25羟维生素D、抗苗勒管激素及性激素与卵巢储备功能下降的相关性分析

Correlation analysis of 25 hydroxyvitamin D,anti mullerian hormone and sex hormone with the diminished ovarian reserve

目的探究25羟维生素D[25-(OH)-D]、抗苗勒管激素(AMH)及性激素与卵巢储备功能下降(DOR)的相关性。方法选取73例不孕症患者,根据是否合并DOR将其分为DOR组(n=35)和对照组(n=38)。比较两组血清[25-(OH)-D]、AMH及性激素水平。分析不孕症患者合并DOR的影响因素,采用ROC曲线评估血清25-(OH)-D、AMH、促卵泡激素/黄体生成素(FSH/LH)对DOR的预测效能。结果DOR组血清25-(OH)-D、AMH水平低于对照组,年龄和血清FSH、FSH/LH、雌二醇(E2)水平高于对照组,差异均有统计学意义(t分别=2.53、4.53、-2.23、-6.79、-3.98、-3.14,P均<0.05)。经logistic回归分析,年龄、FSH/LH是不孕症患者DOR的危险因素(OR分别=1.14、1.75,P均<0.05),25-(OH)-D与AMH是保护因素(OR分别=0.84、0.06,P均<0.05)。经ROC分析,25-(OH)-D、AMH、FSH/LH联合预测DOR的AUC为0.87,灵敏度为88.57%,特异度为78.95%。结论血清25-(OH)-D与AMH水平下降、FSH/LH值升高是不孕症患者合并DOR的影响因素,三者联合对DOR具有一定预测价值。

Objective To explore the correlation between 25 hydroxyvitamin D[25-(OH)-D],anti mullerian hormone(AMH)and sex hormones and the diminished ovarian reserve(DOR).Methods Seventy-three infertility patients were selected and divided into DOR group(n=35)and control group(n=38)according to whether occurred DOR or not.Se⁃rum[25-(OH)-D],AMH and sex hormone levels were compared between the two groups.The influencing factors of pa⁃tients with DOR were analyzed,and the predictive efficacies of serum 25-(OH)-D,AMH,FSH/LH on DOR were evalu⁃ated by ROC curve.Results The serum 25-(OH)-D and AMH levels in DOR group were lower than those in control group,but the age and serum FSH,FSH/LH and E2 levels in DOR group were higher than those in control group,and the differences were statistically significant(t=2.53,4.53,-2.23,-6.79,-3.98,-3.14,P<0.05).Logistic regression analy⁃sis showed that age and FSH/LH were risk factors for DOR in infertility patients(OR=1.14,1.75,P<0.05),and 25-(OH)-D and AMH were protective factors(OR=0.84,0.06,P<0.05).The AUC,sensitivity and specificity of 25-(OH)-D combined with AMH and FSH/LH to predict DOR were 0.87,88.57%and 78.95%respectively.Conclusion The decreasing of serum 25-(OH)-D and AMH levels and the increasing of FSH/LH are influencing fac⁃tors of infertility patients with DOR,and the combination of them has certain predictive value for DOR.