Comparative characteristics of the antinuclear antibody index in girls with various forms of delayed sexual development

Relevance. A healthy generation is a foundation for a healthy family reserve; accordingly, the comprehensive development of girls who have reached puberty is a key criterion for preparing them for future family life. According to WHO (2005), reproductive health is a global priority and is among the Republic of Uzbekistan’s public-health priorities: children and adolescents constitute almost 40% of the population. State attention to this problem is reflected in national monitoring: a 2009 study found that 16.5% of adolescent girls aged 13–18 years in Uzbekistan exhibited clinical signs of delayed sexual development. For this reason, special attention is paid to the period of female puberty and adolescence. Maintaining health at this age contributes to the reproductive, intellectual, economic, and social reserves of society.

Current evidence indicates that the thyroid gland, together with the hypothalamic–pituitary complex, plays an important role in regulating the reproductive system. The thyroid is a key organ that helps maintain the body’s physical and chemical homeostasis. Thyroid function influences critical aspects of sex-hormone activity, including metabolism, brain function, bone growth, immune function, physical and mental development, and sexual maturation. However, the role of the thyroid in the pathogenesis of gonadotropic and sex-hormone metabolic disorders during adolescence—and its molecular contribution to sex-hormone metabolism—remains insufficiently studied.

Given the foregoing and considering environmental and geographic factors, a comprehensive study of risk factors for delayed sexual development is necessary to enable early diagnosis, identify high-risk groups, and thereby reduce morbidity during adolescence.

Objective. To assess the functional state of the sexual-development system in adolescent girls with delayed sexual development, to identify associated risk factors, and to evaluate treatment options and risk-group characteristics.

Materials and methods. A total of 896 adolescent girls aged 13–18 years were screened in Tashkent region. From this screening, 110 girls aged 13–18 years attending schools No. 2, 4, 8, and 13 in Chirchik city were selected using a special questionnaire. A control group comprised 40 healthy adolescent girls (13–18 years) with normal sexual development and regular menstrual cycles. The study was conducted at the Laboratory of Reproductive Immunology, Institute of Human Immunology and Genomics, Academy of Sciences of the Republic of Uzbekistan. Peripheral blood serum was used for immunological assays.

Results. In the comparison group—girls with delayed sexual development but without clinically significant somatic or autoimmune pathology—the ANA index was 0.98 ± 0.02 (median 0.98; interquartile range 0.92–1.03). Although these values were statistically significantly higher than those in the control group (p < 0.001), most remained within the conventional diagnostic limit (1.0–1.2). These findings may indicate a transient, functionally defined activation of the humoral immune system that does not reach the threshold for systemic autoimmune disease.

Conclusion. Measurement of the ANA index in girls with various forms of delayed sexual development revealed a high frequency of immune sensitization in subgroups with autoimmune or somatic underlying pathology. ANA thus appears to be an informative immunological marker reflecting the degree of systemic or organ-specific activation of the humoral immune system, which can affect endocrine regulation of puberty. It is important to consider these indicators in patients with hormonal dysfunction: an elevated or borderline ANA index may serve as an early predictor of the risk of premature ovarian failure syndrome and other future reproductive disorders.