[1]张小琼,谢　涛,汪文雁,等.肥胖型多囊卵巢综合征孕妇血清β细胞营养因子和性激素水平与不良妊娠结局的关系[J].新乡医学院学报,2021,38(9):851-856.[doi:10.7683/xxyxyxb.2021.09.011]
　ZHANG Xiaoqiong,XIE Tao,WANG Wenyan,et al.Relationship between the serum betatrophin and sex hormones levels and adverse pregnancy outcomes in pregnant women with obese polycystic ovary syndrome[J].Journal of Xinxiang Medical University,2021,38(9):851-856.[doi:10.7683/xxyxyxb.2021.09.011]
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肥胖型多囊卵巢综合征孕妇血清β细胞营养因子和性激素水平与不良妊娠结局的关系
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年9
页码:
851-856
栏目:
临床研究
出版日期:
2021-09-05

文章信息/Info

Title:
Relationship between the serum betatrophin and sex hormones levels and adverse pregnancy outcomes in pregnant women with obese polycystic ovary syndrome
作者:
张小琼; 谢　涛; 汪文雁; 肖　丽; 郑剑兰
（陆军第七十三集团军医院/厦门大学附属成功医院产科，福建　厦门　361000）
Author(s):
ZHANG Xiaoqiong; XIE Tao; WANG Wenyan; XIAO Li; ZHENG Jianlan
(Department of Obstetrics,the 73rd Army Hospital,Chenggong Hospital Affiliated to Xiamen University,Xiamen 361000,Fujian Province,China)
关键词:
肥胖; 多囊卵巢综合征; β细胞营养因子; 性激素; 妊娠结局
Keywords:
obesitypolycystic ovary syndromebetatrophinsex hormonepregnancy outcome
分类号:
R711.75
DOI:
10.7683/xxyxyxb.2021.09.011
文献标志码:
A
摘要:
目的　探讨肥胖型多囊卵巢综合征（PCOS）孕妇血清β细胞营养因子、性激素水平与不良妊娠结局的关系。方法　选择2015年1月至2018年6月厦门大学附属成功医院收治的200例PCOS孕妇为研究对象，根据体质量指数（BMI）将患者分为肥胖组（BMI≥25 kg·m-2，n=100）和非肥胖组（BMI＜25 kg·m-2，n=100），另选择同期100例健康孕妇作为对照组，对3组孕妇血清性激素结合球蛋白（SHBG）、黄体生成素（LH）、卵泡刺激素（FSH）、雌二醇（E2）、催乳素（PRL）、总睾酮（T）、β细胞营养因子、血糖水平及胰岛素抵抗指数（HOMA-IR）、胰岛β细胞分泌指数（HOMA-β）进行比较；观察3组孕妇不良妊娠结局发生情况，并对PCOS孕妇发生不良妊娠结局的危险因素进行分析。结果　3组孕妇血清SHBG、LH、E2、T水平比较差异有统计学意义（P＜0.05），3组孕妇血清FSH、PRL水平比较差异无统计学意义（P＞0.05）。肥胖组和非肥胖组孕妇血清SHBG、E2水平显著低于对照组，血清LH、T水平显著高于对照组（P＜0.05）；肥胖组孕妇血清SHBG、E2水平显著低于非肥胖组，血清LH、T水平显著高于非肥胖组（P＜0.05）。3组孕妇口服葡萄糖耐量试验（OGTT）30、60 min时血糖水平比较差异有统计学意义（P＜0.05），3组孕妇OGTT 0、120 min时血糖水平比较差异无统计学意义（P＞0.05）。肥胖组和非肥胖组孕妇OGTT 30、60 min时血糖水平显著高于对照组，肥胖组孕妇OGTT 30、60 min时血糖水平显著高于非肥胖组（P＜0.05）。3组孕妇血清β细胞营养因子水平及HOMA-IR、HOMA-β比较差异有统计学意义（P＜0.05）；肥胖组和非肥胖组孕妇血清β细胞营养因子水平及HOMA-IR、HOMA-β显著高于对照组，肥胖组孕妇血清β细胞营养因子水平及HOMA-IR、HOMA-β显著高于非肥胖组（P＜0.05）。肥胖组、非肥胖组和对照组孕妇不良妊娠结局发生率分别为38.00%（38/100）、24.00%（24/100）、11.00%（11/100）；肥胖组和非肥胖组孕妇不良妊娠结局发生率显著高于对照组（P＜0.05），肥胖组孕妇不良妊娠结局发生率显著高于非肥胖组（P＜0.05）。Logistic回归分析结果显示，SHBG、E2是PCOS孕妇不良妊娠结局的保护因素（P＜0.05），LH、T、血糖、β细胞营养因子、HOMA-IR是PCOS孕妇不良妊娠结局的危险因素（P＜0.05），而HOMA-β与PCOS孕妇不良妊娠结局无关（P＞0.05）。结论　肥胖型PCOS孕妇性激素水平异常，糖代谢与胰岛β细胞功能受损，不良妊娠结局发生率较高；SHBG、E2是PCOS孕妇不良妊娠结局的保护因素，LH、T、血糖、β细胞营养因子、HOMA-IR 是PCOS孕妇不良妊娠结局的危险因素。
Abstract:
Objective　To investigate the relationship between the serum betatrophin and sex hormones levels and adverse pregnancy outcomes in pregnant women with obese polycystic ovary syndrome (PCOS).Methods　A total of 200 pregnant women with PCOS admitted in the Chenggong Hospital Affiliated to Xiamen University from January 2015 to June 2018 were selected as the subjects.According to the body mass index (BMI),the patients were divided into obesity group (BMI≥25 kg·m-2，n=100) and non-obesity group (BMI＜25 kg·m-2，n=100).Meanwhile,100 healthy pregnant women in the same period were selected as the control group.The serum sex hormone binding globulin (SHBG),luteinizing hormone (LH),follicle stimulating hormone (FSH),estradiol (E2),prolactin (PRL),total testosterone (T),betatrophin,blood sugar levels and homeostasis model