β细胞营养因子及核因子κB在多囊卵巢综合征患者治疗中的表达及对妊娠结局的预测价值

Expression of Betatrophin and NF-κB in the treatment of patients with PCOS and their predictive value for pregnancy outcome

目的探讨多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者β细胞营养因子(Betatrophin)和核因子κB(nuclear factor-κB,NF-κB)的表达及对妊娠结局的预测价值。方法选取PCOS患者110例作为研究对象,另选同期进行健康体检的健康育龄女性40例作为对照组,比较2组相关血清指标,观察PCOS患者治疗前后相关血清指标变化及排卵率和妊娠率,分析影响妊娠的危险因素,评估联合检测Betatrophin与NF-κB对患者治疗后妊娠结局的预测价值。结果治疗前PCOS患者血清空腹血糖(fasting blood-glucose,FBG)、空腹胰岛素水平(fasting insulin,FINS)、胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR)、胰岛β细胞功能指数(homeostatic model assessmentβcell function,HOMA-β)、促黄体生成素(luteinizing hormone,LH)、LH/促卵泡生成素(follicle stimulating hormone,FSH)、抗缪勒管激素(anti-mullerian hormone,AMH)、NF-κB、Betatrophin水平均高于对照组(P<0.05);治疗后上述指标均下降,随访1年,PCOS患者的排卵率为77.27%,妊娠率为61.82%。多因素Logistic回归分析显示HOMA-IR、HOMA-β、LH/FSH、AMH、Betatrophin、NF-κB是影响妊娠成功的危险因素,治疗后Betatrophin与HOMA-IR、HOMA-β、LH/FSH、AMH呈正相关(P<0.05);NF-κB与FBG、HOMA-IR、LH/FSH、AMH呈正相关(P<0.05)。ROC曲线显示,Betatrophin、NF-κB联合检测预测PCOS妊娠结局的AUC为0.978(0.961~0.998),敏感度为86.75%,特异度为90.12%。结论Betatrophin、NF-κB水平在PCOS患者中升高,治疗后显著降低,两者血清水平与HOMA-IR、LH/FSH、AMH等呈正相关,联合检测Betatrophin、NF-κB对PCOS妊娠结局有一定预测价值。

Objective To explore the expression ofβ-cell trophic factor(Betatrophin)and nuclear factor-κB(NF-κB)in patients with polycystic ovary syndrome(PCOS)and their predictive value for pregnancy outcome.Methods A total of 110 patients with PCOS were selected as the research subjects,and 40 healthy women of childbearing age who underwent physical examinations during the same period were selected as the control group.The related serum indexes of the two groups were compared.Risk factors for pregnancy was analyzed,and the predictive value of combined detection of Betatrophin and NF-κB for pregnancy outcomes after treatment was evaluated.Results Before treatment,the levels of serum fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),homeostatic model assessmentβcell function(HOMA-β),luteinizing hormone(LH),LH/follicle stimulating hormone(FSH),anti-mullerian hormone(AMH),NF-κB and Betatrophin in PCOS patients were higher than those in the control group(P<0.05),which were reduced after treatment.At 1-year follow-up,the ovulation rate of PCOS patients was 77.27%,and the pregnancy rate was 61.82%.Multivariate Logistic regression analysis showed that HOMA-IR,HOMA-β,LH/FSH,AMH,Betatrophin,and NF-κB were risk factors for pregnancy success,and that Betatrophin was positively correlated with HOMA-IR,HOMA-β,LH/FSH,and AMH after treatment(P<0.05).NF-κB was also positively correlated with FBG,HOMA-IR,LH/FSH,and AMH(P<0.05).The receiver operating characteristic(ROC)curve showed that the area under the ROC curve(AUC)of combined detection of Betatrophin and NF-κB in predicting the pregnancy outcome after PCOS treatment was 0.978(0.961-0.998),the sensitivity was 86.75%,and the specificity was 90.12%.Conclusion The levels of Betatrophin and NF-κB are increased in PCOS patients and significantly decreased after treatment.The serum levels of the two were positively correlated with HOMA-IR,LH/FSH,and AMH.The combined detection of Betatrophin and NF-κB has certain predictive value for pregnancy outcomes of patients with PCOS.