Premature Ovarian Failure Clinical Trial
Official title:
Endothelial Cell Specific Molecule-1 (Endocan) Levels in Women With Premature Ovarian Insufficiency
Objective: To evaluate serum endocan levels in women with premature ovarian insufficiency
(POI) and to compare the results with those of healthy subjects.
Methods: This prospective study included 38 women with idiopathic POI and 39 controls. The
blood for analysis was obtained at the early follicular phase of the menstrual cycle and
serum endocan levels were measured using a commercially available ELISA kit.
Follicle-stimulating hormone (FSH), estradiol, and anti-mullerian hormone (AMH) were measured
at the same time. The continuous values were evaluated using Student's t-test, and
categorical values were evaluated using the Chi-square test. P values < .05 were accepted as
significant.
Study design This was an observational prospective cohort study conducted at Obstetrics and
Gynecology Department of Cengiz Gokcek Obstetrics and Children's Hospital between July and
December 2018. Seventy-seven women were enrolled in the study in two groups. All patients
gave their oral and written informed consent before their inclusion in the study. The
protocol was approved by the Ethics Committee for Clinical Research of Gaziantep University
(Reference number: 2018/64). The study strictly adhered to the principles of the Declaration
of Helsinki.
Data collection and Study intervention:
At enrollment, for both groups, we collected data about age, height, weight, BMI, age of
menarche, obstetrics history, history of smoking, regular exercise and family history of POI.
The investigators defined that POI period is a time from diagnosis to admission. At
enrolment, all patients underwent vaginal ultrasonography for the assessment of antral
follicle count (AFC) and venous blood sample from the antecubital veins for measuring serum
concentration of Endocan, Follicle-stimulating hormone (FSH), E2, anti-mullerian hormone
(AMH) and complete blood count (CBC). In control subjects venous blood samples and AFC were
collected during the early follicular phase of the menstrual cycle (2nd to 5th days) in the
morning (between 08.00 and 09.00 h). In the POI group, measurements were repeated with 4-week
intervals. AMH was not measured in the control group. AFC were assessed through vaginal
ultrasonography by the same author (Mindray DC-7T ultrasound machine, Shenzen-Mindray
Bio-Medical Electronics Co. Ltd., China). Blood samples were separated by centrifugation for
10 minutes at 1500 g after clotting for 30 minutes at room temperature. The serum samples
were subsequently stored in aliquots at -80°C prior to the analysis of endocan. The serum
endocan level was measured using a commercially available enzyme-linked immunosorbent assay
(ELISA) kit, which is produced to detect human endocan levels with high sensitivity and
specificity (Elabscience Biotechnology Inc., Houston, TX, USA). The endocan measurements were
performed in accordance with company's protocol. The kit uses the sandwich ELISA principle. A
biotinylated detection antibody specific for human ESM1 (endocan) and avidin-horseradish
peroxidase conjugate were used in the measurement. Spectrophotometry at a wave length of 450
± 2 nm was used in the detection of optical density, which is proportional to the
concentration of human endocan level. The intra- and inter-assay variation coefficients were
6.36% and 6.09%, respectively.
Endpoints of the study:
The primary endpoint in this analysis was to compare endocan levels in POI group and control
group. The secondary endpoint was to compare endocan levels in POI group for POI period.
Tertiary endpoint was to compare the endocan levels in both groups according to the births.
The normality of distribution of continuous variables was tested using the Shapiro-Wilk test.
To compare numerical variables between 2 groups, Student's t-test (for normal data) or the
Mann-Whitney U test (for non-normal data) was performed. The Chi-square test was used to
assess the relationship between categorical variables, and Spearman's rank correlation
coefficients were used to assess the relationship between non-normal numeric data. Frequency,
percentage (%) and mean ± standard deviations (mean ± SD) are given as descriptive
statistics. Statistical analysis was performed using the SPSS for Windows version 24.0
software package, and p valued < 0.05 were accepted as statistically significant.
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