Department of Laboratory Medicine, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden.
Department of Clinical Chemistry, Region Västra Götaland, Sahlgrenska University Hospital, Bruna stråket 16, 413 45, Gothenburg, Sweden.
Sci Rep. 2022 Aug 3;12(1):13331. doi: 10.1038/s41598-022-17612-2.
For overweight and obese women undergoing in vitro fertilization (IVF) the pregnancy and live birth rates are compromised while the underlying mechanisms and predictors are unclear. The aim was to explore the association between adipose tissue-related inflammatory and metabolic markers and the pregnancy and live birth outcome of IVF in a cohort of predominantly overweight and obese women. Serum samples, fulfilling standardizing criteria, were identified from 195 women having participated in either the control (n = 131) or intervention (n = 64) group of a randomized controlled trial (RCT), seeking to evaluate the effect of a weight reduction intervention on IVF outcome in obese women. Serum high-sensitivity C-reactive protein (hsCRP) and the adipokines leptin and adipocyte fatty acid-binding protein (AFABP) were analyzed for the whole cohort (n = 195) in samples collected shortly before IVF [at randomization (control group), after intervention (intervention group)]. Information on age, anthropometry [BMI, waist circumference, waist-to-height ratio (WHtR)], pregnancy and live birth rates after IVF, as well as the spontaneous pregnancy rate, was extracted or calculated from collected data. The women of the original intervention group were also characterized at randomization regarding all variables. Eight women [n = 3 original control group (2.3%), n = 5 original intervention group (7.8%)] conceived spontaneously before starting IVF. BMI category proportions in the cohort undergoing IVF (n = 187) were 1.6/20.1/78.3% (normal weight/overweight/obese). The pregnancy and live birth rates after IVF for the cohort were 35.8% (n = 67) and 24.6% (n = 46), respectively. Multivariable logistic regression revealed that none of the variables (age, hsCRP, leptin, AFABP, BMI, waist circumference, WHtR) were predictive factors of pregnancy or live birth after IVF. Women of the original intervention group displayed reductions in hsCRP, leptin, and anthropometric variables after intervention while AFABP was unchanged. In this cohort of predominantly overweight and obese women undergoing IVF, neither low-grade inflammation, in terms of hsCRP, other circulating inflammatory and metabolic markers released from adipose tissue (leptin, AFABP), nor anthropometric measures of adiposity or adipose tissue distribution (BMI, waist, WHtR) were identified as predictive factors of pregnancy or live birth rate.Trial registration: ClinicalTrials.gov number, NCT01566929. Trial registration date 30-03-2012, retrospectively registered.
对于接受体外受精 (IVF) 的超重和肥胖女性,妊娠率和活产率会受到影响,但其潜在机制和预测因素尚不清楚。本研究旨在探索脂肪组织相关炎症和代谢标志物与 IVF 妊娠和活产结局之间的相关性,该研究纳入了一组主要为超重和肥胖的女性,她们参与了一项随机对照试验 (RCT) 的对照组(n=131)或干预组(n=64)。该 RCT 旨在评估减肥干预对肥胖女性 IVF 结局的影响。对 195 名女性的血清样本进行了分析,这些女性符合标准(n=195),这些样本采集于接受 IVF 治疗前(随机分组时,对照组;干预后,干预组)。在该队列中,分析了所有女性(n=195)的血清高敏 C 反应蛋白(hsCRP)和脂肪因子瘦素和脂肪细胞脂肪酸结合蛋白(AFABP)。从收集的数据中提取或计算了接受 IVF 治疗后的年龄、人体测量学(BMI、腰围、腰高比(WHtR))、妊娠和活产率以及自然妊娠率的信息。原始干预组的女性也在随机分组时对所有变量进行了特征描述。该研究中,有 8 名女性(n=3 名原始对照组(2.3%),n=5 名原始干预组(7.8%))在开始 IVF 前自然受孕。接受 IVF 的女性(n=187)BMI 类别比例为 1.6/20.1/78.3%(正常体重/超重/肥胖)。该队列的 IVF 后妊娠率和活产率分别为 35.8%(n=67)和 24.6%(n=46)。多变量逻辑回归显示,hsCRP、瘦素、AFABP、BMI、腰围、WHtR 等变量均不是 IVF 后妊娠或活产的预测因素。干预后,原始干预组女性的 hsCRP、瘦素和人体测量学变量均有所下降,而 AFABP 则无变化。在该组主要为超重和肥胖的接受 IVF 的女性中,低水平炎症(hsCRP)、脂肪组织释放的其他循环炎症和代谢标志物(瘦素、AFABP)以及肥胖或脂肪组织分布的人体测量学指标(BMI、腰围、WHtR)均未被确定为妊娠或活产率的预测因素。试验注册:临床试验.gov 编号,NCT01566929。试验注册日期 2012 年 3 月 30 日,回顾性注册。