assessment-insulin resistance (HOMA-IR),homeostasis model assessment-β(HOMA-β) were compared among the three groups.The adverse pregnancy outcomes of the pregnant women in the three groups were observed,and the risk factors of adverse pregnancy outcomes in pregnant women with PCOS were analyzed.Results　There were significant differences in serum SHBG,LH,E2 and T levels among the three groups (P<0.05).There was no significant difference in serum FSH and PRL levels among the three groups (P>0.05).The levels of serum SHBG and E2 in the obesity group and non-obesity group were significantly lower than those in the control group,and the levels of serum LH and T were significantly higher than those in the control group (P<0.05).The levels of serum SHBG and E2 in the obesity group were significantly lower than those in the non-obesity group,and the levels of serum LH and T were significantly higher than those in the non-obesity group (P<0.05).There was significant difference in blood glucose level at oral glucose tolerance test (OGTT) 30 and 60 minutes among the three groups (P<0.05).There was no significant difference in blood glucose level at OGTT 0 and 120 minutes among the three groups (P>0.05).The blood glucose levels at OGTT 30 and 60 minutes in the obesity group and non-obesity group were significantly higher than those in the control group,and the blood glucose levels at OGTT 30 and 60 minutes in the obesity group were significantly higher than those in the non-obesity group (P<0.05).There were significant differences in the levels of serum betatrophin,HOMA-IR and HOMA-β among the three groups (P<0.05).The levels of serum betatrophin,HOMA-IR and HOMA-β in the obesity group and non-obesity group were significantly higher than those in the control group,and the levels of serum betatrophin,HOMA-IR and HOMA-β in the obesity group were significantly higher than those in the non-obesity group (P<0.05).The incidence of adverse pregnancy outcomes in the obesity group,non-obesity group and control group was 38.00% (38/100),24.00% (24/100) and 11.00% (11/100),respectively.The incidence of adverse pregnancy outcomes in the obesity group and non-obesity group was significantly higher than that in the control group (P<0.05),and the incidence of adverse pregnancy outcomes in the obesity group was significantly higher than that in the non-obesity group (P<0.05).Logistic regression analysis showed that the SHBG and E2 were protective factors for adverse pregnancy outcomes in pregnant women with PCOS (P<0.05),and the LH,T,blood glucose,betatrophin and HOMA-IR were risk factors for adverse pregnancy outcomes in pregnant women with PCOS (P<0.05),but the HOMA-β was not associated with adverse pregnancy outcome in pregnant women with PCOS (P>0.05).Conclusion　The obese pregnant women with PCOS have abnormal sex hormone levels,impaired glycometabolism and islet β cell function,and the high incidence of adverse pregnancy outcomes.The SHBG and E2 are the protective factors for adverse pregnancy outcome of pregnant women with PCOS,and the LH,T,blood glucose,betatrophin and HOMA-IR are the risk factors for adverse pregnancy outcome in pregnant women with PCOS.

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更新日期/Last Update: 2021-09-05