PCOS合并不孕患者血清Sp17Ab、Gremlin-1水平与胰岛素抵抗及IVF-ET助孕结局关系  

Correlation between the serum sperm protein-17 antibody and Gremlin-1 levels of infertility women with polycystic ovary syndrome and their insulin resistance and outcomes after in vitro fertilization-embryo transfer

作　　者：颜光翰 陈丹晓 程贤鹦 GAN Kwanghann;CHEN Danxiao;CHENG Xianying(Shulan(Hangzhou)Hospital,Shulan International Medical College,Zhejiang Shuren University,Hangzhou,Zhejiang Province,310022)

机构地区：[1]浙江树人大学树兰国际医学院附属树兰(杭州)医院,310022

出　　处：《中国计划生育学杂志》2025年第4期879-883,890,共6页Chinese Journal of Family Planning

基　　金：浙江省杭州市卫生科技计划项目(B20220020)。

摘　　要：目的:探究多囊卵巢综合征(PCOS)合并不孕患者血清抗精子蛋白17抗体(Sp17Ab)、骨形态发生蛋白拮抗因子(Gremlin-1)水平与胰岛素抵抗及体外受精-胚胎移植(IVF-ET)助孕结局的关系。方法:收集2021年6月-2022年6月浙江大学妇院收治的PCOS合并不孕患者108例为病例组,根据患者IVF-ET助孕是否成功分为失败组(65例)和成功组(43例),同期年龄匹配的月经正常体检健康女性108例为对照组。比较各组血清Sp17Ab、Gremlin-1水平;采用Pearson法分析血清Sp17Ab、Gremlin-1水平与胰岛素抵抗相关性;多因素logistic回归分析PCOS合并不孕患者IVF-ET助孕失败的影响因素;ROC曲线分析血清Sp17Ab、Gremlin-1水平对PCOS合并不孕患者IVF-ET助孕失败的预测价值。结果:病例组血清Sp17Ab(5.55±1.59μg/L)、Gremlin-1水平(2.05±0.58 ng/ml)以及HOMA-IR(2.34±0.66)均高于对照组(4.06±1.23μg/L、1.37±0.36 ng/ml、1.63±0.51),LH水平高于对照组、FSH水平低于对照组;且病例组中失败患者血清Sp17Ab、Gremlin-1水平以及HOMA-IR均高于成功患者(均P<0.05)。FSH降低、Sp17Ab升高、Gremlin-1升高、HOMA-IR升高为PCOS合并不孕患者IVF-ET助孕失败的影响因素(P<0.05),血清Sp17Ab、Gremlin-1水平预测PCOS合并不孕患者IVF-ET助孕失败的曲线下面积(AUC)分别为0.840、0.762,二者联合预测的AUC为0.925,高于单一指标预测(P<0.05),联合预测的敏感度90.7%,特异性81.5%。结论:PCOS合并不孕患者血清Sp17Ab、Gremlin-1水平明显上调,且均与胰岛素抵抗、IVF-ET助孕结局有关,二者联合对PCOS合并不孕患者IVF-ET助孕失败有较好的预测价值。Objective:To investigate the correlation between the serum sperm protein-17 antibody(Sp17Ab)and Gremlin-1 levels of infertility women with polycystic ovary syndrome(PCOS)and their insulin resistance and outcomes after in vitro fertilization-embryo transfer(IVF-ET).Methods:From June 2021 to June 2022,108 infertility women with PCOS who had admitted to the hospital for IVF-ET were included in study group,and these women were divided into group A(65 cases with failed pregnancy)and group B(43 cases with successful pregnancy)based on whether the women with successful pregnancy after IVF-ET or not.Another 108 healthy women with normal menstruation and matched the age who had come to the hospital for physical examination were included in control group during the same period.The levels of the serum Sp17Ab and Gremlin-1 of the women were compared among these groups.Pearson method was used to analyze the correlation between the serum Sp17Ab,Gremlin-1 levels of the infertility women with PCOS and their insulin resistance.Multivariate logistic regression was used to analyze the factors influencing the failure of pregnancy of the infertility women with PCOS after IVF-ET.Receiver operator characteristic(ROC)curve was used to analyze the predictive value of the serum Sp17Ab and Gremlin-1levels of the infertility women with PCOS after IVF-ET for their failure of pregnancy.Results:The levels of the serum Sp17Ab(5.55±1.59μg/L)and Gremlin-1(2.05±0.58ng/ml),and the homeostasis model assessment of insulin resistance(HOMA-IR)value(2.34±0.66)of the women in the study group were significantly higher than those(4.06±1.23μg/L,1.37±0.36ng/ml and 1.63±0.51)of the women in the control group.The level of LH of the women in the study group was significantly higher than that of the women in the control group,and the level of FSH of the women in the study group was significantly lower than that of the women in the control group.In the study group,the serum levels of Sp17Ab and Gremlin-1,and the HOMA-IR value of the women with pregnancy f

关 键 词：多囊卵巢综合征 不孕 抗精子蛋白17抗体 骨形态发生蛋白拮抗因子 胰岛素抵抗 体外受精-胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]