血清NLRP3、IL-18水平与多囊卵巢综合征患者不孕的关系OACSTPCD

Objective To investigate the correlation between serum levels of NOD-like receptor protein 3(NLRP3)and interleukin-18(IL-18)and infertility in patients with polycystic ovary syndrome(PCOS).Methods From March 2020 to March 2023,a total of 294 infertile patients with PCOS were selected as the study group from Nankai University Affiliated Obstetrics and Gynecology Hospital and Tianjin First Central Hospital.Additionally,280 infertile patients due to tubal abnormalities,endometriosis,and other causes were selected as the control group.Clinical data of the two groups were compared.Serum NLRP3 and IL-18 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multivariate stepwise logistic regression analysis was used to identify factors influencing infertility in PCOS patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of serum NLRP3 and IL-18 levels for infertility in PCOS patients.Results There were no significant differences between the two groups in terms of age,duration of infertility,smoking,alcohol consumption,systolic blood pressure,diastolic blood pressure,total cholesterol,high-density lipoprotein,low-density lipoprotein,and follicle-stimulating hormone(P＞0.05).The study group had higher body mass index(BMI),triglycerides,homeostasis model assessment of insulin resistance(HOMA-IR),luteinizing hormone,and transferrin levels compared to the control group(P＜0.05).Serum levels of NLRP3 and IL-18 were significantly higher in the study group(P＜0.05).Multivariate stepwise logistic regression analysis indicated that serum NLRP3[(O)R=4.293(95％CI:1.941,9.495)],serum IL-18[(O)R=4.104(95％CI:1.770,9.515)],HOMA-IR[(O)R=3.404(95％CI:1.477,7.846)],and BMI[(O)R=3.391(95％CI:1.542,7.455)]were risk factors for infertility in PCOS patients(P＜0.05).ROC curve analysis showed that the areas under the curve(AUC)for predicting infertility in PCOS patients using serum IL-18,NLRP3,and their combination were 0.748(95％CI:0.698,0.801),0.844(95％CI:0.796,0.894),and 0.905(95％CI:0.855,0.950),respectively.The sensitivities of serum IL-18,NLRP3,and their combination for predicting infertility in PCOS patients were 66.32％(95％CI:0.572,0.746),79.39％(95％CI:0.713,0.857),and 88.53％(95％CI:0.844,0.934),respectively.The specificities were 70.68％(95％CI:0.623,0.799),73.28％(95％CI:0.656,0.827),and 86.32％(95％CI:0.830,0.908),respectively.Conclusion Elevated serum levels of NLRP3 and IL-18 are closely associated with infertility in PCOS patients and can serve as biological markers for predicting infertility in this population.