The role of endocrine factors and markers of cellular stress in predicting the effectiveness of the treatment of climacteric syndrome in the period of perimenopause

Abstract

Women of menopausal age make up 10% of the world's population, and the problem of pathological menopause remains relevant today. Estrogen deficiency is considered to be the cause of menopause, so the use of replacement therapy is a pathogenetically sound method. It is possible that the immune system also plays a role in shaping the clinical picture. There is a certain relationship between estrogen levels and markers of intracellular stress. Studying the level of heat shock proteins as proven factors of cellular stress, along with endocrine factors, can become a reliable marker for the prognosis, course and compensation of disorders of the neurovegetative state of women in this period of life.

Purpose - to study the role of levels of antimullerian, follicle-stimulating, luteinizing, thyroid-stimulating hormones, levels of antibodies (IgG) to human heat shock protein (Hsp60) and its bacterial homologue (Groel) in the prognosis, diagnosis and treatment of psychopathological manifestations in perimenopausal women.

Materials and methods. The study examined 158 patients with perimenopausal menopausal syndrome between October 2019 and March 2022. The patients were divided into two groups. The 1st (main) group included 80 patients who agreed to receive treatment according to the standard regimen (combined treatment in a cyclic regimen (estrogens + gestagens), and the 2nd (comparative) group included 78 women who refused the proposed treatment

Results. A decrease (p<0.001) in the risk of not achieving a high treatment effect was found for the main group, OR=0.12 (95% CI: 0.06-0.26) compared with the control group. It was found that a higher level of antibodies to GroEl, OR=0.989 (95% CI: 0.984-0.996), revealed a lower (p=0.001) risk of not achieving a high treatment effect. A higher body mass index (BMI) of a woman increases the risk of not achieving a high treatment effect (p<0.001), OR=1.19 (95% CI: 1.10-1.30) for every 1 kg/m². When standardized by BMI, an integral indicator of psychopathological manifestations, taking into account the method of treatment and the level of antimullerian hormone, a decrease (p=0.039) in the risk of failure to achieve a high treatment effect was found for the main group, OR=0.16 (95% CI: 0.07-0.39) compared with the control group.

Conclusions. It has been established that the most informative indicator for predicting the effectiveness of treatment of women with psychopathological manifestations is antimüllerian hormone. The data also show that the determination of the level of antibodies to GroEl correlates with the success of treatment of women with psychopathological manifestations of menopausal syndrome.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institutions mentioned in the paper. Informed consent of women was obtained for the study.

No conflict of interests was declared by the authors.