PCOS患者血清核因子-κB、AMH及BMI对IVF-ET妊娠结局影响

Impact of the levels of serum nuclear factorκB and anti-Muller's hormone,and the value of body mass index of patients with polycystic ovary syndrome on their pregnancy outcomes after vitro fertilization embryo transfer

目的:探究多囊卵巢综合征(PCOS)患者血清核因子-κB(NF-κB)、抗缪勒氏管激素(AMH)以及体质指数(BMI)对行体外受精-胚胎移植(IVF-ET)治疗后妊娠结局的影响及预测价值。方法:回顾性收集2019年1月-2022年10月在本院初次接受IVF-ET助孕治疗的PCOS患者130例,根据临床妊娠结局分为妊娠组(69例)、未妊娠组(61例)。对比两组一般资料、NF-κB、AMH及BMI水平。采用logistic回归分析、受试者工作特征(ROC)模型分析NF-κB、AMH、BMI对妊娠结局的预测价值。结果:两组年龄、不孕年限、PCOS病程、PCOS家族史、血清性激素及促甲状腺激素(TSH)水平均无差异,两组获卵数以及可利用胚胎数无差异(P>0.05);妊娠组血清NF-κB(510.20±166.53 U/L)、AMH(9.50±3.04 ng/ml)低于未妊娠组(655.40±217.71 U/L、11.27±3.71 ng/ml),患者BMI≥24 kg/m2占比(26.1%)低于未妊娠组(50.8%)(均P<0.05)。logistic回归分析显示,血清NF-κB、AMH、BMI水平升高均为影响IVF-ET妊娠结局因素;ROC分析显示,NF-κB、AMH预测妊娠结局的截断值分别为55.846U/L、11.080ng/ml,敏感度分别为56.5%、79.7%,特异度分别为75.4%、54.1%,曲线下面积(AUC)=0.694、0.697;BMII≥24kg/m2预测妊娠结局的敏感度、特异性分别为73.9%、50.8%,AUC为0.624;3指标联合预测的临床价值最高,AUC=0.814。结论:血清外周血NF-κB、AMH、BMI均对PCOS患者行IVF-ET后的妊娠结局有影响,联合检测对妊娠结局有一定预测价值。

Objective:To investigate the impact of the levels of serum nuclear factorκB(NFκB)and anti Muller's hormone(AMH),and the value of body mass index(BMI)of patients with polycystic ovary syndrome(PCOS)on their pregnancy outcomes after vitro fertilization embryo transfer(IVF-ET).Methods:130patients with PCOS who received assisted reproduction by IVF-ET for the first time between January 2019and October 2022were collected retrospectively.These patients divided into two groups according to their clinical pregnancy outcomes,including 69patients with pregnancy in group A and 61patients without pregnancy in group B.The general data,the levels of NFκB and AMH,and the BMI value of the patients were compared between the two groups.Logistic regression analysis and receiver operator characteristic(ROC)curve were used to analyze the predictive values of the levels of NFκB and AMH,and the BMI value of the patients for their pregnancy outcomes.Results:There were no significant differences in the age,the duration of infertility,the duration of PCOS,the family history of PCOS,the serum sex hormone and thyroid stimulating hormone(TSH)levels,the number of oocytes retrieved,and the number of available embryos of the patients between the two groups(P>0.05).The levels of serum NFκB(510.20±166.53U/L)and AMH(9.50±3.04 ng/ml),and the proportion of BMI≥24kg/m2(26.1%)of the patients in group A were significantly lower than those(655.40±217.71U/L,11.27±3.71ng/ml,and 50.8%)of the patients in group B(all P<0.05).Logistic regression analysis showed that the increase of the levels of serum NFκB and AMH,and the BMI value were all the factors affecting the pregnancy outcomes of the patients after IVF-ET.ROC analysis showed that the cut-off values of the levels of NFκB and AMH of the patients for predicting their pregnancy outcomes were 55.846U/L and 11.080ng/ml,the sensitivity of which were 56.5%and 79.7%,the specificity of which were 75.4%and 54.1%,and the area under the curve(AUC)of which were 0.694and 0.697.The sensitivity,the specificity,and the AUC of BMI≥24kg/m2 of the patients for predicting their pregnancy outcomes were 73.9%,50.8%,and 0.624,respectively.The combining levels of NFκB and AMH and the BMI≥24kg/m2 of the patients for predicting their pregnancy outcomes had the highest clinical value(AUC=0.814).Conclusion:The levels of serum NFκB and AMH,and the BMI value of the patients with PCOS influence their pregnancy outcomes,and the combined prediction value of which has certain predictive value for their pregnancy outcomes.