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对胰岛素敏感性,抵抗性和β细胞功能障碍的综合回归建模用于预测女性不孕:一个横截面NHANES研究

Seyed Sobhan Bahreiny¹, Mohammad Ali Khaksar^2,3, Negin Karamali⁴

¹Department of Physiology, Faculty of Medicine, Tehran University of Medical Sciences, Poorsina Ave, Tehran, Iran. bahreiny-s@razi.tums.ac.ir.

Clinical and experimental medicine

|June 30, 2025

概括

以估计的葡萄糖排放率 (eGDR) 衡量较低的胰岛素敏感性与女性不孕症风险增加密切相关. 其他胰岛素指数,如HOMA-IR,也显示与不孕不育的非线性关联.

科学领域:

代谢健康代谢健康
生殖内分泌学生殖内分泌学
流行病学流行病学

背景情况:

胰岛素敏感性,耐药性和β细胞功能对于代谢和生殖健康至关重要.
关键胰岛素相关指数与女性不孕症之间的具体关联需要进一步阐明.
了解这些联系可以为管理女性生殖健康的策略提供信息.

研究的目的:

调查四个与胰岛素相关的指数与女性不孕症之间的联系.
分析这些关联的回归建模和非线性模式.
通过社会人口统计学,生活方式和代谢因素来识别潜在的效果修改.

主要方法:

使用NHANES 2017-2023数据对2832名女性 (18-45岁) 的横截面研究.
采用了多变量逻辑回归,通用添加模型和值效应分析.
综合元分析,分布,子组和相互作用分析进行了强有力的发现.

主要成果:

估计的葡萄糖处置率 (eGDR) 显示出与不孕不育的显著反向关联 (OR范围:0.636-0.85,p < 0.001),具有非线性模式和值效应.
胰岛素抵抗的恒温模型评估 (HOMA-IR) 在未调整的模型中显示出正相关性,但在完全调整后失去了意义.
HOMA-β和胰岛素处置指数 (胰岛素-DI) 呈现出较弱或未调整的关联,对eGDR和HOMA-IR通过BMI和年龄观察到显著的效果修改.

结论:

胰岛素敏感性降低,以较低的eGDR为标志,是女性不孕症风险增加的强有力的预测因素.
胰岛素耐药性 (HOMA-IR) 和胰岛素-DI也表现出与不孕不育的非线性,基于值的关联.
这些发现凸显了葡萄糖-胰岛素平衡在女性生育能力中的关键作用,并建议针对性的干预措施.

关键词:

和胰岛素排放指数指数.贝塔细胞功能贝塔细胞功能横截面研究横截面研究估计的葡萄糖处理速度.女性不孕症女性不孕症胰岛素耐药性的恒常模式评估胰岛素耐药性胰岛素耐药性是一种尼汉斯 (NHANES) 是一个名人.

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