Obstetrics and Gynaecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China; Shanghai Key Laboratory of Reproduction and Development, Shanghai, China.
Department of Reproductive Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Reprod Biomed Online. 2024 Sep;49(3):104099. doi: 10.1016/j.rbmo.2024.104099. Epub 2024 May 3.
Is intra-abdominal fat obesity associated with infertility?
This study analysed data from the 2013-2018 National Health and Nutrition Examination Survey, with a total of 3013 women enrolled. The participants were divided into two groups: infertility and non-infertility. Differences between the two groups were analysed using a weighted Student's t-test or Mann-Whitney U-test for continuous variables, or a weighted chi-squared test for categorical data. Visceral adipose tissue area (VATA) was assessed by dual-energy X-ray absorptiometry. The independent association between infertility and log VATA was assessed by weighted multivariate logistic regression models. Subgroup analyses were performed to assess the strength of the results. Interaction tests were used to examine whether covariates interacted with log VATA to influence infertility.
Log VATA was significantly higher in the infertility group compared with the non-infertility group (P < 0.001). After adjustment for potential confounders, the results of multivariate logistic regression analysis revealed that an increase in log VATA was associated with increased prevalence of female infertility (OR = 2.453, 95% CI 1.278-4.792). Subgroup analyses showed this association in individuals aged <35 years (P = 0.002), Mexican-Americans (P = 0.033), non-hypertensive individuals (P = 0.013) and non-diabetic individuals (P = 0.003).
An enlarged VATA is associated with increased risk of infertility. The direct effect of VATA on female infertility needs to be clarified further to provide a basis for future prevention and treatment of female infertility.
腹部内脏脂肪肥胖与不孕有关吗？
本研究分析了 2013-2018 年全国健康与营养调查的数据，共有 3013 名女性入组。将参与者分为不孕组和非不孕组。使用加权 Student's t 检验或 Mann-Whitney U 检验比较两组间连续变量的差异，使用加权卡方检验比较分类变量的差异。通过双能 X 射线吸收法评估内脏脂肪组织面积（VATA）。使用加权多变量 logistic 回归模型评估不孕与 log VATA 之间的独立关联。进行亚组分析以评估结果的强度。使用交互检验检查协变量是否与 log VATA 相互作用影响不孕。
不孕组的 log VATA 明显高于非不孕组（P<0.001）。在调整了潜在混杂因素后，多变量 logistic 回归分析的结果表明，log VATA 的增加与女性不孕的患病率增加相关（OR=2.453，95%CI 1.278-4.792）。亚组分析显示，这种关联在年龄<35 岁的个体（P=0.002）、墨西哥裔美国人（P=0.033）、非高血压个体（P=0.013）和非糖尿病个体（P=0.003）中存在。
VATA 的增大与不孕风险的增加相关。VATA 对女性不孕的确切影响需要进一步阐明，以为女性不孕的未来预防和治疗提供依据。
