育龄期女性卵巢储备功能下降的影响因素分析

Factors affecting decreased ovarian reserve among women of childbearing age

目的分析育龄期女性卵巢储备功能下降(DOR)的影响因素,为预防DOR提供参考。方法选择2021年1月—2022年6月宁波市妇女儿童医院妇科门诊就诊的患有DOR的18~40岁女性纳入DOR组,同期体检正常的18~40岁女性纳入正常组。通过问卷调查收集2组对象基本信息、运动、饮食、既往病史、生育情况和月经状况等;实验室检测卵泡刺激素(FSH)、黄体生成素(LH)、抗米勒管激素(AMH)和雌二醇(E2)水平。采用多因素logistic回归模型分析育龄期女性DOR的影响因素。结果DOR组200例,年龄M(QR)为32(9)岁;正常组200人,年龄M(QR)为29(12)岁。多因素logistic回归分析结果显示,体重过低(OR=2.935,95%CI:1.374~6.269)、超重肥胖(OR=2.612,95%CI:1.335~5.065)、高油高糖高盐饮食(OR=2.653,95%CI:1.616~4.357)、月经失调(OR=1.977,95%CI:1.284~3.041)、缺乏运动(OR=3.392,95%CI:2.052~5.606)与DOR存在统计学关联。结论体重过低、超重肥胖、高油高糖高盐饮食、月经失调和缺乏运动是育龄期女性发生DOR的影响因素。

Objective To investigate the factors affecting decreased ovarian reserve(DOR)among women of childbearing age,so as to provide insights into prevention of DOR.Methods Women with DOR at ages of 18 to 40 years that were admitted to Department of Gynecology,Ningbo Women and Children’s Hospital during the period from January2021 to June 2022 were recruited(DOR group),while healthy women at ages of 18 to 40 years during the same period served as normal controls.Participants’demographics,exercise,diet,previous medical history,childbearing history and menstruation were collected using questionnaire surveys.The follicle-stimulating hormone(FSH),luteinizing hormone(LH),anti-Müllerian hormone(AMH)and estradiol(E2)levels were tested.Factors affecting DOR were identified among women of childbearing age using a multivariable logistic regression model.Results There were 200 participants in the DOR group,with a median(interquartile range)age of 32(9)years,and 200 participants in the normal group,with a median(interquartile range)age of 29(12)years.Multivariable logistic regression analysis showed that underweight(OR=2.935,95%CI:1.374-6.269),overweight/obesity(OR=2.612,95%CI:1.335-5.065),high-oil-high-glucose-high-salt diet(OR=2.653,95%CI:1.616-4.357),menstrual disorder(OR=1.977,95%CI:1.284-3.041)and lack of exercise(OR=3.392,95%CI:2.052-5.606)were statistically correlated with the development of DOR among women of childbearing age.Conclusions Underweight,overweight/obesity,high-oil-high-glucose-high-salt diet,menstrual disorder and lack of exercise are factors affecting the development of DOR among women of childbearing age.