腰比和女性不孕:一个观察性研究和孟德尔随机化分析
Shanshan Wu1, Huiyun Jiang1, Xi Wang2
1Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Medicine
|November 27, 2025
概括
以腰部至部比率 (WHR) 衡量的中心脂肪率显著增加了女性不孕症的风险. 这项研究证实了WHR作为一个独立的预测指标,突出了其在超出身体质量指数 (BMI) 的生育评估中的重要性.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 人类遗传学 人类遗传学
- 公共卫生 公共卫生
背景情况:
- 中部脂肪,以腰部至部比率 (WHR) 表示,是女性不孕症的可修改风险因素.
- 需要进一步研究WHR和不孕不育之间的因果关系,独立于其他因素,如体重指数 (BMI),需要进一步调查.
研究的目的:
- 通过观察和门德尔随机化 (MR) 方法,研究腰部至部比率 (WHR) 在女性不孕症中的因果作用.
- 评估WHR与不孕症风险之间的关联,考虑潜在的混因素,如BMI.
主要方法:
- 综合观察数据 (国家健康和营养检查调查) 与全基因组关联研究总结统计数据用于MR分析.
- 采用加权后勤回归,用于值检测的一般化添加模型,以及双样本和多变量MR.
- 进行了敏感性分析 (MR-Egger,留出一个,MR-presso) 以确保调查结果的可靠性.
主要成果:
- 在WHR中增加0.1个单位与不孕症风险增加46%有关.
- 在调整了BMI后,WHR仍然是不孕不育的独立预测因素,风险增加了23%.
- 确认无排卵不育的因果关系 (OR=2.10),独立于BMI;WHR>0.85和特定年龄/教育小组中观察到更高的风险.
结论:
- 腰比 (WHR) 是女性不孕症的独立预测指标,特别是无排卵不孕症.
- 将WHR测量纳入生育评估可以识别潜在的风险人群,仅通过BMI就可能错过.
- 针对中心肥胖症的有针对性的生活方式修改可能会减少全球不孕症的负担,并改善生殖结果.
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