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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rsp</journal-id><journal-title-group><journal-title xml:lang="ru">Научно-практическая ревматология</journal-title><trans-title-group xml:lang="en"><trans-title>Rheumatology Science and Practice</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1995-4484</issn><issn pub-type="epub">1995-4492</issn><publisher><publisher-name>IMA-PRESS, LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47360/1995-4484-2023-349-355</article-id><article-id custom-type="elpub" pub-id-type="custom">rsp-3362</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL RESEARCH</subject></subj-group></article-categories><title-group><article-title>Овариальный резерв при системной склеродермии</article-title><trans-title-group xml:lang="en"><trans-title>Ovarian reserve in patients with systemic sclerosis</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3139-8811</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Голоева</surname><given-names>Р. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Goloeva</surname><given-names>R. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><email xlink:type="simple">regina_goloeva@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3248-6426</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ананьева</surname><given-names>Л. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Ananyeva</surname><given-names>L. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6619-718X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алекберова</surname><given-names>З. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Alekberova</surname><given-names>Z. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4285-0869</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Глухова</surname><given-names>С. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Glukhova</surname><given-names>S. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3246-1157</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черкасова</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Cherkasova</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5012-0540</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гарзанова</surname><given-names>Л. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Garzanova</surname><given-names>L. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3650-7658</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Конева</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Koneva</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3552-2522</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Решетняк</surname><given-names>Т. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Reshetnyak</surname><given-names>T. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>115522, Москва, Каширское шоссе, 34а</p></bio><bio xml:lang="en"><p>115522, Moscow, Kashirskoye Highway, 34A</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>V.A. Nasonova Research Institute of Rheumatology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>29</day><month>06</month><year>2023</year></pub-date><volume>61</volume><issue>3</issue><elocation-id>349–355</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Голоева Р.Г., Ананьева Л.П., Алекберова З.С., Глухова С.И., Черкасова М.В., Гарзанова Л.А., Конева О.А., Решетняк Т.М., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Голоева Р.Г., Ананьева Л.П., Алекберова З.С., Глухова С.И., Черкасова М.В., Гарзанова Л.А., Конева О.А., Решетняк Т.М.</copyright-holder><copyright-holder xml:lang="en">Goloeva R.G., Ananyeva L.P., Alekberova Z.S., Glukhova S.I., Cherkasova M.V., Garzanova L.A., Koneva O.A., Reshetnyak T.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://rsp.mediar-press.net/rsp/article/view/3362">https://rsp.mediar-press.net/rsp/article/view/3362</self-uri><abstract><p>Цель исследования – оценить овариальный резерв у женщин с системной склеродермией (ССД) и проанализировать связь концентрации антимюллерова гормона (АМГ) с основными проявлениями заболевания и терапией. Материал и методы. В одномоментное наблюдательное исследование включено 74 пациентки в возрасте от 18 до 40 лет с ССД; группу контроля составили 32 здоровые женщины соответствующего возраста. Концентрацию фолликулостимулирующего гормона (ФСГ), лютенизирующео гормона (ЛГ), пролактина, эстрадиола (Е2) и тестостерона определяли методом иммуноферментного анализа (ELISA, enzyme-linked immunosorbent assay); количественное определение АМГ выполнялось с использованием стандартного хемилюминисцентного анализа на парамагнитных частицах в сыворотке крови. За норму принимали уровень АМГ 1,0–10,6 нг/мл. Уровень АМГ&lt;1,0 нг/мл расценивался как показатель снижения овариального резерва. Результаты. У пациенток с ССД уровень АМГ и тестостерона был статистически значимо ниже, чем в кон тро ле: 1,4 [0,5; 2,3] и 0,45 [0,2; 0,96] нг/мл против 2,4 [1,8; 3,3] (р=0,002) и 1,6 [0,97; 2,5] нг/мл (р=0,0001) соответственно. Концентрация пролактина и Е2 при ССД была выше, чем в контроле: 22,2 [14,0; 31,1] и 140,2 [102,4; 179,7] пг/мл против 10,2 [7,1; 16,6] (р=0,000002) и 95,3 [64,5; 130,0] нг/мл (р=0,002) соответственно. Снижение овариального резерва по уровню АМГ при ССД выявлялось статистически значимо чаще, чем в контроле: в 43% и 9,4% случаев соответственно (p=0,002). Риск снижения АМГ у пациентов с ССД был в 7 раз выше, чем в контроле (отношение шансов (ОШ) – 7,03; 95%-й доверительный интервал (95% ДИ): 1,97–25,11). У больных ССД с низким овариальным резервом чаще выявлялись диффузная форма (46,9%) и подострое течение болезни (53,1%) по сравнению с теми, кто имел нормальный овариальный резерв (23,8% (р=0,033) и 23,4% (р=0,004) соответственно). Частота связанных с ССД органных поражений, иммунологических нарушений, содержание воспалительных маркеров и характер липидного спектра в группах с низким и нормальным уровнем АМГ не различались. Также не выявлено различий по схемам и дозам лечения базисными противовоспалительн ыми препаратами и глюкокортикоидами. Нарушения менструального цикла при ССД отмечались в 31% случаев, в контроле – в 6,2% (р=0,004). Преждевременная недостаточность яичников (ПНЯ) была выявлена у 6,8% пациенток с ССД и ни у одной пациентки в группе контроля (р=0,02). Больные ССД с ПНЯ не отличались по возрасту, длительности болезни, клиническим проявлениям и терапии ССД от пациенток без ПНЯ. Заключение. У больных ССД концентрация АМГ и тестостерона статистически значимо ниже, чем у здоровых женщин того же возраста. Снижение овариального резерва статистически значимо чаще выявлялось у женщин с ССД. Низкий овариальный резерв чаще выявлялся у пациенток с диффузной формой и подострым течением болезни. ПНЯ чаще наблюдалась в группе ССД. </p></abstract><trans-abstract xml:lang="en"><p>Objective. To evaluate the ovarian reserve in women with systemic sclerosis (SSc) and to analyze the relationship of the concentration of anti-Müllerian hormone (AMH) with the main manifestations of the disease and therapy. Material and methods. The study included 74 SSc patients aged 18 to 40 years; the control group consisted of 32 healthy women, matched by age. The concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol (E2) and testosterone was determined by enzyme immunoassay (ELISA), AMH quantitatively using standard chemiluminescent analysis on paramagnetic particles in blood serum. The AMG level of 1.0– 10.6 ng/ml was taken as normative values. Values &lt;1.0 were regarded as a decrease in ovarian reserve. Results. In patients with SSD, the levels of AMH and testosterone were significantly lower than 1.4 [0.5; 2.3] and 0.45 [0.2; 0.96], respectively, versus 2.4 [1.8; 3.3] (p=0.002) and 1.6 [0.97; 2.5] (p=0.0001) in the control. The concentration of prolactin and E2 was recorded higher with SSDs – 22.23 [14.08; 31.18] and 140.2 [102.43; 179.74], respectively, against 10.2 [7.11; 16.68] (p=0.000002) and 95.3 [64.50; 130.0] (p=0.002) in the control. A decrease in the ovarian reserve by the level of AMH was significantly more often detected in patients with SSD in 43% versus 9.4% in the control (p=0.002). The risk of AMH reduction in patients with SSD was 7 times higher compared to the control (OR=7.030; 95% CI: 1.97–25.11). The levels of the hormones studied were comparable in patients with low and normal ovarian reserve. Diffuse form (46.9%) and subacute course of the disease (53.1%) were more often detected in patients with SSD and with low ovarian reserve compared to those with normal ovarian reserve (23.8% (p=0.033); 23.4% (p=0.004)). The frequency of organ lesions of SSDs, immunological disorders, inflammatory markers, and the lipid spectrum in the groups did not differ depending on the level of AMH. There were also no differences in the regimens and doses of treatment with basic anti-inflammatory drugs and glucocorticoids. Menstrual cycle disorders were noted by 31% of patients with SSD versus 6.2% in the control (p=0.004). Premature ovarian insufficiency (POI) was detected in 6.8% of patients with SSD and none in the control group (p=0.02). Patients with SSD and POI did not differ in age, duration of illness, clinical manifestations and therapy of them without POI.Conclusion. The concentration of AMH and testosterone was significantly lower in patients with. A decrease in ovarian reserve was significantly more often detected in women with SSs. Low ovarian reserve was more often detected in patients with diffuse form and subacute course of the disease. POI was more often observed in the group of SSc.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>системная склеродермия</kwd><kwd>овариальный резерв</kwd><kwd>антимюллеров гормон</kwd><kwd>преждевременная недостаточность яичников</kwd><kwd>интерстициальное поражение легких</kwd></kwd-group><kwd-group xml:lang="en"><kwd>systemic sclerosis</kwd><kwd>ovarian reserve</kwd><kwd>anti-Müllerian hormone</kwd><kwd>premature ovarian insufficiency</kwd><kwd>interstitial lung damage</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Работа выполнена за счет средств бюджетного финансирования на выполнение государственного задания по фундаментальной научной теме № 12204004000-7 «FURS-2022-003».</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Denton C, Khanna D. Systemic sclerosis. 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