title: High serum inhibin concentration discriminates autoimmune oophoritis from other forms of primary ovarian insufficiency.
abstract: BACKGROUND
  Primary ovarian insufficiency (POI) is defined by hypergonadotropic amenorrhea occurring before the age of 40 yr. In 4-5% of women with POI, an ovarian autoimmune process can be demonstrated.
  
  
  METHODS
  We have determined the serum concentrations of total inhibin and inhibin B by sensitive ELISAs in 22 women with autoimmune POI (aPOI), 71 women with non-autoimmune idiopathic POI (iPOI), 77 postmenopausal women, and 90 healthy, fertile women (HW). Diagnosis of aPOI was made according to the presence of steroid cell autoantibodies and/or 17alpha-hydroxylase autoantibodies and/or cytochrome P450 side-chain cleavage autoantibodies. All aPOI patients were also positive for adrenal autoantibodies.
  
  
  RESULTS
  Total inhibin levels were significantly higher in women with aPOI (median, 281 pg/ml) than in women with iPOI (median, 74 pg/ml) or HW (median, 133.5 pg/ml) (P < 0.001). Levels of inhibin B were also significantly higher in women with aPOI (median, 109 pg/ml) than in women with iPOI (median, 18 pg/ml) (P < 0.001) or HW (median, 39 pg/ml) (P < 0.05). Serum concentrations of total inhibin and inhibin B were significantly higher in women with POI than in postmenopausal women (P < 0.001), irrespective of the presence/absence of autoantibodies. At receiver-operating characteristic analysis, cutoff values of 133 pg/ml for total inhibin and 60.5 pg/ml for inhibin B ensured 86.4% sensitivity and 81-84.5% specificity for aPOI vs. iPOI.
  
  
  CONCLUSIONS
  We conclude that a variable degree of ovarian function is preserved in women with POI and that aPOI is characterized by increased inhibin production resulting from a selective theca cell destruction, with initial preservation of granulosa cells.
authors.affiliation: Department of Pediatrics, Obstetrics, and Reproductive Medicine, Universityof Siena, Siena, Italy.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Tsigkou
authors.forename: Stefania
authors.initials: S
authors.lastname: Marzotti
authors.forename: Lavinia
authors.initials: L
authors.lastname: Borges
authors.forename: Annalisa
authors.initials: A
authors.lastname: Brozzetti
authors.forename: Fernando
authors.initials: F
authors.lastname: Reis
authors.forename: Paola
authors.initials: P
authors.lastname: Candeloro
authors.forename: Maria
authors.initials: M
authors.lastname: Luisa Bacosi
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
authors.forename: Alberto
authors.initials: A
authors.lastname: Falorni
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood*; D007986:Luteinizing Hormone / Q000097:blood; D008875:Middle Aged; D009869:Oophoritis / Q000097:blood*; D016649:Primary Ovarian Insufficiency / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D001323:Autoantibodies; D007265:Inhibins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone