ЦИТОКІНОВИЙ СПЕКТР ЯК ПРОГНОСТИЧНИЙ МАРКЕР РЕЗУЛЬТАТИВНОСТІ НЕГОРМОНАЛЬНОЇ ТЕРАПІЇ ТИРЕОЇДНОЇ ПАТОЛОГІЇ ПРИ АНОМАЛЬНИХ МАТКОВИХ КРОВОТЕЧАХ У ДІВЧАТ-ПІДЛІТКІВ

Menstrual dysfunction secondary to thyroid disorders substantially impairs overall health, physical development, and quality of life in adolescent girls.The aim of the study. To evaluate non-hormonal therapy outcomes by analyzing immunological markers, specifically the pro-inflammatory cytokines IL-1β and TNF-α, in adolescent girls with abnormal uterine bleeding associated with thyroid pathology.Materials and methods. Ninety-five adolescent girls were enrolled in the study. Of these, 70 patients with abnormal uterine bleeding received treatment at the Department of Gynecology, the Chernivtsi Regional Perinatal Center. The patients were stratified into three groups: Group I — 30 adolescent girls with abnormal uterine bleeding and concomitant thyroid pathology; Group II — 40 adolescent girls with abnormal uterine bleeding without thyroid pathology; Group III — 25 apparently healthy adolescent girls (control). Pro-inflammatory interleukins were quantified via a solid-phase sandwich enzyme-linked immunosorbent assay (ELISA) using antibodies specific to IL-1β and TNF-α, utilizing standard commercial ELISA kits manufactured by DRG International, Inc. (USA). The study was approved by the Bioethics Committee of Bukovinian State Medical University (Protocol № 2, February 9, 2015) and conducted in accordance with established principles of bioethics. Statistical analysis was performed using Microsoft Excel and Statistica 11 software. Estimate precision was assessed via 95% confidence intervals (95% CI), with statistical significance defined as p < 0.05. The study was conducted under the research program of the Department of Obstetrics and Gynecology of the BSMU, " Preserving and Restoring the Reproductive Health of Women and Adolescent Girls with Obstetric and Gynecological Pathology" (state registration No. 0121U110020, 2021–2025).Results of the study. In adolescent girls with abnormal uterine bleeding and concomitant thyroid pathology, standard inpatient therapy induced a trend toward cytokine profile modulation, characterized by divergent changes in IL-1β and TNF-α — a 21.21% decrease and an 18.46% increase, respectively — highlighting the need for individualized treatment approaches.The modified therapeutic regimen elicited a more pronounced immunoregulatory response, characterized by cytokine profile modulation and normalization of IL-1β and TNF-α levels toward reference values, reflecting a 1.34-fold increase in IL-1β and a 2.31-fold increase in TNF-α. The developed therapeutic program optimized immune mediator activity, enhanced nonspecific immune resistance, stabilized neuroendocrine regulation, and reduced bleeding recurrence.Conclusions. Serial measurement of pro-inflammatory cytokines IL-1β and TNF-α may serve as an adjunctive diagnostic and prognostic marker for abnormal uterine bleeding associated with thyroid dysfunction. In adolescents with combined pathology, cytokine profile modulation manifested as divergent changes of IL-1β and TNF-α levels following standard treatment regimen for abnormal uterine bleeding, indicating an unstable immunoregulatory effect lacking a dominant anti-inflammatory response. The proposed therapeutic regimen proved superior to standard approaches by reducing treatment duration, restoring immune reactivity, and improving the overall physiological status of young patients, as evidenced by a 53.49% reduction in IL-1β levels—a decrease twofold greater than that observed with the standard treatment regimen.