Correlation Between Estrogen Levels And Peripheral Blood CD4+ T Lymphocyte Subsets Th17/Treg In Patients Of POI

Objective:By studying the changes of Th17/Treg ratio of peripheral blood CD4+ T cell subsets in patients with early-onset ovarian insufficiency(POI)and the correlation between estrogen levels and CD4+ T lymphocyte subsets Th17/Treg,the immunological etiology of POI patients was discussed,and theoretical targets were provided for the effective prevention and clinical diagnosis and treatment of POI.Methods:1.From January 2022 to January 2023,25 women and 25 women with health examination were selected for "early-onset ovarian insufficiency" in the outpatient clinic of Shanxi Provincial Maternal and Child Health Care Hospital,all aged 25～40 years,among which women with early-onset ovarian insufficiency were POI group and women with healthy physical examination were selected as control group.The inclusion criteria of the POI group: Menopause ≥4 months;FSH was measured twice at intervals greater than 4 weeks,and the results were greater than 25 m IU/ml;Have not been treated with estrogens or immunosuppressants within 3 months.Control group inclusion criteria:menstrual cycle and menstrual period,ultrasound detection of ovulation;There is no abnormality in the sex hormone test,and the timing of blood drawing is consistent with the state of the menstrual cycle in the body.Exclude those with family history,and infectious diseases;Those with signs of kidney or liver disease;People with immune system disorders;cancer patients who have received chemoradiotherapy within the past five years;Those with a history of gynaecological surgery;Those who have supplemented hormonal drugs in the past six months;People suffering from acute and chronic infectious diseases;Those with other gynecological endocrine diseases;Dementia,mental disorders;Those who conceal medical history,have incomplete medical history,or are unable to cooperate with examination and communication.2.The expression differences of sex hormones and CD4+ T lymphocyte subsets Th17 and Treg were compared between the two groups,and the correlation between estrogen and Th17/Treg was studied.Results:1.Compared with healthy women,the hormone levels in POI patients changed significantly,and the AMH levels in POI patients were significantly reduced,while the FSH levels were significantly higher than those in healthy women,there were statistical differences.2.Compared with the healthy women,the proportion of CD4+ T cell subsets of CD4+ T cells in the POI group increased in percentage of Th17 cells and the absolute value of Th17 cells,while the absolute value of Treg and the proportion of Treg cells decreased,but the Th17/Treg ratio increased,which was statistically different(P<0.05).There were no obvious differences between the proportion and absolute and B cell values of CD4+ T cell subsets.3.The E2 level of POI patients was negatively correlated with the proportion of CD4+T lymphocyte subsets Th17 and Th17/Treg,and there were statistical differences.(r=-0.374,P=0.042;r=-0.517,P=0.001).Treg were positively correlated with serum E2 levels(r=0.401,P<0.05).There was a positive correlation between serum AMH level and estrogen level,and TSH level was negatively correlated with E2 level,with statistical differences.(r=﹣0.406,P<0.05)。4.The correlation between age and serum AMH level was statistically different(r=-0.369,P=0.045).The percentages of CD4+ T lymphocyte subsets Th17 and Treg cells were positively correlated with age,and there was a statistical difference(r=0.571,P<0.05,r=0.389,P=0.032).There was no correlation between age and Th17/Treg ratio(r=0.234,P=0.214).Serum TSH levels were not correlated with age(r=0.257,P=0.170).5.The TSH level of POI patients was positively correlated with the level of CD4+ T cell subsets Th17 and Treg and Th17/Treg,and the difference was statistically significant(r=0.425,P<0.05;r=0.571,P<0.05;r=0.582,P<0.05),and the correlation between serum AMH level and TSH level was statistically different.(r=﹣0.370,P<0.05)。6.The serum AMH level of POI patients was correlated with peripheral blood T cell subsets Th17 and Th17/Treg(r=-0.421,P<0.05;r=-0.486,P<0.05).AMH and Treg cell percentages were positively correlated(r=0.396,P<0.05).Conclusion:1.Compared with healthy women,the expression levels of E2,P,T and AMH were decreased in POI patients.2.Compared with healthy women,the percentage of Th17 cells increased,the percentage of Treg decreased,and the Th17/Treg ratio increased.3.POI estrogen level was negatively correlated with the absolute value of Th17 cells and Th17/Treg,and positively correlated with the absolute value of Treg cells,indicating that the decrease in estrogen level was related to Th17/Treg balance imbalance.4.Compared with healthy women,serum TSH levels in POI patients were correlated with Th17 cell percentage,Treg cell percentage and Th17/Treg percentage,indicating that the immune system and thyroid function interacted with each other and participated in the occurrence of POI.