Ulyanovsk Medico-biological Journal

CLINICAL MEDICINE

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DOI 10.34014/2227-1848-2023-2-86-97

THE ROLE OF HOMOCYSTEINE IN THE PATHOGENESIS OF GYNECOLOGICAL DISEASES

Yu.D. Sidorova, L.Yu. Davidyan, A.Yu. Bogdasarov

Ulyanovsk State University, Ulyanovsk, Russia

 

Despite the fact that homocysteine was first described in 1932, at present, the study of changes in the synthesis and content of this amino acid reveals new mechanisms for the disease development. It should be mentioned that studies confirming the correlation between elevated homocysteine levels and human pathologies (cardiovascular diseases, pregnancy complications, neuropsychiatric disorders) have appeared only recently. This indicates that hyperhomocysteinemia has not been resolved and deserves clinicians’ and researchers’ attention.

Most publications present studies on hyperhomocysteinemia as part of the pathogenesis of cardiovascular diseases. However, more recently, elevated homocysteine level has been considered as a marker in preeclampsia and postoperative thromboembolism, including that after reproductive surgery. It was noted that in early pregnancy the activation of endothelial cells is changed in women with hyperhomocysteinemia and uterine fibroids. It increases thrombosis risks, and later, during the chorion formation, an endothelial defect can cause fetoplacental insufficiency, and in case of endotheliosis progression lead to preeclampsia and eclampsia. In recent years, some authors associate hyperhomocysteinemia with disorders of the female reproductive system and ovulatory abilities, possible pathogenesis of benign tumors, pregnancy pathologies and delivery issues.

A detailed study of elevated homocysteine in women can help in solving a number of issues, such as the role of hyperhopmocysteinemia in the pathogenesis of gynecological diseases and development of reproductive disorders.

There is much information on the role of homocysteine in the development of endothelial dysfunction and significant metabolic disorders. At the same time, there is not enough studies on the changes in folate metabolism, which cause hyperhomocysteinemia and directly affect the development of endocrine gynecological and obstetric pathologies. These problems require further analysis. The correlation between the hyperhomocysteinemia and development of gynecological pathologies is currently one of the promising scientific areas. Special attention is paid to the pathogenesis of uterine fibroids in terms of vascular theory. Despite ongoing research, there is only insufficient information on the role of excess homocysteine in the pathogenesis of uterine fibroids.

Key words: homocysteine, hyperhomocysteinemia, endothelial dysfunction, metabolism, gynecological endocrinology.

 

Conflict of interest. The authors declare no conflict of interest.

Author contributions
Research concept and design: Sidorova Yu.D., Davidyan L.Yu.
Literary search, participation in the research study, data processing: Sidorova Yu.D., Davidyan L.Yu.
Data analysis and interpretation: Sidorova Yu.D., Davidyan L.Yu.
Text writing and editing: Sidorova Yu.D., Davidyan L.Yu., Bogdasarov A.Yu.
 

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Received July 19, 2021; accepted February 3, 2023.

 

Information about the authors

Sidorova Yuliya Dmitrievna, Postgraduate Student, Chair of Postgraduate Education and Family Medicine, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-8002-9211

Davidyan Liana Yur'evna, Doctor of Sciences (Medicine), Professor, Chair of Postgraduate Education and Family Medicine, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/ 0000-0002-1049-1830

Bogdasarov Azat Yur'evich, Doctor of Sciences (Medicine), Professor, Chair of Obstetrics and Gynecology, Ulyanovsk State University. 432017, Russia, Ulyanovsk, L. Tolstoy St., 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/ 0000-0002-7026-0620

 

For citation

Sidorova Yu.D., Davidyan L.Yu., Bogdasarov A.Yu. Rol' gomotsisteina v patogeneze akushersko-ginekologicheskikh zabolevaniy [The role of homocysteine in the pathogenesis of gynecological diseases]. Ul'yanovskiy mediko-biologicheskiy zhurnal. 2023; 2: 86–97. DOI: 10.34014/2227-1848-2023-2-86-97 (in Russian).

 

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УДК 618.14-006.36-092

DOI 10.34014/2227-1848-2023-2-86-97

РОЛЬ ГОМОЦИСТЕИНА В ПАТОГЕНЕЗЕ АКУШЕРСКО-ГИНЕКОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ

Ю.Д. Сидорова, Л.Ю. Давидян, А.Ю. Богдасаров

ФГБОУ ВО «Ульяновский государственный университет», г. Ульяновск, Россия

 

Несмотря на то что гомоцистеин впервые описали еще в 1932 г., в настоящее время изучение изменений синтеза и содержания этой аминокислоты открывает новые механизмы формирования заболеваний. Отметим, что исследования, подтверждающие взаимосвязь повышенного содержания гомоцистеина с патологическими состояниями человека (сердечно-сосудистыми заболеваниями, осложнениями беременности, нервно-психическими расстройствами), появились только в последние десятилетия. Это свидетельствует о том, что проблема гипергомоцистеинемии не решена и заслуживает внимания клиницистов и исследователей.

