Метаболомика в предикции эндокринного бесплодия у женщин с метаболическим синдромом

Objectives. To compare metabolic profile of patients with metabolic syndrome (MS) having generation function disorders (endocrine infertility) and/or disturbances of their menstrual cycle and females with MS without fertile disturbances and normal menstrual cycle; on the basis of the obtained results to elaborate prognostic mathematic model of endocrine infertility development in females with MS. Material and methods. The analysis of carbohydrate, lipid, amino acid metabolism in 45 patients with MS, who had fertile dysfunction and/or menstrual cycle disturbances has been made. The comparison group was composed of 30 fertile females at the reproductive age with MS and normal menstrual cycle. Results. Carbohydrate metabolism indices in patients with MS and fertile dysfunction and those in patients with MS but without reproductive function and menstrual cycle disturbances do not differ significantly. More significant differences in lipid metabolism disturbances have been revealed in fertile patients with MS compared to females with MS and reproductive system dysfunction, which testifies to the lack of prognostic value of these criteria. The most significant differences have been found in amino acids metabolism in patients with MS and reproductive system dysfunction. A reliable increase of the level of 22 free amino acids and their derivatives in blood plasma compared to the control group has been revealed. Discriminant, canonical and contingency analyses with stepwise procedure have been made. Mathematic formula for prognostication of endocrine infertility development in women with MS has been devised. Conclusions. Mathematic formula of a high degree of reliability (95%) to prognosticate endocrine infertility in patients with MS has been devised on the basis of metabolic profile indices. The diagnostic efficacy (accuracy) of the proposed method is 94,67%. This method allows to develop individual therapeutic programs for females with MS and fertile disturbances as well as to organize therapeutic and diagnostic process adequately.