RU2695264C1 - Method for prediction of accelerated aging of women, based on clinical data on the state of reproductive function - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to gynecology, and can be used in prediction of accelerated body aging. That is ensured by determining a body weight index – BWI (kg/m). Chest circumference (cm) and pelvis intercrest (cm) diameter are measured. Length of the menstrual cycle is also recorded. Each of the considered features is assigned a certain number of points as follows: at BWI 25 kg/mand more than 6 points, with a chest girth of 85.5 cm and more – 4 points, with pelvic diameter of 27.5 cm and more – 0.5 points, with menstruation duration of 34 days and more – 1 point. Total score is calculated. If the total score is 9 and more, a high risk of accelerated aging of the female body is recorded.EFFECT: method provides the most accurate diagnosis of accelerated body aging, which enables assessing reproductive capacity and correcting well-timed pathological conditions.1 cl, 7 tbl, 2 ex

Description

The invention relates to medicine, namely to obstetrics and gynecology, relates to a method for predicting the aging rate of an organism of women, based on the assessment of somatometric and clinical data related to the reproductive system (duration of the menstrual cycle and intercostal diameter of the pelvis). The invention can be used to identify risk groups for the development and prognosis of diseases of the organs of the reproductive system during routine examinations, on outpatient visits, in hospitals, scientific research, determination of environmental, climatogeographic, ethnic factors affecting the aging rate of women in the early stages of the disease.

In the structure of gynecological diseases in women, diseases of the organs of the reproductive system are leading, one of the manifestations of which is menstrual irregularities associated with polymenorrhea and lengthening of the menstrual cycle. The frequency of these disorders among women of reproductive age is 18%. In the population of women with a menstrual cycle of 30-35 days, the number of cycles with luteal phase deficiency increases, the number of anovulatory cycles increases to 7.7% (Saidova R.A., Makatsaria A.D., 2005). Menstrual irregularities are symptoms of a number of diseases, a clinical manifestation of complex pathophysiological processes that occur in various parts of the neuroendocrine system, hyperplastic diseases of the uterus (myoma, endometriosis), and inflammatory diseases of the pelvic organs. The external manifestation of these processes is the physical development of the female body, especially changes in the component composition of the body and the amount of adipose tissue. Thus, somatometric indicators of women, taking into account clinical data, can be used to assess the rate of aging and identify risk groups for diseases of the reproductive sphere.

The proposed method allows for a comprehensive assessment of age-related changes in the reproductive system of women’s body, to identify a risk group, to conduct an in-depth pathogenetic analysis of age-related changes, and also to determine the rate of aging of the female body with various disorders.

Currently, more than 100 markers and many methods for determining age-related changes have been proposed for assessing the biological age and aging rate of a person: physiological and pathological, functional and morphological, clinical-laboratory, biochemical, neuropsychic, etc.

Assessing the aging of the human body in existing methods is carried out according to the deviation of the individual biological age (BV) of a person from his calendar age (KB), and an increased risk of early development of age-related pathology, which affects the quality and life expectancy, is determined.

Determination of BV and individual aging rate is especially relevant for assessing and predicting the risk of development, the most common chronic diseases of modern man, linked to the ontogenetic development and aging processes: arterial hypertension, coronary heart disease, obesity, type 2 diabetes mellitus, atherosclerosis, etc.

A known method for determining the rate of aging of the human cardiovascular system (RU No. 2193341, A61B 5/02, publ. 11/27/2002), which allows to determine the biological age and rate of aging of the cardiovascular system. The proper biological age of the cardiovascular system (DBV CCC) is determined by the formula DBV CCC = (KB ind-KB media) R ² + KB media, where, KB ind.- individual calendar age; KB medium-calendar age in subjects, R - multiple correlation coefficient of the biological age of the cardiovascular system, including the measurement of systolic blood pressure. Then conduct a regression analysis and calculate the biological age of the cardiovascular system according to the formulas for men and women. Find the difference between the biological and due biological age of the cardiovascular system. In this case, an additional study of central hemodynamics, microcirculation is carried out, the general conjunctival index, cardiac index, cardiac efficiency index are calculated, and the biological age of the cardiovascular system is calculated according to the formula for women: BV CVS women = 0.38⋅ADS + 3.07⋅KI -4.77⋅SI-1.24⋅IERs, where the digital indicators are constants of the regression equation, BV CCC - biological age of the cardiovascular system, years; ADS - systolic blood pressure, mmHg, CI - general conjunctival index, points; SI - heart index, l / m ² ; IERS - index of the efficiency of the heart, units With a difference in biological age and proper biological age below -6.3 years, the slowdown of the aging rate was determined, from -6.3 to +5.5 years - the average aging rate, and above +5.5 years - an increase in the aging rate of the cardiovascular system . The proposed method improves the accuracy and objectivity of determining the rate of aging and biological age of the cardiovascular system. The disadvantage of this method is the assessment of aging selectively for the cardiovascular system and does not allow a comprehensive assessment of the health status of women.