Большинство публикаций представляет исследования гипергомоцистеинемии в рамках патогенеза сердечно-сосудистых заболеваний, однако совсем недавно повышенное содержание гомоцистеина стали рассматривать в качестве маркера преэклампсии беременных и послеоперационных тромбоэмболий, в т.ч. после операций на репродуктивных органах. Отмечено, что у женщин с гипергомоцистеинемией и миомой матки, вступающих в беременность, изменена активация эндотелиальных клеток, что обусловливает повышенный риск тромбозов, а в дальнейшем, при формировании хориона, дефект эндотелия может привести к фетоплацентарной недостаточности, а также при прогрессировании эндотелиоза к преэклампсии и эклампсии. В последние годы начали появляться публикации, связывающие гипергомоцистеинемию с проблемами женской репродуктивной системы с акцентом на овуляторные способности женщины, возможным патогенезом доброкачественных заболеваний, патологическими состояниями во время беременности, вопросами родоразрешения.

Детальное изучение проблемы повышенного содержания гомоцистеина у женщин может помочь в решении ряда вопросов, среди которых участие гипергомоцистеинемии в патогенезе гинекологических заболеваний и формировании нарушений репродуктивной функции.

Сведения о роли гомоцистеина в развитии эндотелиальной дисфункции и формировании (или сопровождении) значимых метаболических нарушений имеют множество подтверждений. Но при этом исследований о значении изменений фолатного обмена, приводящих к гипергомоцистеинемии и непосредственно влияющих на формирование эндокринной гинекологической и акушерской патологии, недостаточно, что требует дополнительного анализа. Изучение связи развития гинекологической патологии с гипергомоцистеинемией в настоящее время является одним из перспективных научных направлений. Особое место занимают вопросы патогенеза миомы матки в аспекте сосудистой теории. Несмотря на проводимые в этой области исследования, на сегодняшний день недостаточно сведений об участии избытка гомоцистеина в патогенезе миомы матки.

Ключевые слова: гомоцистеин, гипергомоцистеинемия, эндотелиальная дисфункция, метаболизм, эндокринная гинекология.

 

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Вклад авторов
Концепция и дизайн исследования: Сидорова Ю.Д., Давидян Л.Ю.
Литературный поиск, участие в исследовании, обработка материала: Сидорова Ю.Д., Давидян Л.Ю.
Анализ и интерпретация данных: Сидорова Ю.Д., Давидян Л.Ю.
Написание и редактирование текста: Сидорова Ю.Д., Давидян Л.Ю., Богдасаров А.Ю.

 

Литература

  1. Savage D.G., Lindenbaum J., Stabler S.P., Allen R.H. Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies. Am J Med. 1994; 96: 239–246.

  2. Klee G.G. Cobalamin and folate evaluation; measurement of methylmalonic acid and homocysteine vs vitamin B12 and folate. Clin Chem. 2000; 46: 1277–1283.

  3. Refsum H., Ueland P.M., Nygård O., Vollset S.E. Homocysteine and cardiovascular disease. Ann Rev Med. 1998; 49: 31–62.

  4. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002; 288: 2015–2022.

  5. Ray J.G., Laskin C.A. Folic acid and homocyst(e)ine metabolic defects and the risk of placental abruption, pre-eclampsia and spontaneous pregnancy loss: a systematic review. Placenta. 1999; 20: 519–529.

  6. Vollset S.E., Refsum H., Irgens L.M., Emblem B.M., Tverdal A., Gjessing H.K. Plasma total homocysteine, pregnancy complications, and adverse outcomes: the Hordaland Homocysteine Study. Am J Clin Nutr. 2000; 71: 962–968.

  7. Nilsson K., Gustafson L., Faldt R., Andersson A., Brattstrom L., Lindgren A. Hyperhomocysteinaemia – a common finding in a psychogeriatric population. Eur J Clin Invest. 1996; 26: 853–859.

  8. Smith A.D. Homocysteine, B vitamins, and cognitive deficit in the elderly [Editorial]. Am J Clin Nutr. 2002; 75: 785–786.

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Поступила в редакцию 19.07.2021; принята 03.02.2023.

 

Авторский коллектив

Сидорова Юлия Дмитриевна – аспирант кафедры последипломного образования и семейной медицины, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: https://orcid.org/0000-0002-8002-9211

Давидян Лиана Юрьевна – доктор медицинских наук, профессор кафедры последипломного образования и семейной медицины, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-1049-1830

Богдасаров Азат Юрьевич – доктор медицинских наук, профессор кафедры акушерства и гинекологии, ФГБОУ ВО «Ульяновский государственный университет». 432017, Россия, г. Ульяновск, ул. Л. Толстого, 42; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it., ORCID ID: http://orcid.org/0000-0002-7026-0620

 

Образец цитирования

Сидорова Ю.Д., Давидян Л.Ю., Богдасаров А.Ю. Роль гомоцистеина в патогенезе акушерско-гинекологических заболеваний. Ульяновский медико-биологический журнал. 2023; 2: 86–97. DOI: 10.34014/2227-1848-2023-2-86-97.