Serum Concentration Of Leptin, Estradiol And Expression Of Leptin, Ob-R And ER In Eutopic And Ectopic Endometrium From Patients With Endometriosis

Objective: Endometriosis (EMs) is one of common gynecological disorders, affecting 10%-15% of women during their reproductive age. EMs is a estrogen-dependent disease, its pathogenesis is unclear yet, maybe relate to heredity, immunity, and so on. It's also doubtful whether EMs etiology is related to endocrine disbalance. In order to acquire EMs pathogenesis, serum concentration of leptin, estradiol and expression of leptin, ob-R and ER in eutopic and ectopic endometrium were investigated in women with and without EMs.Methods: All the patients were chosen from the second hospital of Hebei Medical University during November 2005 to August 2006. 30 women with dysfunctional uterine bleeding were recruited as control group, who were excluded EMs based on their symptoms, signs and the finding of B type ultrasound. 30 inpatients with EMs asking for surgery were randomly selected as study group, who were finally diagnosed by surgery and pathology. Blood was drawn from ulnar vein when patients were hungry, eutopic endometrium of all women including study and control group and ectopic endometrium of EMs patients were sampled by dilatation and curettage. Enrolled women were excluded from present study if they suffered acute infection and severe diseases including function failure of heart, liver, kidney. In the same time, they didn't use hormones preparation within 3 months. There were no significant differences between two groups of their age and body mass index (BMI) (P>0.05).1 The concentrations of serum leptin and estradiol (E2) were detected by radioimmunoassay kit. The results were analyzed using t test and Pearson correlation analysis, and data were represent by (mean±SD).2 The expression of leptin, leptin receptor (ob-R) and estrogen receptor (ER) were detected by immunohistochemistry. The results were analyzed by rank sum test.Results1 General informationThere were no significant differences between two groups of their age and BMI.2 Serum concerntration of leptin and E2There were no significant differences of concertration of leptin and E2 in serum in the two groups (P>0.05). Comparing with control group, there was no significant difference of serum concentration of E2 in the same phase(proliferative and secretory phase) (P>0.05). In each group (EMs and control group), serum concentration of E2 in proliferative phase was significant higher than that in secretory phase (P<0.05). In EMs group, there were no relationship between serum leptin level and BMI (r1=0.21, P1>0.05); but in control group, there was positive correlation between serum leptin level and BMI (r=0.468, P<0.05). There were no significant difference between serum leptin level and E2 in the two groups (r1=0.19, P1>0.05; r2=0.11, P2>0.05).3 The expression of leptin, ob-R and ER protein in endometrium of proliferative and secretory phaseIn EMs group, eutopic and ectopic endometrial tissues were respectively reserved, both of them had 30 cases, includeing 13 cases in proliferative phase and 17 cases in secretory phase. In the control group, 30 cases included 14 cases in proliferative phase and 16 cases in secretory phase.3.1 The expression of leptin protein in endometrial tissues3.1.1 In proliferative phaseIn proliferative phase, the expression of leptin protein in the eutopic and ectopic endometrial tissues from patients with EMs were significant weaker than that from control group (P1<0.05,P2<0.05). But in EMs patients itself, the differences between eutopic and ectopic endometrial tissues were not found (P>0.05).3.1.2 In secretory phaseIn secretory phase, the expression of leptin protein in the eutopic endometrial tissues from patients with EMs was significant weaker than that from control group (P<0.05), but this change was not found in the ectopic endometrial tissues (P>0.05). But in EMs patients itself, the differences between eutopic and ectopic endometrial tissues were not significant (P>0.05).3.2 The expression of ob-R protein in endometrial tissues3.2.1 In proliferative phaseIn proliferative phase, the expression of ob-R protein in the endometrial tissues from patients with and without EMs had not been found significantly differences (P>0.05).3.2.2 In secretory phaseIn secretory phase, the expression of ob-R protein in the eutopic endometrial tissues from patients with EMs was significant weaker than that from control group (P<0.05), but this change had not been found in the ectopic endometrial tissues (P>0.05). But in EMs patients itself, the differences between eutopic and ectopic endometrial tissues were not significant (P>0.05).3.3 The expression of ER protein in endometrial tissues3.3.1 In proliferative phaseIn proliferative phase, the expression of ER protein in the eutopic endometrial tissues from patients with EMs had been found more enhanced than that from control group (P<0.05), but this change had not been found in the ectopic endometrial tissues (P>0.05). The differences between eutopic and ectopic endometrial tissues from patients with EMs were not significant (P>0.05).3.3.2 In secretory phase In secretory phase, the expression of ER protein in the eutopic endometrial tissues from patients with EMs was more enhanced than that from control group (P<0.05), but this change had not been found in the ectopic endometrial tissues (P>0.05). But in EMs patients itself, the differences between eutopic and ectopic endometrial tissues were not significant (P>0.05).3.4 Comparing the expression of leptin, ob-R and ER protein in secretory phase with proliferative phaseIn the different phases of menstrual cycle, the expression of leptin, ob-R and ER protein in the endometrial tissues from patients with and without EMs had not been found significantly differences (P1>0.05, P2>0.05, P3>0.05).Conclusion1 There was not correlation between the serum concentration of leptin and BMI in EMs group, which was significant different from control group. The upset balance between leptin and BMI maybe responsible to the pathogenesis of EMs.2 The weaker expression of leptin and ob-R protein in eutopic and ectopic endometrial tissues from EMs, maybe one of the pathogenesis of EMs.3 The enhanced expression of ER protein in eutopic endometrium from EMs, which maybe led endometia sensitiveness fortifiedly to estrogen, and encouraged the occurrence and development of EMs.4 The expressions of leptin, ob-R and ER protein in the eutopic endometrial tissues from patients with EMs had been found statistical differences with control group. It evidenced that the eutopic endometrial tissues from patients with EMs were different from control group in the expression of hormone and the sensitiveness to estrogen.