Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310006, People's Republic of China.
Zhejiang Provincial Clinical Research Center for Child Health, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Eur J Med Res. 2023 Aug 30;28(1):305. doi: 10.1186/s40001-023-01280-7.
Endometriosis is associated with systemic metabolic indicators, including body mass index (BMI), glucose metabolism and lipid metabolism, while the association between metabolic indexes and the occurrence and assisted reproductive technology (ART) outcome of endometriosis is unclear. We aimed to evaluate the characteristics of systemic metabolic indexes of endometriosis patients with infertility and their effects on pregnancy outcome after ART treatment.
A retrospective cohort study involve 412 endometriosis patients and 1551 controls was conducted. Primary outcome was metabolic indexes, and secondary measures consisted of the influence of metabolic indexes on the number of retrieved oocytes and ART outcomes.
Endometriosis patients had higher insulin (INS) [6.90(5.10-9.50) vs 6.50(4.80-8.90) μU/mL, P = 0.005]. A prediction model for endometriosis combining the number of previous pregnancies, CA125, fasting blood glucose (Glu) and INS, had a sensitivity of 73.9%, specificity of 67.8% and area under curve (AUC) of 0.77. There were no significant differences in ART outcomes and complications during pregnancy. The serum levels of Glu before pregnancy were associated with GDM both in endometriosis group (aOR 12.95, 95% CI 1.69-99.42, P = 0.014) and in control group (aOR 4.15, 95% CI 1.50-11.53, P = 0.006).
We found serum Glu is related to the number of retrieved oocytes in control group, serum INS is related to the number of retrieved oocytes in endometriosis group, while serum Glu and INS before pregnancy are related to the occurrence of GDM in two groups. A prediction model based on metabolic indexes was established, representing a promising non-invasive method to predict endometriosis patients with known pregnancy history.
子宫内膜异位症与包括体重指数（BMI）、葡萄糖代谢和脂代谢在内的全身代谢指标有关，而代谢指标与子宫内膜异位症的发生和辅助生殖技术（ART）结局的关系尚不清楚。我们旨在评估不孕子宫内膜异位症患者全身代谢指标的特征及其对 ART 治疗后妊娠结局的影响。
进行了一项回顾性队列研究，共纳入 412 例子宫内膜异位症患者和 1551 例对照。主要结局是代谢指标，次要措施包括代谢指标对获卵数和 ART 结局的影响。
子宫内膜异位症患者的胰岛素（INS）水平较高[6.90（5.10-9.50）比 6.50（4.80-8.90）μU/mL，P=0.005]。结合既往妊娠次数、CA125、空腹血糖（Glu）和 INS 预测子宫内膜异位症的模型，其灵敏度为 73.9%，特异性为 67.8%，曲线下面积（AUC）为 0.77。两组在 ART 结局和妊娠期间的并发症方面无显著差异。妊娠前血清 Glu 水平与子宫内膜异位症组（比值比 12.95，95%可信区间 1.69-99.42，P=0.014）和对照组（比值比 4.15，95%可信区间 1.50-11.53，P=0.006）的 GDM 均相关。
我们发现对照组血清 Glu 与获卵数相关，子宫内膜异位症组血清 INS 与获卵数相关，而两组妊娠前血清 Glu 和 INS 与 GDM 的发生相关。建立了基于代谢指标的预测模型，这是一种有前途的非侵入性方法，可以预测有已知妊娠史的子宫内膜异位症患者。
