Xia Hexia, Zhang Ruixiu, Sun Xiaoli, Wang Lu, Zhang Wei
Department of Reproductive Endocrinology, Obstetrics and Gynecology Hospital, Fudan University and Shanghai Key Laboratory of Female Reproductive Endocrine Related Disease, Shanghai, China.
Affiliated Hospital of Nantong University, Nantong, Jiangsu, China.
J Clin Hypertens (Greenwich). 2017 May;19(5):504-509. doi: 10.1111/jch.12957. Epub 2016 Dec 27.
To explore preconception risk factors for preeclampsia (PE) in women with polycystic ovary syndrome (PCOS), a prospective cohort study was conducted in 92 infertile Chinese women with PCOS who had a singleton pregnancy by ovulation induction and were followed up for 6 weeks after delivery. The patients underwent assessment of physical, endocrine, and metabolic features before ovulation induction. Fifteen (16.3%) patients were diagnosed with PE. Logistic regression analysis showed that preconception sex hormone-binding globulin (SHBG), insulin level at 120 minutes, and body mass index were three independent risk factors for PE (odds ratio [OR], 0.981; 95% confidence interval [CI], 0.964-0.998 [P=.027]; OR, 1.011; 95% CI, 1.000-1.021 [P=.048]; and OR, 1.249; 95% CI, 0.992-1.572 [P=.059], respectively). Receiver operator characteristic analysis indicated the risk value of prepregnancy SHBG, insulin level at 120 minutes, and body mass index (area under the curve=.788, .686, and .697, respectively). Preconception low SHBG levels, overweight/obesity, and hyperinsulinism might be correlated with the subsequent development of PE in patients with PCOS.
为了探究多囊卵巢综合征（PCOS）女性子痫前期（PE）的孕前危险因素，对92例中国不孕的PCOS女性进行了一项前瞻性队列研究，这些女性通过促排卵实现单胎妊娠，并在产后随访6周。患者在促排卵前接受了身体、内分泌和代谢特征评估。15例（16.3%）患者被诊断为PE。逻辑回归分析显示，孕前性激素结合球蛋白（SHBG）、120分钟时的胰岛素水平和体重指数是PE的三个独立危险因素（比值比[OR]分别为0.981；95%置信区间[CI]为0.964 - 0.998[P = 0.027]；OR为1.011；95% CI为1.000 - 1.021[P = 0.048]；OR为1.249；95% CI为0.992 - 1.572[P = 0.059]）。受试者工作特征分析表明孕前SHBG、120分钟时的胰岛素水平和体重指数的风险值（曲线下面积分别为0.788、0.686和0.697）。孕前低SHBG水平、超重/肥胖和高胰岛素血症可能与PCOS患者随后发生PE有关。
