不明原因不孕和可育女性血清瘦素与生殖激素的关系
Relationship of Serum Leptin and Reproductive Hormones in Unexplained Infertile and Fertile Females.
作者信息
Baig Mukhtiar, Azhar Abid, Rehman Rehana, Syed Hareem, Tariq Saba, Gazzaz Zohair J
机构信息
Medical Education and Simulation, King Abdulaziz University, Jeddah, SAU.
Karachi Institute of Biotechnology and Genetic Engineering, University of Karachi, Karachi, PAK.
出版信息
Cureus. 2019 Dec 31;11(12):e6524. doi: 10.7759/cureus.6524.
OBJECTIVE
To investigate the relationship between serum leptin and reproductive hormones in females with unexplained infertility (UI).
METHODOLOGY
It was a case-control study conducted in the Gynecology and Obstetrics Department and Infertility Clinic, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. A total of 235 primary infertile females with an unidentified cause of infertility were selected from the Infertility Clinics. The patients were excluded if they were found to have polycystic ovary syndrome, endometriosis, tubal blockage, irregular menstrual cycles, hyperthyroidism, hypothyroidism, hyperprolactinemia, hyperandrogenemia, fasting blood sugar >110 mg/dl, and male factor infertility. A total of 205 healthy, fertile females were selected from the general population. The blood samples of both groups were collected on the 12th and 21st day of their menstrual cycle. Serum leptin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2 levels were measured. Statistical analysis was executed using the SPSS version 16 (SPSS Inc., Chicago, IL).
RESULTS
No significant difference was observed in leptin values of fertile and UI females, 37.110±1.19 vs. 35.321±0.901. In the preovulatory phase (12th day) of the cycle, infertile subjects with body mass index (BMI) <20 and 20-24.9 had significantly higher values for leptin (p<0.05), whereas, with an increase in BMI, leptin levels were reduced in these females. Leptin was reduced further in the luteal phase of infertile females with BMI 25-30, with a significantly lower value for FSH (p<0.005), LH (p<0.005), and estradiol (p<0.005. In infertile subjects, it correlated with estradiol (r=0.501, p<0.005), BMI (r=0.903, p<0.001), and progesterone (r=0.146, p<0.05).
CONCLUSION
Low levels of leptin observed to have an increase in the BMI of UI females were associated with a reduced estradiol and progesterone production in the luteal phase of the cycle.
目的
探讨不明原因不孕症（UI）女性血清瘦素与生殖激素之间的关系。
方法
这是一项在巴基斯坦卡拉奇真纳研究生医学中心妇产科和不孕症诊所进行的病例对照研究。从不孕症诊所选取了235名原发性不孕且病因不明的女性。如果患者患有多囊卵巢综合征、子宫内膜异位症、输卵管堵塞、月经周期不规律、甲状腺功能亢进、甲状腺功能减退、高泌乳素血症、高雄激素血症、空腹血糖>110mg/dl以及男性因素不孕症，则将其排除。从普通人群中选取了205名健康、有生育能力的女性。两组的血液样本均在月经周期的第12天和第21天采集。检测血清瘦素、促卵泡生成素（FSH）、促黄体生成素（LH）和雌二醇水平。使用SPSS 16版（SPSS公司，伊利诺伊州芝加哥）进行统计分析。
结果
有生育能力的女性和UI女性的瘦素值无显著差异，分别为37.110±1.19和35.321±0.901。在月经周期的排卵前期（第12天），体重指数（BMI）<20和20 - 24.9的不孕受试者瘦素值显著更高（p<0.05），而随着BMI的增加，这些女性的瘦素水平降低。BMI为25 - 30的不孕女性在黄体期瘦素进一步降低，FSH（p<0.005）、LH（p<0.005）和雌二醇（p<0.005）的值显著更低。在不孕受试者中，瘦素与雌二醇（r = 0.501，p<0.005）、BMI（r = 0.903，p<0.001）和孕酮（r = 0.146，p<0.05）相关。
结论
观察到UI女性BMI增加时瘦素水平降低，这与月经周期黄体期雌二醇和孕酮分泌减少有关。
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