Abstract
Objective:To investigate the relationship of serum glucose and lipid metabolism,sex hormones,anti-Müllerian hormone(AMH),homocysteine(HCY),and clinical pregnancy in overweight/obese infertile patients with polycystic ovary syndrome(PCOS).Methods:A retrospective analysis was conducted on 105 overweight/obese infertile patients with PCOS(study group)and 50 overweight/obese individuals without PCOS(control group)admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from Aug.2021 to Feb.2024.The two groups were compared in terms of glucose and lipid metabolism,serum sex hormones,AMH,and HCY levels.The study group was further divided into clinical pregnancy subgroup(n=55)and clinical non-pregnancy subgroup(n=50)based on follow-up outcomes.The correlation of various indicators,and their predictive value for pregnancy outcomes were analyzed.Results:The fasting plasma glucose(FPG),insulin resistance index(HOMA-IR),apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),total cholesterol(TC),and triglyceride(TG)levels in the study group[(5.14±0.52)mmol/L,4.22±0.45,(2.06±0.27)g/L,(1.95±0.32)g/L,(6.11±0.65)mmol/L and(2.65±0.28)mmol/L]were significantly higher than those in the control group[(4.68±0.51)mmol/L,1.18±0.19,(1.84±0.21)g/L,(1.47±0.18)g/L,(4.82±0.53)mmol/L and(2.07±0.26)mmol/L;t=5.180,45.803,5.074,9.878,11.846,12.331,P＜0.001].High-density lipoprotein cholesterol(HDL-C)level in the study group[(0.89±0.10)mmol/L]was significantly lower than that in the control group[(1.03±0.15)mmol/L;t=6.885,P＜0.001].Serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH,testosterone(T),AMH and HCY levels in the study group[(6.24±0.65)mIU/mL,(9.85±1.02)mIU/mL,1.60±0.17,(0.78±0.10)ng/mL,(13.18±1.42)ng/mL and(11.84±1.26)μmol/L]were significantly higher than those in the control group[(4.89±0.52)mIU/mL,(7.63±0.79)mIU/mL,1.54±0.16,(0.55±0.13)ng/mL,(6.73±0.75)ng/mL and(6.57±0.68)μmol/L;t=12.851,13.566,2.093,12.114,30.144,27.686,P＜0.05].In the study group,serum AMH was positively correlated with LH/FSH and T(r=0.657,0.746,P＜0.05),and HCY was positively correlated with FSH and T(r=0.715,0.567,P＜0.05).The level of serum LH,LH/FSH,AMH and HCY in the clinical pregnancy subgroup[(9.55±0.97)mIU/mL,1.52±0.16,(12.88±1.41)ng/mL and(10.91±1.15)μmol/L]were significantly lower than those in the clinical non-pregnancy subgroup[(10.18±1.14)mIU/mL,1.63±0.17,(13.52±1.36)ng/mL and(12.86±1.34)μmol/L;t=3.568,3.921,2.362,9.348,P＜0.05].Elevated levels of LH/FSH,AMH and HCY are risk factors for clinical non-pregnancy in infertile patients with overweight and obese PCOS(OR=1.756,1.817,1.647,P＜0.05).The area under the ROC curve of the combined prediction of LH/FSH,AMH and HCY for clinical non-pregnancy in overweight/obese PCOS patients was 0.854,which was higher than the individual prediction results of each index(0.776,0.812,0.803).Conclusions:Overweight/obese infertile patients with PCOS have more severe disturbances in glucose and lipid metabolism as well as in sex hormone indicators.In addition,AMH and HCY levels are elevated in these patients.Both indicators are closely related to clinical pregnancy and worthy of detection.关键词
肥胖/多囊卵巢综合征/不孕症/糖脂代谢/性激素/抗米勒管激素/同型半胱氨酸/妊娠Key words
Obesity/Polycystic ovary syndrome/Infertility/Glucose and lipid metabolism/Sex hormone/Anti-Müllerian hormone/Homocysteine/Pregnancy分类
医药卫生