A known method for determining the biological age of a person by the totality of morphological and functional indicators that determine health reserves (RU No. 2612602, C1, publ. 09.03.2017), includes an analysis of indicators of the functional state of the cardiovascular, respiratory systems of the body, physical performance, additionally assess the presence and severity of harmful habits, chronic diseases, body mass index (BMI), indicators of muscle strength and psychoemotional state of a person, which are scored by the degree of deviation from the age norm. The disadvantage of this method is the complexity of its implementation and the need to use special equipment.

A known method for determining the biological age of a person, including measuring the length and body weight, waist circumference, determining the calendar age and average calendar age in a sample of subjects; skin conditions (turgor and wrinkling), hair (graying, loss, baldness), eye age (by the distance from which the subject reads the text), the number of teeth; measurement of systolic and diastolic blood pressure, heart rate, temperature under the tongue and in the elbow bends, determination of the threshold of taste sensitivity (by 12 dilutions of sodium chloride solution), attention index (Bourdon test), and the volume of exhaled air using a peak flow meter. The main disadvantages of this method during mass screening examinations is the complexity associated with the use of a large number of measured and calculated indicators (about 30), insufficient objectivity and information content, due to the assessment of a number of subjective indicators (severity of graying and hair loss, baldness, wrinkling of the skin) using rank (point) scale.

Closest to what we offer by its technical nature is a method for determining the biological age of a person and the aging rate, proposed by A.G. Gorelkin and B. B. Pinhasov (RU No. 2387374, АВВ 5/107, publ. 04/27/2010). This method allows to increase the objectivity and information content of the assessment of biological age. The determination of the biological age and aging rate of the body according to this method is carried out on the basis of somatometry: length (m) and body weight (kg), girth of the chest, waist and buttocks (cm), determine the calendar age of the subject, evaluate the aging rate. The aging rate coefficient is calculated by the formula: KSS = OT * MT / OYA * P ² * (14.7 + 0.26 * RL + 0.001 * RL ² ), where: OT - waist circumference, cm; MT - body weight, kg; OA - buttock circumference, cm; P - body length, m; RL - the difference in years between calendar and ontogenetic age, an indicator of the (physiological) norm for women. Evaluation of the data: from 0.95 to 1.05, the aging rate is normal; less than 0.95 - slowed aging rate; more than 1.05 - accelerated aging of the body. After calculating the coefficient of the aging rate, the biological age is calculated by the formula: BV = KSS * (KB-18) +18, where KSS is the coefficient of the aging rate; KB - calendar age in years. We add 0.9 to the total number of years if more than 9 months have passed since the day of birth. The age of the “ontogenetic norm” is defined for women 18 years old, by this age in the process of ontogenesis the development and establishment of the functions of all systems of the human body is completed.

The advantage of this method is the use of an available somatometric method that does not require special equipment. The disadvantage of this method is that it does not take into account the clinical data affecting the aging of the body of women.

In the patent literature we have not found ways to determine the biological age and aging rate of the body of women in conjunction with clinical indicators regarding the reproductive function of women.

A new technical task is the diagnosis of individuals with accelerated aging of the body to highlight the risk group of gynecological diseases to assess their reproductive capabilities.

To solve the problem in a method for predicting accelerated aging of a woman’s body, based on clinical data on the state of reproductive function, BMI (kg / m ² ), chest coverage (cm), pelvic diameter (cm) are determined, the duration of the menstrual cycle is recorded for each of the signs assign a certain number of points as follows: with a BMI of 25 kg / m ² or more - 6 points, with a chest coverage of 85.5 cm or more - 4 points, with a pelvis diameter of 27.5 cm or more - 0.5 points, with a menstrual cycle of 34 d nya and more - 1 point, calculate the sum of the points, and with a score of 9 or higher, a high risk of accelerated aging of the woman's body is recorded.

