Ovarian Reserve and Matrix Metalloproteinases

June 29, 2022 updated by: Esin Merve Erol Koç, Ankara City Hospital Bilkent

Serum Prolidase Activity in Primary Ovarian Insufficiency

Primary Ovarian Insufficiency (POI) is dysfunction of ovaries before 40 years of age. It has been reported that genetic factors, endocrine disorders, previous pelvic surgeries, chemotherapy and radiotherapy, and autoimmune mechanisms play a role in 10%, however the etiology has not been clarified in 90% of the cases. Oxidative stress and autoimmunity has been shown to be responsible in the etiopathogenesis of POI. Prolidase is an imidodipeptidase. Prolidase was shown to be related with oxidative stress and autoimmune diseases in previous studies. In addition, it is thought that the level of prolidase plays a role both in the etiopathogenesis and progression of diseases. This study aims to investigate the level of prolidase enzyme in women with POI.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Primary Ovarian Insufficiency (POI) is dysfunction of ovaries before 40 years of age. It has been reported that genetic factors, endocrine disorders, previous pelvic surgeries, chemotherapy and radiotherapy, and autoimmune mechanisms play a role in 10%, however the etiology has not been clarified in 90% of the cases that are diagnosed as idiopathic POI. Recent studies concentrated on the role of immune mechanisms in idiopathic POI. Prolidase is a matrix metalloproteinase that plays a role in various metabolic processes and is responsible for the destruction of dipeptides containing proline and hydroxyproline. The prolidase has been shown to be related with oxidative stress and autoimmune diseases in previous studies. Prolidase was shown to be a diagnostic and prognostic value in a number of diseases. Proline and hydroxyproline are metabolites produced through the prolidase activity. Proline itself is also considered as a kind of metabolic stress indicator. On the other hand, free proline in the medium is known to inhibit the prolidase enzyme activity. Therefore, simultaneous measurement of proline and hydroxyproline levels in the medium enables to more accurately calculate the prolidase activity. This study aim to analyze the prolidase level in POI patients compared to healthy menstruating women. Besides the prolidase activity, we also aim to measure proline and hydroxyproline levels in order to provide the calibration for accurate results in terms of prolidase activity.

Study Type

Observational

Enrollment (Actual)

133

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey
      • Ankara, Turkey, 06100
        • Ankara City Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 40 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

Study population includes a total of 133 participants. The study group consists of 68 women with the diagnosis of idiopathic POI, and the control group consists of 65 normally menstruating women.

Description

Inclusion Criteria:

  • Clinical diagnosis of POI for study group
  • Regularly menstruating women for control group
  • Normally developed secondary sexual characteristics

Exclusion Criteria:

  • Cardiovascular diseases including hypertension
  • Type 1 or type 2 diabetes mellitus
  • Morbid obesity
  • Primary adrenal insufficiency
  • Uterine fibroids
  • Thyroid dysfunctions including Hashimoto thyroiditis and Grave's disease
  • Hepatic dysfunctions
  • Renal insufficiency
  • Genetic disorders in chromosome constitution or karyotype analysis including monosomy X, trisomy X and gene mutations as BMP15, FMR I, POFIB, and GDF9
  • Neurologic diseases
  • Psychiatric disorders
  • Autoimmune diseases or syndromes including Addison's disease, autoimmune syndromes, scleroderma, Sjogren's syndrome, myasthenia gravis, inflammatory bowel diseases, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus and familial Mediterranean fever
  • History of any malignancy
  • History of exposure to chemotherapeutic agents or radiotherapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Case-Control
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
POI group (Study group)
  • The study group included 68 women with POI.
  • The POI cases had been diagnosed as idiopathic POI.
  • The POI diagnosis was based on the presence of amenorrhea before the age of 40, increased serum FSH level higher than 40 mIU/ml, and decreased estradiol levels lesser than 50 pg/mL.
Diagnostic test: Prolidase Level
Measurement of venous blood serum level of prolidase enzyme level by ELISA method.
Diagnostic test: Follicle Stimulating Hormone Level
Measurement of venous blood serum level of follicle stimulating hormone level.
Diagnostic test: Estradiol Level
Measurement of venous blood serum level of estradiol hormone level.
Diagnostic test: Proline Level
Measurement of venous blood serum level of proline level.
Diagnostic test: Hydroxyproline Level
Measurement of venous blood serum level of hydroxyproline level.
Diagnostic test: Anti-mullerian Hormone Level
Measurement of venous blood serum level of anti-mullerian hormone level.
Diagnostic test: Antral Follicle Count
Ultrasonographic evaluation of antral follicle count to determine ovarian reserve.
Diagnostic test: Prolactine Level
Measurement of venous blood serum prolactine hormone level.
Diagnostic test: Thyroid Stimulating Hormone Level
Measurement of venous blood serum thyroid stimulating hormone level.
Normally menstruating women (Control group)
  • Control group consisted of 65 healthy, regularly menstruating women.
  • The women were at the age of lesser than 40 years old.
  • The women were recruited consecutively from those that applied to outpatient clinics to get counselling for family planning.
Diagnostic test: Prolidase Level
Measurement of venous blood serum level of prolidase enzyme level by ELISA method.
Diagnostic test: Follicle Stimulating Hormone Level
Measurement of venous blood serum level of follicle stimulating hormone level.
Diagnostic test: Estradiol Level
Measurement of venous blood serum level of estradiol hormone level.
Diagnostic test: Proline Level
Measurement of venous blood serum level of proline level.
Diagnostic test: Hydroxyproline Level
Measurement of venous blood serum level of hydroxyproline level.
Diagnostic test: Anti-mullerian Hormone Level
Measurement of venous blood serum level of anti-mullerian hormone level.
Diagnostic test: Antral Follicle Count
Ultrasonographic evaluation of antral follicle count to determine ovarian reserve.
Diagnostic test: Prolactine Level
Measurement of venous blood serum prolactine hormone level.
Diagnostic test: Thyroid Stimulating Hormone Level
Measurement of venous blood serum thyroid stimulating hormone level.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Serum prolidase level
Time Frame: 10 minutes
Units per liter
10 minutes

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Serum proline level
Time Frame: 10 minutes
Micromole per liter
10 minutes
Serum hydroxyproline level
Time Frame: 10 minutes
Micromole per liter
10 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankara City Hospital Bilkent

Investigators

  • Principal Investigator: Esin Merve Erol Koç, MD, Ankara City Hospital Bilkent

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

August 10, 2021

Primary Completion (Actual)

February 12, 2022

Study Completion (Actual)

March 7, 2022

Study Registration Dates

First Submitted

June 24, 2022

First Submitted That Met QC Criteria

June 29, 2022

First Posted (Actual)

July 5, 2022

Study Record Updates

Last Update Posted (Actual)

July 5, 2022

Last Update Submitted That Met QC Criteria

June 29, 2022

Last Verified

June 1, 2022

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E1-20-1189

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

IPD Plan Description

IPD are available which may be shared in necessary conditions.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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