在辅助生殖技术中,胰岛素耐药性和复发性流产之间的关系:一项回顾性病例控制研究
Yacong Cao1, Miao Ding2, Jingbo Chen1
1Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Medicine
|May 29, 2025
概括
胰岛素耐药性 (IR) 与辅助生殖技术 (ART) 患者的复发性怀孕丧失 (RPL) 有关. 在治疗前解决IR可能会降低流产风险.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 代谢健康 代谢健康
- 辅助生殖技术 辅助生殖技术
背景情况:
- 重复流产 (RPL) 影响了大量接受辅助生殖技术 (ART) 的女性.
- 胰岛素抵抗 (IR) 是一种代谢状况,因其对生殖结果的潜在影响而越来越受认可.
研究的目的:
- 在接受辅助生殖技术 (ART) 的患者中,研究胰岛素抵抗 (IR) 和复发性妊娠损失 (RPL) 之间的关联.
主要方法:
- 追溯分析比较RPL和非RPL组之间的葡萄糖和胰岛素指数.
- 使用禁食胰岛素 (FINS),HOMA-IR,HOMA-β和AUCI来评估胰岛素敏感性.
- 调整后勤回归模型被用于评估IR指数和RPL风险之间的相关性.
主要成果:
- 与没有RPL组相比,患有RPL的患者表现出明显更高的FINS,1小时胰岛素,2小时胰岛素,AUCI,HOMA-IR和HOMA-β水平.
- 胰岛素抵抗和HOMA-IR≥2.14的发生率在RPL组显著更高.
- 调整后的分析显示,IR是RPL的独立风险因素 (OR:1.87;95%CI:1.18-2.94).
- 增加的FINS,HOMA-IR和HOMA-β与较高的RPL发病率有关.
结论:
- 胰岛素耐药性是接受辅助生殖技术的患者再次流产的独立风险因素.
- 建议针对胰岛素敏感性的预治疗干预措施,如生活方式修改或甲胺,以改善ART的结果并降低流产风险.
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