摘要
目的探讨肥胖型多囊卵巢综合征(PCOS)孕妇血清25羟维生素D[25(OH)D]、性激素结合球蛋白(SHBG)水平变化及对不良妊娠的预测价值。方法选取肥胖型PCOS孕妇125例(PCOS组)和同期52例健康孕妇(对照组),根据妊娠结局将肥胖型PCOS孕妇分为不良妊娠组和良好妊娠组。采用酶联免疫吸附法检测血清25(OH)D、SHBG水平。通过多因素Logistic回归分析肥胖型PCOS孕妇不良妊娠的影响因素,受试者工作特征(ROC)曲线分析血清25(OH)D、SHBG水平对PCOS孕妇不良妊娠的预测价值。结果与对照组比较,PCOS组血清25(OH)D、SHBG水平降低(P均<0.05)。125例肥胖型PCOS孕妇妊娠结局不良48例(不良妊娠组)和妊娠良好77例(良好妊娠组),不良妊娠发生率为38.40%(48/125)。与良好妊娠组比较,不良妊娠组血清25(OH)D、SHBG水平降低(P均<0.05)。黄体生成素/促卵泡生成素升高、睾酮升高、低密度脂蛋白胆固醇升高、稳态模型评估—胰岛素抵抗升高为肥胖型PCOS孕妇不良妊娠的独立危险因素,25(OH)D升高、SHBG升高为独立保护因素(P均<0.05)。血清25(OH)D联合SHBG预测肥胖型PCOS孕妇的曲线下面积为0.882,大于血清25(OH)D、SHBG水平单独预测的0.783、0.775(P均<0.05)。结论肥胖型PCOS孕妇血清25(OH)D、SHBG水平降低,与不良妊娠密切相关;血清25(OH)D、SHBG联合检测对肥胖型PCOS孕妇不良妊娠的预测价值较高。
Objective To investigate the changes in serum 25-hydroxyvitamin D[25(OH)D]and sex hormonebinding globulin(SHBG)levels in pregnant women with obese polycystic ovary syndrome(PCOS)and their predictive val⁃ue for adverse pregnancy.Methods Totally 125 pregnant women with obese PCOS(PCOS group)and 52 healthy preg⁃nant women in the same period(control group)were selected,and the pregnant women with obese PCOS were divided into the adverse pregnancy group(48)and good pregnancy group(77)according to the pregnancy outcome.Serum 25(OH)D and SHBG levels were measured by enzyme-linked immunosorbent assay.Factors of adverse pregnancy in the obese preg⁃nant women with PCOS were analyzed by multifactorial Logistic regression,and the predictive value of serum 25(OH)D and SHBG levels for adverse pregnancy in pregnant women with PCOS was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,serum 25(OH)D and SHBG levels were reduced in the PCOS group(both P<0.05).The incidence of adverse pregnancy in 125 pregnant women with obese PCOS was 38.40%(48/125).Serum 25(OH)D and SHBG levels were lower in the adverse pregnancy group than those in the good pregnancy group(both P<0.05).Elevated luteinizing hormone/follicle-stimulating hormone,elevated testosterone,elevated lowdensity lipoprotein cholesterol,and elevated homeostasis model assessment-insulin resistance were independent risk fac⁃tors for adverse pregnancy in pregnant women with obese PCOS,and elevated 25(OH)D and elevated SHBG were independent protective factors(all P<0.05).The area under the curve of serum 25(OH)D combined with SHBG in predicting obese PCOS was 0.882,which was greater than that(0.783 and 0.775)of serum 25(OH)D and SHBG levels alone(both P<0.05).Conclusion Serum 25(OH)D and SHBG levels in pregnant women with obese PCOS decrease,which are closely associated with adverse pregnancy,and the combined detection of serum 25(OH)D and SHBG is of high value in predicting adverse pregnancy in pregnant women with obese PCOS.
作者
唐淼
蔡奚梅
龚燕
TANG Miao;CAI Ximei;GONG Yan(Obstetrics and Gynecology Department,Changshu Hospital of Traditional Chinese Medicine,Changshu 215500,China)
出处
《山东医药》
CAS
2024年第22期16-20,共5页
Shandong Medical Journal
基金
江苏省妇幼健康研究项目(F202014)。
