血清维生素D在不同类型不孕女性中的表达及与卵巢功能和代谢指标的关系  

Expression of serum vitamin D in women with different types of infertility and its relationship with ovarian function and metabolic indicators

作　　者：周妮[1] 麻妙艳 陈庆[1] 卢晓宁[1] 席稳燕 邬晋芳[1] ZHOU Ni;MA Miaoyan;CHEN Qing;LU Xiaoning;XI Wenyan;WU Jinfang(Department of Obstetrics and Gynecology,the Second Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710004,China;Department of Ultrasound,the Second Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院妇产科,陕西西安710004 [2]西安交通大学第二附属医院超声科,陕西西安710004

出　　处：《中国妇幼健康研究》2025年第2期109-116,共8页Chinese Journal of Woman and Child Health Research

基　　金：陕西省自然科学基础研究计划(JQ8068)。

摘　　要：目的探究不同类型不孕女性血清维生素D(Vit D)的表达及与卵巢功能和代谢指标的相关性。方法选取2021年12月至2023年10月就诊于西安交通大学第二附属医院生殖医学中心的206名不孕症女性。根据不孕原因将其分为多囊卵巢综合征(PCOS)组(n=77)、卵巢储备功能减退(DOR)组(n=82)、对照组(n=47)。比较三组不孕女性血清Vit D水平,分析各组血清Vit D水平与卵巢功能及代谢指标(脂代谢、甲状腺代谢、空腹血糖、同型半胱氨酸)的相关性。结果DOR组、PCOS组及对照组的血清Vit D水平比较,差异有统计学意义(F=3.235,P<0.05),其中DOR组及PCOS组均低于对照组,但只有PCOS组与对照组比较,差异有统计学意义(t=-2.518,P<0.05)。在调整了年龄和体质量指数(BMI)与未调整年龄和BMI后,对三组不孕女性的血清Vit D水平与各项卵巢功能进行相关性分析,结果显示:DOR组、PCOS组及对照组的血清Vit D水平与抗苗勒管激素(AMH)、窦卵泡数(AFC)、基础卵泡刺激素(bFSH)及雌二醇(E_(2))均无相关性(P>0.05);对三组不孕女性的血清Vit D水平与各项代谢指标进行相关性分析,结果显示:DOR组、PCOS组及对照组的血清Vit D水平与总胆固醇(TC)均呈负相关(调整了年龄和BMI前后,r值分别为-0.454、-0.455、-0.442、-0.432、-0.446、-0.475,P<0.05),血清Vit D水平与高密度脂蛋白(HDL)均呈正相关(调整了年龄和BMI前后,r值分别为0.376、0.379、0.476、0.477、0.360、0.329,P<0.05),血清Vit D水平与抗甲状腺过氧化物酶抗体(TPO-Ab)均呈负相关(调整了年龄和BMI前后,r值分别为-0.466、-0.479、-0.527、-0.534、-0.494、-0.502,P<0.05),而三组的血清Vit D水平与甘油三酯(TG)、低密度脂蛋白(LDL)、空腹血糖、促甲状腺素(TSH)、游离T3(FT3)、游离T4(FT4)、抗甲状腺球蛋白抗体(Anti-TGAb)及同型半胱氨酸(HCY)均无相关性(P>0.05)。结论合并卵巢病变的不孕女性更易出现血清Vit D水平的降低,血清Vit DObjective To explore the expression of serum vitamin D(Vit D)with different types of infertility and its correlation with ovarian function and metabolic indicators.Methods A total of 206 women with infertility who visited the Reproductive Medicine Center of the Second Affiliated Hospital of Xi'an Jiaotong University from December 2021 to October 2023 were included.Based on the causes of infertility,they were divided into three groups:polycystic ovary syndrome(PCOS)group(n=77),the diminished ovarian reserve(DOR)group(n=82)and control group(n=47).Serum Vit D levels were compared among the three groups,and the correlations between serum Vit D levels and ovarian function as well as metabolic indicators(lipid metabolism,thyroid metabolism,fasting blood glucose,and homocysteine)were analyzed for each group.Results The serum Vit D levels among DOR group,PCOS group and control group showed significant differences(F=3.235,P<0.05).Both the DOR and PCOS groups had lower serum Vit D levels than the control group,but only the difference between the PCOS group and the control group was statistically significant(t=-2.518,P<0.05).Correlation analysis between serum Vit D levels and ovarian function was performed in the three groups,both before and after adjusting for age and BMI.The results indicated that serum Vit D levels in the DOR,PCOS,and control groups were not significantly correlated with anti-Müllerian hormone(AMH),antral follicle count(AFC),basal follicle-stimulating hormone(bFSH),or estradiol(E_(2))(P>0.05).Correlation analysis between serum Vit D levels and metabolic indicators showed:Serum Vit D levels were negatively correlated with total cholesterol(TC)in all three groups(before and after adjusting for age and BMI,r=-0.454,-0.455,-0.442,-0.432,-0.446 and-0.475,respectively,P<0.05).Serum Vit D levels were positively correlated with high-density lipoprotein(HDL)in all three groups(before and after adjusting for age and BMI,r=0.376,0.379,0.476,0.477,0.360 and 0.329,respectively,P<0.05).Serum Vit D levels were negativ

关 键 词：不孕症 维生素D 卵巢功能 代谢指标 

分 类 号：R173[医药卫生—妇幼卫生保健]