The proposed method is based on the results of a study of female Caucasians (n = 234), while taking into account the following somatometric indicators: length and body weight; girths of the waist, chest and buttocks; diameter of the pelvis, the duration of the menstrual cycle. To interpret the results, a ROC analysis and risk assessment associated with individual characteristics were carried out based on the calculation of the odds ratio. The method of A.G. was used as a method for verifying the presence of accelerated aging. Gorelkina and B. B. Pinhasova. In order to identify indicators that have the highest prognostic value for assessing the risk of atherosclerotic vascular changes, we performed a ROC analysis.

One of the important estimates in the ROC analysis is the area under the curve. The higher this area, the more efficiently or more accurately a patient can be assigned to a group with a disease. Of the somatometric indicators, the highest area under the curve had the following indicators: BMI, chest girth, waist, pelvic diameter and the duration of the menstrual cycle (table 1). Since the waist circumference is included in the formula for calculating the aging rate, it is therefore not advisable to evaluate this indicator as a prognostic one. Threshold values are determined for BMI, chest girth, intercostal diameter of the pelvis, the duration of the menstrual cycle to calculate the odds ratio (table 2, 3, 4, 5).

Based on the ROC analysis, the following threshold levels of indicators were selected: for BMI ≥25 kg / m ² ; chest circumference ≥85.5 cm; intercostal diameter of the pelvis≥27.5 cm; menstrual cycle duration ≥34 days.

Using these thresholds, the odds ratios for Caucasian women were calculated (Table 6). It is known that the odds ratio characterizes the association between the achievement of a certain level of an indicator and the development of an event. It was found that for Caucasian women, a BMI of ≥25 kg / m ² is largely associated with the risk of accelerated aging of the body, the odds ratio criterion was 64.3; a chest circumference of ≥85.5 cm is also associated with a high risk of accelerated aging of the body, the odds ratio criterion was 37.1. The duration of the menstrual cycle≥30 days or more is associated with the risk of accelerated aging of the body, the odds ratio was 2.7; intercostal diameter of the pelvis≥27.5 cm, is also associated with the risk of accelerated aging of the body, the odds ratio is 3.9.

Based on the values of the odds ratios characterizing the risk for each clinical sign, a scoring score was proposed for each of the considered signs: with a BMI of 25 kg / m ² or more - 6 points, with a chest coverage of 85.5 cm or more - 4 points, with a pelvic diameter of 27.5 cm or more - 0.5 points, with a menstrual cycle of 34 days or more - 1 point.

Next, it was necessary to determine the level of the total score, which allows you to effectively separate patients with high and low risk of atherosclerotic changes. For this, a ROC analysis was used (Tables 7, 8), on the basis of which it was established that the most optimal level for the total score is 2.5 points.

Each patient was measured for chest coverage, intercostal diameter of the pelvis, height and weight, body mass index was calculated, and the duration of the menstrual cycle was recorded. Further, each sign was assigned the following number of points: with a BMI of 25 kg / m ² or more - 6 points, with a chest coverage of 85.5 cm or more - 4 points, with a pelvis diameter of 27.5 cm or more - 0.5 points, with a duration of the menstrual cycle of 34 days or more - 1 point, and with a total score of 9 or higher, a high risk of accelerated aging of the woman's body is recorded.

A new technical result is to increase the accuracy and information content of the method when applied to women by taking into account the clinical data regarding reproductive function, expanding the scope, namely the possibility of using the method to highlight risk groups.

What is new is that, based on the somatometric method of assessing a woman’s physical health using the simple available methods of intravital examination of the body (determining BMI, girth of the chest, and intercostal diameter of the pelvis), taking into account the clinical data on the woman’s reproductive function (menstrual cycle duration), it is possible to predict accelerated aging of the body . Studying the relationship of somatometric indicators with biological age, the rate of aging, and the risk of developing diseases of the female reproductive system will allow us to form a risk group for the development of somatic diseases that affect the reproductive system in order to correct them in a timely manner.

These distinguishing features are not known in the medical and patent literature. Thus, the proposed method meets the criterion of "novelty."

The combination of distinctive features does not follow explicitly for a specialist from the prior art. Thus, the proposed method meets the criterion of "inventive step".

The method has passed clinical trials in the laboratory of Khakass State University. N.F. Katanova. Thus, this technical solution meets the criteria of the invention "industrially applicable".

The method is as follows:

1) Measure the height of a woman in meters with an accuracy of 0.01 m and weight in kg with an accuracy of 0.5 kg. BMI body mass index (kg / m ² ) is calculated.

2) Measure the coverage of the chest in centimeters with an accuracy of 0.5 cm.

