血清Hcy、FGF-21、CTRP9水平对胰岛素抵抗型PCOS伴先兆流产妊娠结局的影响  

Effect of serum Hcy,FGF-21 and CTRP9 levels on pregnancy outcome of insulin resistant PCOS with threatened abortion

作　　者：赵振杰[1] 李德欣[1] 张伟[1] ZHAO Zhen-jie;LI De-xin;ZHANG Wei(Department of Laboratory,the First Hospital of Fangshan District,Beijing 102400,China)

机构地区：[1]北京市房山区第一医院检验科,北京102400

出　　处：《临床和实验医学杂志》2022年第13期1397-1400,共4页Journal of Clinical and Experimental Medicine

基　　金：北京市科学技术委员会项目(编号:Z190600162218)。

摘　　要：目的探讨血清同型半胱氨酸(Hcy)、成纤维细胞生长因子21(FGF-21)、补体C1q肿瘤坏死因子相关蛋白9(CTRP9)水平对胰岛素抵抗型多囊卵巢综合征(PCOS)伴先兆流产妊娠结局的影响。方法回顾性选取2020年1月至2022年1月在北京市房山区第一医院治疗的胰岛素抵抗型PCOS伴先兆流产产妇92例(A组),非胰岛素抵抗型PCOS伴先兆流产产妇81例(B组),同时选取不伴PCOS的先兆流产产妇80例作为对照(C组)。比较各组血清Hcy、FGF-21、CTRP9、血糖、血脂等水平;分析A组患者血清Hcy、FGF-21、CTRP9与空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)的相关性;观察各类型患者的妊娠结局,比较A组流产和非流产产妇血清Hcy、FGF-21、CTRP9水平;分析血清Hcy、FGF-21、CTRP9预测流产的价值。结果A组血清Hcy、FGF-21、空腹血糖、空腹胰岛素、HOMA-IR、总胆固醇、甘油三酯、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)明显高于B组和C组,而CTRP9明显低于B组和C组,差异均有统计学意义(P<0.05)。B组血清Hcy、FGF-21、空腹血糖、空腹胰岛素、HOMA-IR、总胆固醇、甘油三酯、LDL-C和HDL-C明显高于C组,而CTRP9明显低于C组,差异均有统计学意义(P<0.05)。A组产妇血清Hcy、FGF-21与HOMA-IR呈正相关(P<0.05),而CTRP9与HOMA-IR呈负相关(P<0.05)。A组和B组流产率分别为20.65%和13.58%,明显高于C组,差异均有统计学意义(P<0.05);A组和B组流产率比较差异无统计学意义(P>0.05)。A组流产产妇血清Hcy、FGF-21分别为(15.52±1.73)μmol/L和(97.15±14.43)pg/mL,明显高于非流产产妇[(14.18±1.90)μmol/L、(88.06±13.22)pg/mL],而CTRP9为(221.03±64.43)ng/mL,明显低于非流产产妇[(266.61±61.03)ng/mL],差异均有统计学意义(P<0.05)。血清Hcy、FGF-21、CTRP9预测胰岛素抵抗型PCOS伴先兆流产产妇流产的ROC曲线下面积分别为0.761、0.815和0.740。结论胰岛素抵抗型PCOS伴先兆流产产妇血清Hcy、FGF-21水平�Objective To investigate the effects of serum homocysteine(Hcy),fibroblast growth factor 21(FGF-21)and complement C1q tumor necrosis factor associated protein 9(CTRP9)on the pregnancy outcome of insulin resistant polycystic ovary syndrome(PCOS)with threatened abortion.Methods A total of 92 pregnant women with insulin resistant PCOS with threatened abortion treated in the First Hospital of Fangshan District from January 2020 to January 2022 were retrospectively selected(group A),81 pregnant women with non insulin resistance PCOS and threatened abortion(group B),and 80 pregnant women without PCOS were selected as the control(group C).The levels of serum Hcy,FGF-21,CTRP9,blood glucose,and blood lipids in each group were compared;the correlation between serum Hcy,FGF-21,CTRP9 and fasting blood glucose,fasting insulin,and insulin resistance index(HOMA-IR)in group A patients was analyzed;pregnancy outcomes of patients in each group were observed;the levels of serum Hcy,FGF-21,CTRP9 were compared between abortion and non-abortion women in group A;the value of serum Hcy,FGF-21,CTRP9 in predicting abortion was analyzed.Results Serum Hcy,FGF-21,fasting blood glucose,fasting insulin,HOMA-IR,total cholesterol,triglycerides,low density lipoprotein cholesterol(LDL-C)and high density lipoprotein cholesterol(HDL-C)in group A were significantly higher than those in group B and group C,while CTRP9 was significantly lower than that in group B and group C,the differences were statistically significant(P<0.05).Serum Hcy,FGF-21,fasting blood glucose,fasting insulin,HOMA-IR,total cholesterol,triglycerides,LDL-C and HDL-C in group B were significantly higher than those in group C,while CTRP9 was significantly lower than that in group C,the differences were statistically significant(P<0.05).Serum Hcy,FGF-21 were positively correlated with HOMA-IR in parturients of group A(P<0.05),CTRP9 was negatively correlated with HOMA-IR(P<0.05).The abortion rates in group A and group B were 20.65%and 13.58%respectively,which were significantly higher

关 键 词：多囊卵巢综合征 先兆流产 同型半胱氨酸 成纤维细胞生长因子21 补体C1Q 肿瘤坏死因子相关蛋白9 胰岛素抵抗 妊娠结局 

分 类 号：R711.75[医药卫生—妇产科学] R714.21[医药卫生—临床医学] R446.1