. Disorders of sexual development. In: Yen SSC, Jaffe RB, Barbieri RL. Eds. Reproductive endocrinology. Physiology, pathophysiology and clinical management. 4th ed. Philadelphia: WB Saunders, 1999;367.

  22. Durlinger AL, Gruijters MJ, Kramer P, Karels B, Ingraham HA, Natchigal MW, et al. Anti-Müllerian hormone inhibits initiation of primordial follicle growth in the mouse ovary. Endocrinology 2002;143:1076-1084.

  23. Weenen C, Laven JS, Von Bergh AR, Cranfield M, Groome NP, Visser JA, et al. Anti-Müllerian hormone expression pattern in the human ovary: potential implications for initial and cyclic follicle recruitment. Mol Hum Reprod 2004;10:77-78.

  24. Baarends AR, Uilenbroek JT, Kramer P, Hoogerbrugge JW, vanLeeuwen EC, Themmen AP, et al. Anti-müllerian hormone and anti-müllerian hormone type II receptor messenger ribonucleic acid expression in rat ovaries during postnatal development, the estrous cycle, and gonadotropin-induce follicle growth. Endocrinology 1995;136:4951-4962.

  25. Fanchin R, Schonauer LM, Righini C, Frydman N, Frydman R, Taieb J. Serum anti-Müllerian hormone dynamics during controlled ovarian hyperstimulation. Hum Reprod 2003;18:323-327.

  26. Fanchin R, Méndez Lozano DH, Louafi N, Achour- Frydman N, Frydman R, Taieb J. Dynamics of serum anti-Mullerian hormone levels during the luteal phase of controlled ovarian hyperstimulation. Hum Reprod 2005;20:747-751.

  27. Soto N, Iñiguez G, López P, Larenas G, Mujica V, Rey RA, et al. Anti-Müllerian hormone and inhibin B levels as markers of premature ovarian aging and transition to menopause in type I diabetes mellitus. Human Reprod 2009;24:2838-2844.

  28. Freeman EW, Gracia CR, Sammel MD, Lin H, Chong-Leon LL, Strauss JF III. Association of anti-müllerian hormone levels with obesity in late reproductive-age women. Fertil Steril 2007;87:101-106.

  29. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol 1990;94:435-438.

  30. Mashal RD, Fejzo ML, Friedman AJ, Mitchner N, Nowak RA, Rein MS, et al. Analysis of androgen receptor DNA reveals the independent clonal origins of uterine leiomyomata and the secondary nature of cytogenetic aberrations in the development of leiomyomata. Genes Chromosomes Cancer 1994;11:1-6.

  31. Englund K, Blanck A, Gustavsson I, Lundkvist U, Sjoblom P, Norgren A, et al. Sex steroid receptors in human myometrium and fibroids: changes during the menstrual cycle and gonadotropin-releasing hormone treatment. J Clin Endocrinol Metab 1996;83:4092-4096.

  32. Otubu JA, Buttram VC, Besch NF, Besch PK. Unconjugated steroids in leiomyomas and tumor-bearing myometrium. Am J Obstet Gynecol 1982;143:130-133.

  33. Goldzieher JW, Maqueo M, Ricaud L, Aguilar JA, Canales E. Induction of degenerative changes in uterine myomas by high-dosage progestin therapy. Am J Obstet Gynecol 1966;96:1078-1087.

  34. Tiltman AJ. The effect of progestins on the mitotic activity of uterine fibromyomas. Int J Gynecol Pathol 1985;4:89-96.

  35. Carr BR, Marshburn PB, Weatherall PT, Bradshaw KD, Breslav NA, Byrd W, et al. An evaluation of the effect of gonadotropin-releasing hormone analogs and medroxyprogesterone acetate on uterine leiomyomata volume by magnetic resonance imaging: a prospective, randomized, double blind, placebo-controlled, crossover trial. J Clin Endocrinol Metab 1993;76:1217-1223.

  36. Steinauer J, Pritts EA, Jackson R, Jacoby AF. Systematic review of mifepristone for the treatment of uterine leiomyomata. Obstet Gynecol 2004;103:1331-1336.

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