3) Measure the intercostal diameter of the pelvis in centimeters with an accuracy of 0.5 cm

4) Register by interrogation and analysis of medical documentation the duration of the menstrual cycle in days

5) Assign each of the indicators the corresponding number of points as follows: with a BMI of 25 kg / m ² or more - 6 points, with a chest coverage of 85.5 cm or more - 4 points, with a pelvis diameter of 27.5 cm or more - 0 , 5 points, with a menstrual cycle of 34 days or more - 1 point.

6) Calculate the amount of points and with a total score of 9 or higher, a high risk of accelerated aging of the woman's body is recorded.

The proposed method for determining the biological age and aging rate of an organism of women is illustrated by examples of specific performance.

Example 1

The patient is 24.6 years old. Body length - 172.0 cm; body weight - 67.0 kg; BMI - 22.6 kg / m ² ; chest circumference - 84 cm; waist circumference - 77 cm; buttocks girth - 99 cm; the diameter of the shoulders is 38 cm; pelvis diameter - 28 cm, menarche from 13 years old; cycle time 28 days. According to the proposed method, indicators are assigned the corresponding number of points: BMI - 22.6 kg / m ² - 0 points, chest circumference - 84 cm - 0 points, pelvis diameter - 28 cm - 0.5 points, menstrual cycle duration - 28 days - 0 points. Thus, the total score was 0.5 points. According to the proposed method, the risk of root aging for this patient is regarded as low.

When calculating the coefficient of the aging rate (KSS) according to the method of A.G. Gorelkina and B. B. Pinkhasova KSS = 77 * 67/99 * 77 ² * (14.7 + 0.26 * 0.7 + 0.001 * 0.7 ² ) = 0.9; KSS - 0.9, corresponds to the norm. Conclusion: the aging rate is normal. Thus, in this case, the results of the proposed method are comparable with the results obtained previously known methods

Example 2

Patient aged 22.8 years. Body length - 165.0 cm; body weight - 78.0 kg; BMI - 28.6 kg / m ² ; chest circumference - 92 cm; waist circumference - 84 cm; hip circumference - 108 cm; the diameter of the shoulders is 36 cm; pelvis diameter - 28 cm; menarche from the age of 12; cycle time 45 days. According to the proposed method, indicators are assigned the appropriate number of points: BMI - 28.6 kg / m ² - 6 points, chest circumference - 92 cm - 4 points, pelvis diameter - 28 cm - 0.5 points, menstrual cycle duration - 45 days - 1 points. Thus, the total score was 11.5 points. According to the proposed method, the risk of root aging for this patient is regarded as high. When calculating the coefficient of the aging rate (KSS) according to the method of A.G. Gorelkina and B. B. Pinkhasova KSS = 1.1, corresponds to accelerated aging. Thus, in this case, the results of the proposed method are comparable with the results obtained previously known methods

Thus, the use of the somatometric method for assessing a woman’s physical health using the simple available methods of intravital examination of the body (determination of BMI, chest circumference, intercostal diameter of the pelvis), taking into account the clinical data on the woman’s reproductive function (menstrual cycle duration), allows predicting accelerated aging of the body. Studying the relationship of somatometric indicators with biological age, the rate of aging, and the risk of developing diseases of the female reproductive system will allow us to form a risk group for the development of somatic diseases that affect the reproductive system in order to correct them in a timely manner.

These distinguishing features are not known in the medical and patent literature. Thus, the proposed method meets the criterion of "novelty."

Sources of information taken into account when compiling the description:

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2. Grigoriev, S.G. The role and place of logistic regression and ROC analysis in solving medical diagnostic problems / S.G. Grigoriev, Yu.V. Lobzin, N.V. Skripchenko // Journal of Infectology. - 2016. - T. 8, No. 4. - S. 36-45.

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Claims (1)

A method for predicting accelerated aging of a woman’s body, based on clinical data on the state of reproductive function, which consists in determining BMI (kg / m ² ), measuring chest circumference (cm), intercostal diameter of the pelvis (cm), recording the duration of the menstrual cycle, then to each taking into account signs, assign a certain number of points as follows: with a BMI of 25 kg / m ² or more - 6 points, with a chest circumference of 85.5 cm or more - 4 points, with a pelvis diameter of 27.5 cm or more - 0.5 points with menstrual duration of a cycle of 34 days or more - 1 point, calculate the sum of the points, and with a total of 9 or more, a high risk of accelerated aging of the woman's body is recorded.