对氧磷酶1及甲状腺自身抗体交互作用与甲功正常患者辅助生殖流产风险的相关性研究  

Correlation analysis of the interaction between paraoxonase 1 and thyroid antibodies on the risk of abortion in patients with normal thyroid function undergoing assisted reproduction

作　　者：张瑞 刘东方[2] 周厚地 杨宇萱 李颖 Zhang Rui;Liu Dongfang;Zhou Houdi;Yang Yuxuan;Li Ying(Department of Endocrinology,the University-Town Hospital of Chongqing Medical University,Chongqing 400000,China;Department of Endocrinology and Metabolism,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 404100,China;Department of Endocrinology,Chongqing Red Cross Hospital(Jiangbei District People′s Hospital),Chongqing 400020,China)

机构地区：[1]重庆医科大学附属大学城医院内分泌内科,重庆400000 [2]重庆医科大学附属第二医院内分泌代谢病科,重庆404100 [3]重庆市红十字会医院(江北区人民医院)内分泌科,重庆400020

出　　处：《国际内分泌代谢杂志》2024年第6期405-409,共5页International Journal of Endocrinology and Metabolism

基　　金：重庆市卫生健康委员会医学科研项目(2024WSJK069);重庆市教育委员会人文社会科学研究项目(22SKGH073)。

摘　　要：目的分析甲状腺功能正常的辅助生殖患者发生流产的影响因素,探讨对氧磷酶1(paraoxonase 1,PON1)及甲状腺自身抗体的交互作用与辅助生殖流产风险的相关性。方法回顾性选取165例行辅助生殖的患者,根据患者是否流产分为两组,其中流产组27例,未流产组138例,比较两组患者基线病史信息及实验室检查的差异,利用二元logistic回归分析PON1及甲状腺自身抗体与流产的交互作用。结果在调整年龄、体重指数、不孕年限、促甲状腺激素、游离三碘甲状腺原氨酸、游离甲状腺素、黄体生成素、卵泡刺激素、睾酮、雌二醇、催乳素、抗苗勒管激素、获卵数、受精胚胎数、移植胚胎数后,PON1及甲状腺抗体与流产的发生具有显著相关性(β=1.669,95%CI:1.044~2.668,P=0.032;β=3.834,95%CI:1.085~13.546,P=0.037)。PON1与甲状腺自身抗体存在明显的交互作用(P交互<0.046)。PON1与甲状腺抗体亚组分析显示,高水平PON1及甲状腺抗体阳性组是低水平PON1及甲状腺抗体阴性组流产发生风险的15.375倍。结论高水平PON1与甲状腺自身抗体对辅助生殖流产的发生存在交互作用,甲状腺自身抗体阳性及同时存在更高水平的PON1可能与辅助生殖流产的风险增加存在一定的相关性。ObjectiveTo investigate the influencing factors of abortion in patients with intact thyroid function underlying assisted reproductive technology and explore whether the interaction between paraoxonase 1(PON1)and thyroid antibodies correlated with the onset of miscarriage.MethodsA total of 165 patients preparing for assisted reproduction were retrospectively selected,according to whether the patients had miscarriages,patients were divided into two groups,with 27 cases in the miscarriage group and 138 cases in group without miscarriage.The differences in medical history and laboratory tests between the two groups were compared.The interaction between PON1 and thyroid antibodies on abortion was analyzed by binary logistic regression.ResultsAfter adjusting for age,body mass index,infertility years,thyroid stimulating hormone,free triiodothyronine,free thyroxine,luteinizing hormone,follicle stimulating hormone,testosterone,estradiol,prolactin,anti-mullerian hormone,number of retrieved eggs,number of fertilized embryos,and number of transferred embryos,both PON1 and thyroid antibodies had significant associations with miscarriage(β=1.669,95%CI:1.044-2.668,P=0.032;β=3.834,95%CI:1.085-13.546,P=0.037).A significant interaction was observed between PON1 and thyroid antibodies in relation to abortion(P interaction<0.046).The subgroup analysis of PON1 and thyroid antibodies showed that the high level PON1 and thyroid antibody positive group had a 15.375 times higher risk of miscarriage compared to the low level PON1 and thyroid antibody negative group.ConclusionHigh level PON1 and thyroid antibodies have an interaction on the occurrence of abortion in women underlying assisted reproductive technology.The presence of thyroid antibodies and elevated levels of PON1 may be related to the elevated risk of miscarriage.

关 键 词：甲状腺自身抗体 对氧磷酶1 辅助生殖 妊娠结局 流产 

分 类 号：R714.21[医药卫生—妇产科学]