PDF(Pubmed)
Abstract：
Female and latent genital tuberculosis (FGTB and LGTB) in young women may lead to infertility by damaging ovarian reserve function, but the regulatory mechanisms remain unclear. In this study, we investigated the effects of FGTB and LGTB on ovarian reserve function and potential regulatory mechanisms by untargeted metabolomics of follicular fluid, aiming to provide insights for the clinical management and treatment approaches for afflicted women. We recruited 19 patients with FGTB, 16 patients with LGTB, and 16 healthy women as a control group. Clinical data analysis revealed that both the FGTB and LGTB groups had significantly lower ovarian reserve marker levels compared to the control group, including lower anti-Müllerian hormone levels (FGTB: 0.82 [0.6, 1.1] μg/L; LGTB: 1.57 [1.3, 1.8] μg/L vs. control: 3.29 [2.9, 3.5] μg/L), reduced antral follicular counts (FGTB: 6 [5.5, 9.5]; LGTB: 10.5 [7, 12.3] vs. control: 17 [14.5, 18]), and fewer retrieved oocytes (FGTB: 3 [2, 5]; LGTB: 8 [4, 8.3] vs. control: 14.5 [11.5, 15.3]). Conversely, these groups exhibited higher ovarian response marker levels, such as longer gonadotropin treatment days (FGTB: 12 [10.5, 12.5]; LGTB: 11 [10.8, 11.3] vs. control: 10 [8.8, 10]) and increased gonadotropin dosage requirements (FGTB: 3300 [3075, 3637.5] U; LGTB: 3037.5 [2700, 3225] U vs. control: 2531.25 [2337.5, 2943.8] U). All comparisons were statistically significant at P < 0.05. The results suggested that FGTB and LGTB have adverse effects on ovarian reserve and response. Untargeted metabolomic analysis identified 92 and 80 differential metabolites in the control vs. FGTB and control vs. LGTB groups, respectively. Pathway enrichment analysis revealed significant alterations in metabolic pathways in the FGTB and LGTB groups compared to the control group (P < 0.05), with specific changes noted in galactose metabolism, biotin metabolism, steroid hormone biosynthesis, and nicotinate and nicotinamide metabolism in the FGTB group, and caffeine metabolism, primary bile acid biosynthesis, steroid hormone biosynthesis, and glycerophospholipid metabolism in the LGTB group. The analysis of metabolic levels has revealed the potential mechanisms by which FGTB and LGTB affect ovarian reserve function, namely through alterations in metabolic pathways. The study emphasizes the importance of comprehending the metabolic alterations associated with FGTB and LGTB, which is of considerable relevance for the clinical management and therapeutic approaches in afflicted women.
摘要：
年轻女性的女性和潜伏性生殖器结核（FGTB和LGTB）可能通过损害卵巢储备功能而导致不孕。但监管机制仍不清楚。在这项研究中,我们通过卵泡液的非靶向代谢组学研究了FGTB和LGTB对卵巢储备功能和潜在调节机制的影响，旨在为患病妇女的临床管理和治疗方法提供见解。我们招募了19名FGTB患者，16例LGTB患者，16名健康女性作为对照组。临床数据分析显示，与对照组相比，FGTB和LGTB组的卵巢储备标志物水平均明显降低，包括较低的抗苗勒管激素水平（FGTB：0.82[0.6,1.1]μg/L；LGTB：1.57[1.3,1.8]μg/Lvs.对照：3.29[2.9，3.5]μg/L），窦卵泡计数减少（FGTB：6[5.5，9.5]；LGTB：10.5[7，12.3]与控制：17[14.5，18]），和更少的检索卵母细胞（FGTB：3[2，5]；LGTB：8[4，8.3]与控制：14.5[11.5，15.3]）。相反，这些组表现出更高的卵巢反应标志物水平，例如更长的促性腺激素治疗天数（FGTB：12[10.5，12.5]；LGTB：11[10.8，11.3]vs.对照：10[8.8，10]）和增加的促性腺激素剂量要求（FGTB：3300[3075，3637.5]U；LGTB：3037.5[2700，3225]Uvs.控制：2531.25[2337.5，2943.8]U）。所有比较均有统计学意义,P<0.05。结果表明，FGTB和LGTB对卵巢储备和反应有不利影响。非靶向代谢组学分析确定了对照与对照中的92种和80种差异代谢物FGTB和控制vs.LGTB组,分别。通路富集分析显示，与对照组相比，FGTB和LGTB组的代谢通路发生了显著变化(P<0.05)。随着半乳糖代谢的特定变化，生物素代谢，类固醇激素生物合成，以及FGTB组的烟酸和烟酰胺代谢，和咖啡因的新陈代谢，初级胆汁酸生物合成，类固醇激素生物合成，和LGTB组的甘油磷脂代谢。代谢水平的分析揭示了FGTB和LGTB影响卵巢储备功能的潜在机制，即通过代谢途径的改变。该研究强调理解与FGTB和LGTB相关的代谢改变的重要性。这对于患病妇女的临床管理和治疗方法具有相当大的相关性。
