摘要
目的:观察多囊卵巢综合征(PCOS)不孕症患者内分泌功能与脂质代谢的相关性,及对生育结局的影响。方法:本文为回顾性研究,病例纳入120例PCOS不孕症患者,所有患者均接受辅助生育治疗,治疗方法均为体外受精-胚胎移植(IVF-ET),根据妊娠结局不同,将成功受孕的70例PCOS患者列为成功组,将受孕失败的50例PCOS患者列为失败组,比较2组患者的内分泌功能指标[促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、抗缪勒氏管激素(AMH)、促甲状腺激素(TSH)、血清游离甲状腺素(FT4)]及脂质代谢指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)],经Pearson相关性系数验证内分泌指标与脂质代谢的相关性,经绘制受试者工作特征曲线(ROC)验证各内分泌指标对IVF-ET治疗失败的预测效能。结果:成功组FSH、FT4、HDL-C[(4.28±1.06)mIU/mL、(14.69±5.23)pmol/L、(1.42±0.66)mmol/L]均高于失败组[(3.25±0.46)mIU/mL、(10.35±3.47)pmol/L、(0.88±0.24)mmol/L](P<0.05),LH、E2、AMH、TSH、TC、TG、LDL-C[(3.36±0.82)mIU/mL、(551.45±100.72)pg/mL、(6.13±1.23)ng/mL、(4.14±1.28)mIU/mL、(8.23±2.11)mmol/L、(4.15±1.17)mmol/L、(4.24±1.36)mmol/L]均低于失败组[(4.11±1.31)mIU/mL、(622.75±100.61)pg/mL、(7.02±1.85)ng/mL、(7.75±2.39)mIU/mL、(10.66±3.41)mmol/L、(5.27±2.42)mmol/L、(6.25±2.46)mmol/L](P<0.05)。经Spearman相关性系数检验,PCOS患者的FSH、FT4与TC、TG、LDL-C呈负相关,与HDL-C呈正相关;而LH、E2、AMH、TSH与TC、TG、LDL-C呈正相关,与HDL-C呈负相关。经ROC曲线验证,PCOS患者的血清性激素及甲状腺激素分泌水平与其脂质代谢紊乱密切相关,LH、E2、AMH、TSH水平升高,FSH、FT4水平降低可能为IVF-ET治疗失败的影响因素。结论:PCOS患者的FSH、FT4水平降低,LH、E2、AMH、TSH水平升高均可能导致IVF-ET治疗失败,通过检测,PCOS患者内分泌功能指标对IVF-ET治疗失败有一定的预
Objective:To observe the correlation between endocrine function and lipid metabolism in patients with polycystic ovary syndrome(PCOS)infertility,and its impact on prognosis.Methods:120 patients with PCOS infertility were included in this study,all of whom received assisted reproductive therapy using in vitro fertilization embryo transfer(IVF-ET).Based on different pregnancy outcomes,70 successful PCOS patients were classified as a success group,and 50 failed PCOS patients were classified as a failure group.The endocrine function indicators of the two groups were compared,including follicle stimulating hormone(FSH),luteinizing hormone(LH)estradiol(E2),anti mullerian hormone(AMH),thyroid stimulating hormone(TSH),serum free thyroxine(FT4),as well as lipid metabolism indicators,including total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),all of which were validated by Spearman correlation coefficients to determine the correlation between various endocrine indicators and lipid metabolism.Receiver operating characteristic curves(ROC)were plotted to verify the predictive efficacy of various endocrine indicators for IVF-ET treatment failure.Results:FSH,FT4,HDL-C[(4.28±1.06)mIU/mL,(14.69±5.23)pmol/L,(1.42±0.66)mmol/L]of the success group were higher than those of the failure group[(3.25±0.46)mIU/mL,(10.35±3.47)pmol/L,(0.88±0.24)mmol/L](P<0.05).LH,E2,AMH,TSH,TC,TG,and LDL-C[(3.36±0.82)mIU/mL,(551.45±100.72)pg/mL,(6.13±1.23)ng/mL,(4.14±1.28)mIU/mL,(8.23±2.11)mmol/L,(4.15±1.17)mmol/L,(4.24±1.36)mmol/L]were all lower than those of the failure group[(4.11±1.31)mIU/mL,(622.75±100.61)pg/mL,(7.02±1.85)ng/mL,(7.75±2.39)mIU/mL,(10.66±3.41)mmol/L,(5.27±2.42)mmol/L,(6.25±2.46)mmol/L](P<0.05).According to Spearman correlation coefficient test,FSH and FT4 in PCOS patients were negatively correlated with TC,TG,and LDL-C,and positively correlated with HDL-C,while LH,E2,AMH,TSH were positively correlated with TC,TG,and LDL-C and negatively corr
作者
梅玉粘
贾春静
MEI Yuzhan;JIA Chunjing(Department of Endocrinology,The Central Hospital of Zhumadian City,Henan 463000,China)
出处
《淮海医药》
CAS
2024年第3期240-244,共5页
Journal of Huaihai Medicine
基金
河南省医学科技攻关项目(LHGJ202101285)。
关键词
多囊卵巢综合征
不孕症
体外受精-胚胎移植
内分泌功能
脂质代谢
Polycystic ovary syndrome
Infertility
External fertilization embryo transfer
Endocrine function
Lipid metabolism
