| 陈霞慧,赵莹莹,黄金娃,陈 月,于月新.血清瘦素、鸢尾素、SHBG、AQP8与PCOS不孕症接受IVF-ET患者激素水平和妊娠结局的关系研究[J].,2022,(24):4790-4794 |
| 血清瘦素、鸢尾素、SHBG、AQP8与PCOS不孕症接受IVF-ET患者激素水平和妊娠结局的关系研究 |
| Relationship Study between Serum Leptin, Irisin, SHBG and AQP8 and Hormone Levels and Pregnancy Outcome in Patients with PCOS Infertility Undergoing in IVF-ET |
| 投稿时间：2022-05-20 修订日期：2022-06-16 |
| DOI：10.13241/j.cnki.pmb.2022.24.038 |
| 中文关键词: 多囊卵巢综合征 不孕症 体外受精-胚胎移植 瘦素 |
| 英文关键词: Polycystic ovary syndrome Infertility In vitro fertilization-embryo transfer Leptin |
| 基金项目:辽宁省科学技术基金项目（19JSZ12） |
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| 中文摘要: |
| 摘要 目的：研究血清瘦素、鸢尾素、性激素结合球蛋白（SHBG）、水通道蛋白8（AQP8）与多囊卵巢综合征（PCOS）不孕症接受体外受精-胚胎移植（IVF-ET）患者性激素水平和妊娠结局的关系。方法：选取2020年1月～2022年1月我院收治的293例接受IVF-ET的PCOS不孕症患者，根据是否临床妊娠成功将其分为临床妊娠失败组（n=118）和临床妊娠成功组（n=175）。收集患者临床资料，检测血清瘦素、鸢尾素、SHBG、AQP8水平。Pearson相关系数分析PCOS患者不孕症血清瘦素、鸢尾素、SHBG、AQP8水平与性激素水平的相关性，多因素Logistic回归分析PCOS不孕症接受IVF-ET患者妊娠结局影响因素，受试者工作特征（ROC）曲线分析血清瘦素、鸢尾素、SHBG、AQP8水平单独及联合预测PCOS不孕症接受IVF-ET患者临床妊娠失败的价值。结果：与临床妊娠成功组比较，临床妊娠失败组促卵泡生成素（FSH）、促性腺激素（Gn）用量、获卵数、受精率、优胚率、SHBG水平降低，黄体生成素（LH）、LH/FSH、睾酮（T）、胰岛素抵抗指数（HOMA-IR）、瘦素、鸢尾素、AQP8水平升高。Pearson相关系数显示，PCOS不孕症患者血清瘦素、鸢尾素、AQP8与FSH水平呈负相关，与LH、LH/FSH、T水平呈正相关（P均＜0.05）；SHBG与FSH水平呈正相关，与LH、LH/FSH、T水平呈负相关（P均＜0.05）。多因素Logistic回归分析显示，LH/FSH、T、HOMA-IR、瘦素、鸢尾素、AQP8为PCOS不孕症接受IVF-ET患者临床妊娠失败的危险因素，优胚率、SHBG为保护因素（P均＜0.05）。ROC曲线显示，血清瘦素、鸢尾素、SHBG、AQP8水平联合预测PCOS不孕症接受IVF-ET患者临床妊娠失败的曲线下面积（AUC）大于各指标单独预测。结论：血清瘦素、鸢尾素、SHBG、AQP8水平与PCOS不孕症接受IVF-ET患者FSH、LH、LH/FSH、T水平和临床妊娠失败相关，有助于预测PCOS不孕症患者妊娠结局。 |
| 英文摘要: |
| ABSTRACT Objective: To study the relationship between serum leptin, irisin, sex hormone binding globulin (SHBG) and aquaporin 8 (AQP8) and sex hormone levels and pregnancy outcome in patients with polycystic ovary syndrome (PCOS) infertility undergoing in vitro fertilization-embryo transfer (IVF-ET). Methods: A total of 293 patients with PCOS infertility undergoing IVF-ET who were admitted to our Hospital from January 2020 to January 2022 were selected, and the patients were divided into clinical pregnancy failure group (n=118) and clinical pregnancy success group (n=175) according to whether or not the pregnancy was clinically successful. Clinical data of patients were collected, and serum leptin, irisin, SHBG and AQP8 levels were measured. Pearson's correlation coefficient was used to analyze the correlation between serum leptin, irisin, SHBG and AQP8 levels and sex hormone levels in PCOS infertility, multivariate Logistic regression was used to analyze influencing factors of pregnancy outcome in PCOS infertility patients undergoing IVF-ET, and receiver operating characteristic (ROC) curves were used to analyze the value of serum leptin, irisin, SHBG and AQP8 levels alone and in combination to predict clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET. Results: Compared to the clinical pregnancy success group, the clinical pregnancy failure group had lower follicle stimulating hormone (FSH), gonadotropin (Gn) dosage, number of eggs gained, fertilization rate, excellent embryo rate and SHBG levels, and higher luteinizing hormone (LH), LH/FSH, testosterone (T), insulin resistance index (HOMA-IR), leptin, irisin and AQP8 levels. Pearson correlation coefficients showed that serum leptin, irisin and AQP8 were negatively correlated with FSH level, and positively correlated with LH, LH/FSH and T levels in patients with PCOS infertility (all P＜0.05). SHBG was positively correlated with FSH level, and negatively correlated with LH, LH/FSH and T levels (all P＜0.05). Multivariate Logistic regression analysis showed that LH/FSH, T, HOMA-IR, leptin, irisin and AQP8 were independent risk factors for clinical pregnancy failure in patients undergoing IVF-ET for PCOS infertility, and excellent embryo rate and SHBG were independent protective factors (all P＜0.05). The ROC curves showed that the area under the curve (AUC) for serum leptin, irisin, SHBG and AQP8 levels in combination to predict clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET were greater than each indicator alone. Conclusion: Serum leptin, irisin, SHBG and AQP8 levels are associated with FSH, LH, LH/FSH, T levels and clinical pregnancy failure in PCOS infertility patients undergoing IVF-ET, and it is helpful to predict the pregnancy outcome of patients with PCOS infertility. |
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