BMP-15、sRAGE、MMP9在PCOS患者卵泡液中表达及其与卵子质量的相关性分析

Expression of BMP-15,sRAGE and MMP9 in the Follicular Fluid of Patients with PCOS and Their Correlation with Egg Quality

【目的】探讨骨形态发生蛋白-15(BMP-15)、可溶性糖基化终产物受体(sRAGE)及基质金属蛋白酶9(MMP9)在多囊卵巢综合征(PCOS)患者卵泡液中的表达及其与卵子质量的相关性。【方法】选取2015年1月至2018年2月在本院实施体外受精-胚胎移植(IVF-ET)患者96例,其中PCOS的患者63例,根据胰岛素抵抗指数(HOMA-IR)分为胰岛素抵抗的PCOS患者35例(IR组)和非胰岛素抵抗的PCOS患者28例(非IR组),因输卵管因素或男性因素导致不孕的排卵功能正常患者33例为对照组。检测三组卵泡液中BMP-15、sRAGE、MMP9、促卵泡激素(FSH)、黄体生成素(LH)、雌激素(E2)、睾酮(T)水平,并分析各指标与卵子质量的相关性。【结果】IR组、非IR组的卵泡液中sRAGE、MMP9水平显著高于对照组(P<0.05),BMP-15显著低于对照组(P<0.05),IR组的卵泡液中sRAGE高于非IR组(P<0.05);三组患者血清FSH、E2水平比较差异无统计学意义(P>0.05),IR组、非IR组的血清LH、T水平高于对照组(P<0.05),但I R组、非I R组的血清L H水平比较差异无统计学意义(P>0.05);IR组、非IR组、对照组的卵子成熟率、受精率比较差异无统计学意义(P>0.05),IR组、非IR组的获卵数目高于对照组(P<0.05),优质胚胎率低于对照组(P<0.05)。PCOS患者卵泡液中BMP-15、sRAGE水平与受精率、优质胚胎率呈显著的正相关(P<0.05),而MMP9与受精率、优质胚胎率呈显著负相关(P<0.05)。【结论】PCOS患者BMP-15水平降低、sRAGE及MMP9水平升高,且与卵子发育质量有关。

【Objective】To investigate the expression of BMP-15,sRAGE and MMP9 in the follicular fluid of patients with PCOS and their correlation with egg quality.【Methods】A total of 96 patients undergoing in vitro fertilization-embryo transfer(IVF-ET)in our hospital from January 2015 to February 2018 were selected.Among them,63 patients with PCOS were divided into 35 cases with insulin-resistant PCOS(IR group)and 28 cases with non-insulin resistant PCOS(non-IR group)according to the insulin resistance index(HOMA-IR).In addition,33 infertility(normal ovulation)cases caused by fallopian tube or male factors were used as the control group.The levels of BMP-15,sRAGE,MMP9,FSH,LH,E2 and T(testosterone)were detected from the follicular fluid of the three groups.The correlation between those index and egg quality was analyzed.【Results】The levels of sRAGE and MMP9 in the follicular fluid of the IR and non-IR groups were significantly higher than those in the control group(P<0.05),while the level of BMP-15 was significantly lower than the control group(P<0.05).The level of sRAGE in the follicular fluid of the IR group was higher than that of the non-IR group(P<0.05).There was no significant difference in serum FSH and E2 levels among the three groups(P>0.05).The levels of serum LH and T in the IR and non-IR groups were higher than those in the control group(P<0.05).However,there was no significant difference in serum LH level between the IR and non-IR groups(P>0.05).The egg maturation rate and fertilization rate did not show any significant difference between the IR group,the non-IR group and the control group(P>0.05).The number of eggs obtained in the IR group and non-IR group was higher than that of control group(P<0.05),while the rate in the IR group and non-IR group was lower than that in the the control group(P<0.05).The levels of BMP-15 and sRAGE in the follicular fluid of patients with PCOS were positively related to the fertilization rate and high-quality embryo rate(P<0.05),while MMP9 was negatively related to the fertilization rate and high-quality embryo rate(P<0.05).【Conclusion】PCOS patients have lower level of BMP-15 and higher levels of sRAGE and MMP9,which are related to the quality of egg development.