Robinson Research Institute, University of Adelaide, Adelaide, SA, Australia.
Centre for Reproductive Medicine, Amsterdam Reproduction and Development Research Institute, Amsterdam UMC, University of Amsterdam, AZ Amsterdam, the Netherlands.
BJOG. 2020 Jul;127(8):930-939. doi: 10.1111/1471-0528.16171. Epub 2020 Mar 18.
There is currently no concise systematic review or meta-analysis addressing cardio-metabolic risk factors in women experiencing infertility.
To determine whether infertile women have higher levels of cardiovascular risk factors compared with fertile women.
We performed a systematic literature search using PubMed, Embase and CINAHL, Scopus and additional manual and bibliographic searches for relevant articles (end search date 6 November 2019).
We selected studies that compared cardio-metabolic risk factors in fertile and infertile women of reproductive age.
At least two authors independently screened potentially eligible studies.
There was an increased presence of several cardio-metabolic risk factors in infertile women compared with fertile women. Infertile women had statistically significant higher body mass index (BMI), increased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) compared with fertile women. Fasting glucose, fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and mean arterial pressure were not found to be different between fertile and infertile women. A subgroup analysis revealed that TC, fasting glucose and fasting insulin were increased, and high-density lipoprotein was decreased only in women with polycystic ovarian syndrome compared with fertile women, whereas BMI, TG and LDL-C were statistically significantly increased in women with any indication of infertility compared with fertile women.
Infertile women have a higher level of cardio-metabolic risk factors compared with fertile women. This finding has clinical implications for infertile women in general, and those attempting to conceive through medically assisted reproduction.
Infertile women appear to have a higher level of cardio-metabolic risk factors compared with fertile women.
目前尚无简明的系统评价或荟萃分析专门针对不孕女性的心血管代谢危险因素。
确定不孕女性的心血管危险因素水平是否高于生育女性。
我们使用 PubMed、Embase 和 CINAHL、Scopus 以及其他手动和文献检索进行了系统的文献检索（检索截止日期为 2019 年 11 月 6 日）。
我们选择了比较生育年龄不孕和生育女性心血管代谢危险因素的研究。
至少有两名作者独立筛选了潜在合格的研究。
与生育女性相比，不孕女性存在几种心血管代谢危险因素的发生率更高。不孕女性的体重指数（BMI）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）显著升高。与生育女性相比，空腹血糖、空腹胰岛素、稳态模型评估的胰岛素抵抗（HOMA-IR）和平均动脉压没有差异。亚组分析显示，仅多囊卵巢综合征女性的 TC、空腹血糖和空腹胰岛素升高，高密度脂蛋白降低，而任何原因不孕的女性 BMI、TG 和 LDL-C 均显著升高。
与生育女性相比，不孕女性的心血管代谢危险因素水平更高。这一发现对一般不孕女性具有临床意义，对试图通过医学辅助生殖受孕的女性具有临床意义。
与生育女性相比，不孕女性似乎具有更高的心血管代谢危险因素水平。
