复发性流产与代谢性指标相关性研究

Correlation between recurrent spontaneous abortion and metabolic indexes

目的探讨复发性流产(RSA)与代谢性指标的关系。方法选取2021年8月1日至2022年6月25日太原市妇幼保健院生殖内分泌科门诊RSA女性患者60例为研究对象,同期招募月经规律、无流产史的妇女60例为对照组,采用体脂仪进行人体成分分析,测量血压并抽血测定甲状腺功能、同型半胱氨酸(Hcy)、尿酸、血脂水平以及肝功能、肾功能,并进行糖耐量试验和胰岛素释放试验;比较分析RSA与代谢性指标的可能相关性。结果RSA组与对照组两组患者间年龄、体质量指数(BMI)、体脂率、血脂水平、Hcy水平及尿酸水平等比较均无统计学差异(P>0.05);RSA组患者糖代谢异常的发生率显著高于对照组(90.0%vs.50.0%,P<0.001)。在RSA患者中,糖代谢异常组内脏脂肪面积增多(≥80 cm 2)者比例显著高于糖代谢正常组(61.1%vs.0%,P<0.05)。结论RSA女性患者无论肥胖与否,均易发生糖代谢异常,并且RSA患者的糖代谢异常与内脏脂肪面积增多相关。所以除了关注RSA女性的生育外,还要关注患者糖代谢的情况,同时需要进行生活方式干预,以减少内脏脂肪为主。

Objective:To explore the correlation between recurrent spontaneous abortion(RSA)and metabolic indexes.Methods:Sixty female patients with RSA in the outpatient department of Reproductive Endocrinology of Taiyuan Maternal&Child Health Care Hospital from August 1,2021 to June 25,2022 were selected as the subjects.At the same time,60 women with regular menstruation and without abortion history were recruited as the controls.Human body composition was analyzed by body fat meter,blood pressure was measured and blood was drawn to measure thyroid function,homocysteine(Hcy),uric acid,blood lipid,liver function,kidney function,glucose tolerance test and insulin release test.The correlation between RSA and metabolic indicators was compared and analyzed.Results:There were no significant differences in age,body mass index(BMI),body fat rate,blood lipid,Hcy and uric acid level between RSA group and control group(P>0.05).The incidence of abnormal glucose metabolism in RSA patients was significantly higher than that in the control group(90.0%vs.50.0%,P<0.001).In RSA patients,the proportion of increased visceral fat area(≥80 cm 2)in abnormal glucose metabolism group was significantly higher than that in normal glucose metabolism group(61.1%vs.0%,P<0.05).Conclusions:Whether the female patients with RSA are obese or not,they are prone to abnormal glucose metabolism,and the abnormal glucose metabolism in RSA patients is related to the increase of visceral fat area.Therefore,in addition to focusing on the fertility of RSA women,attention should also be paid to the glucose metabolism of patients,and lifestyle intervention is required to reduce visceral fat.