| 秦 屹,吕改琴,任 淼,李 萍,由思佳.血清NRG-1、NRG-4与多囊卵巢综合征患者慢性低度炎症状态、胰岛素抵抗的相关性分析及对妊娠结局的影响[J].,2024,(7):1248-1251 |
| 血清NRG-1、NRG-4与多囊卵巢综合征患者慢性低度炎症状态、胰岛素抵抗的相关性分析及对妊娠结局的影响 |
| Correlation Analysis between Serum NRG-1, NRG-4 and Chronic Low-Grade Inflammation Status and Insulin Resistance in Patients with Polycystic Ovary Syndrome and Their Influence for Pregnancy Outcomes |
| 投稿时间：2023-11-24 修订日期：2023-12-20 |
| DOI：10.13241/j.cnki.pmb.2024.07.009 |
| 中文关键词: 多囊卵巢综合征 NRG-1 NRG-4 炎症状态 胰岛素抵抗 妊娠结局 |
| 英文关键词: Polycystic ovary syndrome NRG-1 NRG-4 Inflammation status Insulin resistance Pregnancy outcome |
| 基金项目:首都卫生发展科研专项项目（首发2020-2Z-6043） |
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| 中文摘要: |
| 摘要 目的：分析血清神经调节蛋白-1（NRG-1）、神经调节蛋白-4（NRG-4）与多囊卵巢综合征（PCOS）患者慢性低度炎症状态、胰岛素抵抗的相关性，并探讨对妊娠结局的影响。方法：选取2018年1月~2021年10月在中国康复研究中心北京博爱医院收治的PCOS患者161例（PCOS组），另以年龄为对照选取同期来院体检的健康女性100例（对照组）。检测受试者血清NRG-1、NRG-4、白细胞计数（WBC）、C反应蛋白（CRP）水平及胰岛素抵抗指数（HOMA-IR），分析NRG-1、NRG-4与WBC、CRP及HOMA-IR的相关性。追踪PCOS患者的妊娠结局，分为妊娠结局不良组与妊娠结局良好组。采用单因素和多因素Logistic回归分析妊娠结局不良的影响因素。采用受试者工作特征（ROC）曲线分析NRG-1、NRG-4、CRP及HOMA-IR对妊娠结局不良的预测价值。结果：与对照组比较，PCOS组的NRG-1、NRG-4、CRP、WBC及HOMA-IR水平升高（P＜0.05）；Pearson相关性分析显示，NRG-1、NRG-4与CRP、WBC及HOMA-IR均呈正相关（P＜0.05）；单因素分析结果显示，妊娠结局不良组的血清NRG-1、NRG-4、CRP、WBC及HOMA-IR均高于妊娠结局良好组（P＜0.05）；多因素Logistic回归分析显示NRG-1>10.55 pg/mL、NRG-4>27.20 pg/mL、CRP>7.51 mg/L及HOMA-IR>3.35为PCOS患者妊娠结局不良的危险因素（P＜0.05）。NRG-1、NRG-4、CRP、HOMA-IR单独及联合应用时的ROC-AUC（0.95CI）分别为0.706(0.429～0.980)、0.709(0.405～0.988)、0.749(0.535～0.938)、0.747(0.496～0.988)、0.850(0.739～0.959)，联合预测大于单一指标。结论：血清NRG-1、NRG-4的在PCOS患者呈高水平，与慢性低度炎症状态、胰岛素抵抗指标呈正相关，且为影响妊娠结局不良的危险因素。联合NRG-1、NRG-4、CRP、HOMA-IR对PCOS患者妊娠结局不良的预测价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the correlation between serum neuregulin-1 (NRG-1), neuregulin-4 (NRG-4) and chronic low-grade inflammation status and insulin resistance in patients with polycystic ovary syndrome (PCOS), and to explore the influence for pregnancy outcomes. Methods: 161 patients with PCOS (PCOS group) who were admitted to Beijing Boai Hospital of China Rehabilitation Research Center from January 2018 to October 2021 were selected, another 100 healthy women with age as control (control group) who were came to the hospital for physical examination during the same period were selected. The serum NRG-1, NRG-4, white blood cell count (WBC), C-reactive protein (CRP) levels and homeostasis model assessment-insulin resistance index (HOMA-IR) in the subjects were detected, and the correlation between NRG-1, NRG-4, WBC, CRP, and HOMA-IR was analyzed. The pregnancy outcomes in patients with PCOS were tracked, they were divided into poor pregnancy outcomes group and good pregnancy outcomes group. Univariate and multivariate logistic regression were used to analyze the influencing factors of adverse pregnancy outcomes. The predictive value of NRG-1, NRG-4, CRP, and HOMA-IR in adverse pregnancy outcomes used receiver operating characteristic (ROC) curve analysis. Results: Compared with control group, the NRG-1, NRG-4, CRP, WBC and HOMA-IR levels increased in PCOS group(P<0.05). Pearson correlation analysis showed that NRG-1 and NRG-4 were positively correlated with CRP, WBC, and HOMA-IR(P<0.05). The results of single factor analysis showed that the serum NRG-1, NRG-4, CRP, WBC, and HOMA-IR levels in poor pregnancy outcomes group were higher than those in good pregnancy outcomes group(P<0.05). Multivariate logistic regression analysis showed that NRG-1>10.55 pg/mL, NRG-4>27.20 pg/m, CRP>7.51 mg/L and HOMA-IR>3.35 were all risk factors for poor pregnancy outcomes in PCOS patients (P<0.05). The ROC-AUC (0.95CI) of NRG-1, NRG-4, CRP, and HOMA-IR when used alone or in combination were 0.706 (0.429~0.980), 0.709 (0.405~0.988), 0.749 (0.535~0.938), 0.747 (0.496~0.988), and 0.850 (0.739~0.959), respectively, Joint prediction was greater than a single indicator. Conclusion: The serum NRG-1 and NRG-4 levels are high in patients with PCOS, which are positively correlated with chronic low-grade inflammatory status and insulin resistance indicators, and they are risk factors for affects poor pregnancy outcomes.The combination of NRG-1, NRG-4, CRP, and HOMA-IR has a high predictive value for poor pregnancy outcomes in PCOS patients. |
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