早发性卵巢功能不全患者肠道微生物代谢产物的变化及其对不孕情况的影响  

Changes of intestinal microbial metabolites in patients with premature ovarian insufficiency and their effects on infertility

作　　者：何凤屏 刘彦慧 马秋林 熊符[2] 唐莉 张咏梅 HE Feng-ping;LIU Yan-hui;MA Qiu-lin(Dongguan Institute of reproduction and genetics,Dongguan maternal and Child Health Hospital Affiliated to Southern Medical University,Dongguan Guangdong 523125,China)

机构地区：[1]南方医科大学附属东莞妇幼保健院东莞市生殖与遗传研究所,广东东莞523125 [2]南方医科大学基础医学院遗传重点实验室,广东广州510515

出　　处：《临床和实验医学杂志》2022年第14期1537-1541,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省基础与应用基础研究基金区域重点项目(编号:2020B1515120009)。

摘　　要：目的探讨早发性卵巢功能不全(POI)患者肠道微生物代谢产物脂多糖、多氨和色氨酸的变化及其对不孕情况的影响。方法回顾性选取2019年3月至2021年3月南方医科大学附属东莞妇幼保健院临床诊断100例POI患者为研究组,其中轻度POI患者60例(POI轻度组),重度POI患者40例(POI重度组),另外选取同期卵巢功能正常妇女100名作为对照组。比较3组脂多糖、多氨、色氨酸、激素、血脂、炎症因子[白细胞介素(IL)-6、肿瘤坏死因子α(TNF-α)]、氧化应激[活性氧、氧化低密度脂蛋白(OX-LDL)]水平,采用Spearman分析POI患者血清中脂多糖、多氨和色氨酸分别与IL-6、TNF-α、活性氧、OX-LDL的相关性。结果POI轻度组和POI重度组的脂多糖表达水平为(1.86±0.63)、(3.78±1.32)ng/mL,显著高于对照组[(0.93±0.14)ng/mL],多氨表达水平为(33.56±5.47)、(16.69±3.92)ng/mL,显著低于对照组[(47.62±7.82)ng/mL],色氨酸表达水平为(56.27±8.85)、(22.53±4.67)ng/mL,显著低于对照组[(74.14±10.32)ng/mL],差异均有统计学意义(P<0.001)。POI轻度组和POI重度组的促卵泡激素(FSH)、总胆固醇和低密度脂蛋白(LDL)水平均高于对照组,雌二醇水平低于对照组,差异均有统计学意义(P<0.05)。POI轻度组和POI重度组血清OX-LDL、活性氧、IL-6和TNF-α水平显著高于对照组,差异均有统计学意义(P<0.05)。Spearman分析显示,POI患者脂多糖分别与IL-6和TNF-α水平呈正相关(r=0.745、0.772,P<0.05);脂多糖与活性氧、OX-LDL水平正相关(r=0.594、0.526,P<0.05);多氨水平与IL-6和TNF-α呈负相关(r=-0.682、-0.536,P<0.05);色氨酸水平与活性氧、OX-LDL水平呈负相关(r=-0.553、-0.492,P<0.05)。结论POI患者的肠道微生物代谢产物的表达水平均与对照组具有差异性。POI患者的肠道微生物代谢产物脂多糖表达水平上调,多氨和色氨酸表达水平下调,可能是影响不孕的主要因素之一。Objective To investigate the changes of intestinal microbial metabolites lipopolysaccharide(LPS),polyamine and tryptophan in patients with premature ovarian insufficiency(POI)and their effects on infertility.Methods A total of 100 patients with POI clinically diagnosed in Dongguan Maternal and Child Health Hospital Affiliated to Southern Medical University from March 2019 to March 2021 were retrospectively selected as the study group,including 60 patients with mild POI(mild POI group),40 patients with severe POI(severe POI group),and 100 women with normal ovarian function in the same period were selected as the control group.The levels of lipopolysaccharides,polyamines,tryptophan,hormones,blood lipids,inflammatory factors[interleukin(IL)-6,tumor necrosis factor alpha(TNF-α)],oxidative stress[reactive oxygen species,oxidized low-density lipids protein(OX-LDL)]in 3 groups were compared,and the correlations of serum lipopolysaccharide,polyamine,and tryptophan in POI patients with IL-6,TNF-α,reactive oxygen species,and OX-LDL,respectively,were analyzed using Spearman.Results The levels of lipopolysaccharide in the mild POI group and the severe POI group were(1.86±0.63)and(3.78±1.32)ng/mL,which were significantly higher than those in the control group[(0.93±0.14)ng/mL],the levels of polyamine were(33.56±5.47)and(16.69±3.92)ng/mL,which were significantly lower than those in the control group[(47.62±7.82)ng/mL],and the levels of tryptophan were(56.27±8.85)and(22.53±4.67)ng/mL,which were significantly lower than those in the control group[(74.14±10.32)ng/mL],and the differences were statistically significant(P<0.05).The levels of follicle-stimulating hormone(FSH),total cholesterol and low-density lipoprotein(LDL)in the mild POI group and the severe POI group were higher than those in the control group,and the level of estradiol was lower than that in the control group,and the differences were statistically significant(P<0.05).The levels of OX-LDL,reactive oxygen species,IL-6 and TNF-αin the mild POI group and

关 键 词：早发性卵巢功能不全 肠道微生物 脂多糖 多氨 色氨酸 

分 类 号：R711.75[医药卫生—妇产科学]