多囊卵巢综合征痰湿证miRNA-483-3p差异表达的临床意义

Expression and Clinical Value of miRNA-483-3p in Polycystic Ovary Syndrome Patients with Phlegm Dampness Syndrome

目的通过分析多囊卵巢综合征(PCOS)痰湿证患者血清、卵泡液、颗粒细胞miR-483-3p的差异表达、生殖内分泌特点、糖脂代谢及体外受精结局,探讨多囊卵巢综合征痰湿证的发病机制。方法总计纳入52例体外受精-胚胎移植不孕症患者,其中痰湿证PCOS患者17例(痰湿组),非痰湿证PCOS患者18例(非痰湿组),男性因素不孕患者17例(对照组)。实时荧光定量PCR检测miRNA-483-3p的表达。比较3组患者的临床特征、实验室指标及miRNA-483-3p的相对表达量。结果 (1)痰湿组体质量指数(BMI)、腰臂比(WHR)、睾酮(T)、空腹胰岛素(FINS)水平显著高于非痰湿组和对照组(P<0.05)。(2) 3组间血清、卵泡液、颗粒细胞中miRNA-483-3p的相对表达水平差异有统计学意义(P<0.05)。PCOS患者尤其是痰湿组的相对表达量显著低于对照组和非痰湿组(P<0.05)。(3)相关分析表明,血清miRNA-483-3p的相对表达水平与血清T、FINS水平密切相关。卵泡液、颗粒细胞miRNA-483-3p的相对表达水平与获卵率、卵母细胞成熟率、正常受精率、优质胚胎率显著相关(P<0.05)。结论多囊卵巢综合征患者血清、卵泡液、颗粒细胞中miR-483-3p呈现特异性低表达,可能与多囊卵巢综合征痰湿证的病因病机密切相关。

Objective To study the pathogenesis of phlegm dampness syndrome in polycystic ovary syndrome by researching on the differential expression of miR-483-3 p in serum, follicular fluid, and granulosa cells, the characteristics of reproductive endocrine and the glycolipid metabolism of polycystic ovary syndrome(PCOS) patients. Methods A total of 52 infertile patients undergoing in vitro fertilization-embryo transfer were enrolled, including 17 PCOS patients with phlegm dampness syndrome(phlegm dampness group), 18 PCOS patients without phlegm dampness syndrome(non-phlegm dampness group) and 17 infertile patients with male factor(control group). The expression of miRNA-483-3 p was detected by real-time fluorescent quantitative PCR. The clinical data, laboratory parameters and the relative expression of miRNA-483-3 p was compared between the three groups. Results(1) The level of BMI, WHR, T and FINS in the phlegm-dampness group were significantly higher than those in the non-dampness group and the control group.(P<0.05);(2)There were significant differences in the relative expression level of miRNA-483-3 p in the three groups(P<0.05). The relative expression in PCOS patients, especially in the PCOS phlegm-damp group was quite lower than the control group and the non-dampness group(P<0.05).(3) Correlation analysis showed that the relative expression level of miRNA-483-3 p was significantly correlated with serum T, FINS, oocyte retrieval rate, oocyte maturation rate, normal fertilization rate, good-quality embryo rate(P<0.05). Conclusion The specific expression of miR-483-3 p in serum, follicular fluid, and granulosa cells of PCOS patients, especially those with phlegm-dampness syndrome, may be involved in the pathogenesis of phlegm-dampness syndrome in polycystic ovary syndrome.