| 吴惠梅,曾 彬,黄千贻,李柳铭,李慕军.血清SF、AMH、APN、NF-κB与肥胖型多囊卵巢综合征不孕患者胰岛素抵抗和IVF-ET助孕妊娠结局的关系研究[J].,2022,(16):3153-3157 |
| 血清SF、AMH、APN、NF-κB与肥胖型多囊卵巢综合征不孕患者胰岛素抵抗和IVF-ET助孕妊娠结局的关系研究 |
| Association Study of Serum SF, AMH, APN, NF-κB with Insulin Resistance and Pregnancy Outcome in IVF-ET Assisted Conception in Obese Polycystic Ovary Syndrome Infertile Patients |
| 投稿时间：2022-01-28 修订日期：2022-02-24 |
| DOI：10.13241/j.cnki.pmb.2022.16.031 |
| 中文关键词: 肥胖 多囊卵巢综合征 不孕 SF AMH APN NF-κB 胰岛素抵抗 IVF-ET |
| 英文关键词: Obesity Polycystic ovary syndrome Infertility SF AMH APN NF-κB Insulin resistance IVF-ET |
| 基金项目:广西重点研发计划项目（桂科AB20238002） |
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| 中文摘要: |
| 摘要 目的：探讨血清铁蛋白（SF）、抗苗勒管激素（AMH）、脂联素（APN）、核因子-κB（NF-κB）与肥胖型多囊卵巢综合征（PCOS）不孕患者胰岛素抵抗（IR）和体外受精-胚胎移植（IVF-ET）助孕妊娠结局的关系。方法：选取2019年1月～2021年1月广西医科大学第一附属医院收治的120例PCOS不孕症患者，根据体重指数（BMI）分为肥胖组（BMI≥28 kg/m2，79例）和非肥胖组（BMI＜28 kg/m2，41例），肥胖组患者根据IVF-ET妊娠结局分为妊娠失败组47例和妊娠成功组32例。酶联免疫吸附法检测血清AMH、APN、NF-κB、SF水平，计算稳态模型胰岛素抵抗指数（HOMA-IR），采用Pearson相关系数分析肥胖型PCOS不孕症患者血清AMH、APN、NF-κB、SF水平与HOMA-IR的相关性，采用多因素Logistic回归分析IVF-ET助孕妊娠结局的影响因素。结果：肥胖组血清AMH、NF-κB、SF水平和HOMA-IR高于非肥胖组，APN水平低于非肥胖组（P＜0.05）。Pearson相关性分析显示，肥胖型PCOS不孕症患者的HOMA-IR与血清AMH、NF-κB、SF水平呈正相关（r=0.663、0.734、0.687，均P＜0.05），与APN水平呈负相关（r=-0.683，P＜0.05）。妊娠失败组黄体生成素（LH）、LH/促卵泡生成素（FSH）比值、HOMA-IR、血清AMH、NF-κB、SF水平均高于妊娠成功组，受精率、优胚率、FSH、APN水平均低于妊娠成功组（P＜0.05）。多因素Logistic回归分析显示，LH、LH/FSH、HOMA-IR、SF、AMH、NF-κB水平升高是肥胖型PCOS不孕症患者IVF-ET妊娠失败的危险因素，APN水平升高是IVF-ET妊娠失败的保护因素（P＜0.05）。结论：肥胖型PCOS不孕症患者血清AMH、NF-κB、SF水平升高，APN水平降低，且与IR和IVF-ET助孕妊娠结局有关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the relationship between serum ferritin (SF), anti-Müllerian hormone (AMH), adiponectin (APN) and nuclear factor-κB (NF-κB) with insulin resistance and pregnancy outcome in vitro fertilization-embryo transfer (IVF-ET) assisted conception in obese polycystic ovary syndrome infertility (PCOS) patients. Methods: 120 cases of PCOS infertility patients who were treated in the First Affiliated Hospital of Guangxi Medical University from January 2019 to January 2021 were divided into obesity group (BMI ≥28 kg/m2, 79 cases) and non obesity group (BMI < 28 kg/m2, 41 cases) according to body mass index (BMI). Patients in obesity group were divided into pregnancy failure group (47 cases) and pregnancy success group (32 cases) according to IVF-ET pregnancy outcome. The levels of serum AMH, APN, NF-κB and SF were detected by enzyme-linked immunosorbent assay. Homeostasis model insulin resistance index (HOMA-IR) was calculated.Pearson correlation coefficient was used to analyze the correlation between the levels of serum AMH, APN, NF-κB, SF and HOMA-IR in obese PCOS infertility patients, and multivariate Logistic regression was used to analyze the influencing factors of IVF-ET assisted pregnancy outcome. Results: The levels of serum AMH, NF-κB, SF and HOMA-IR in obese group were higher than those in non obese group, while the level of APN was lower than that in non obese group (P<0.05). Pearson correlation analysis showed that HOMA-IR was positively correlated with serum AMH, NF-κB and SF levels (r= 0.663, 0.734, 0.687, all P<0.05), and negatively correlated with APN level (r=-0.683, P<0.05). The levels of luteinizing hormone (LH), LH / follicle stimulating hormone (FSH) ratio, HOMA-IR, SF, AMH and NF-κB in pregnancy failure group were higher than those in the successful pregnancy group, and the fertilization rate, excellent embryo rate, FSH and APN were lower than those in the successful pregnancy group (P<0.05). Multivariate logistic regression analysis showed that LH, LH / FSH, HOMA-IR, SF, AMH, NF-κB levels increase of were the risk factor of IVF-ET pregnancy failure in obese PCOS infertility patients, and the increase of APN level was the protective factor of IVF-ET pregnancy failure(P<0.05). Conclusion: Serum levels of AMH, NF-κB, SF are increased and APN is decreased in obese PCOS infertile patients, which are associated with IR and IVF-ET assisted pregnancy outcomes. |
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