血清CHI3L1、TXNIP水平对多囊卵巢综合征患者妊娠结局的预测价值

The predictive value of serum chitinase-3-like protein 1 and thioredoxin-interacting protein levels for pregnancy outcomes in patients with polycystic ovary syndrome

目的探究血清壳多糖酶3样蛋白1(CHI3L1)、硫氧还蛋白互作蛋白(TXNIP)水平对多囊卵巢综合征(PCOS)患者妊娠结局的预测价值。方法选取2021年6月至2023年1月临清市人民医院诊治的112例PCOS患者作为PCOS组,另选取同时间段同院孕检的健康孕妇105例作为对照组。比较PCOS组与对照组、PCOS组不同妊娠结局患者的临床指标,采用Pearson检验分析血清CHI3L1、TXNIP表达与孕酮水平、新生儿体重的相关性,采用多因素Logistic回归分析PCOS患者妊娠结局的影响因素,绘制受试者工作特征(ROC)曲线分析血清CHI3L1、TXNIP表达对PCOS患者妊娠结局的预测价值。结果妊娠结局不良组(n=43)的孕妇剖宫产率及黄体生成素、CHI3L1、TXNIP、孕酮、空腹血糖、空腹胰岛素水平均高于妊娠结局良好组(n=69)和对照组(P<0.05),新生儿体重低于妊娠良好组和对照组(P<0.05)。PCOS患者血清CHI3L1、TXNIP表达水平与孕妇孕酮水平均呈正相关(P<0.05)。剖宫产率及新生儿体重、黄体生成素、CHI3L1、TXNIP、孕酮、空腹血糖、空腹胰岛素水平均为PCOS患者妊娠结局的独立影响因素(P<0.05)。ROC曲线显示,血清CHI3L1、TXNIP单独和联合预测PCOS发生的曲线下面积(AUC)分别为0.822、0.844、0.915,联合诊断高于CHI3L1、TXNIP任意单独诊断(P<0.05)。结论PCOS患者CHI3L1、TXNIP水平升高,两者联合对PCOS患者妊娠结局的预测价值更高。

Objective To investigating the predictive value of serum chitinase-3-like protein 1(CHI3L1)and thioredoxin-interacting protein(TXNIP)levels for pregnancy outcome in patients with polycystic ovary syndrome(PCOS).Methods A total of 112 PCOS patients diagnosed and treated in Linqing People′s Hospital from June 2021 to January 2023 were selected as the PCOS group,and 105 cases of healthy pregnant women who underwent pregnancy examination in the same hospital during the same period were selected as the control group.The clinical indicators between PCOS group and control group,and between patients with different pregnancy outcomes in the PCOS group were compared.Serum CHI3L1 and TXNIP expression and progesterone level and neonatal weight were analyzed by Pearson test.Multivariable Logistic regression were used to analyze the influencing factors of the pregnancy outcomes of patients with PCOS.Receiver operating characteristics(ROC)curve were drawn to analyze the predictive value of serum CHI3L1 and TXNIP expression on pregnancy outcomes in PCOS patients.Results Maternal cesarean section rate,luteinizing hormone,CHI3L1,TXNIP,progesterone,fasting glucose and fasting insulin levels in the group with poor pregnancy outcomes(n=43)were higher than those in the group with good pregnancy outcomes(n=69)and the control group(P<0.05),and neonatal weights were lower than those in the group with good pregnancy outcomes and the control group(P<0.05).In patients with PCOS,serum CHI3L1,TXNIP expression levels were positively correlated with maternal progesterone levels(P<0.05).Cesarean section rate,neonatal weight,luteinizing hormone,CHI3L1,TXNIP,progesterone,fasting glucose and fasting insulin levels were all independent influencing factors of pregnancy outcomes in patients with PCOS(P<0.05).ROC curves showed that the area under the curve(AUC)for serum CHI3L1 and TXNIP alone and in combination predicted the occurrence of PCOS was 0.822,0.844 and 0.915,and the combined diagnosis was higher than any CHI3L1 and TXNIP alone(P<0.05).Conclusions The levels of CHI3L1 and TXNIP were increased in PCOS patients,and the combination of the two indicators has a higher predictive value for pregnancy outcome in patients with PCOS.