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多囊卵巢综合征患者体重指数与排卵效果及临床妊娠率的相关性分析

Correlation analysis of BMI with ovulation effect and clinical pregnancy rate in patients with polycystic ovary syndrome.

作者信息

Zeng Xiaoqiong, Yang Chao

机构信息

Department of Gynecology and Reproductive and Gynecological Endocrinology, Changde Maternal and Child Health Care Hospital Changde 415000, Hunan, China.

出版信息

Am J Transl Res. 2024 Aug 15;16(8):4174-4181. doi: 10.62347/KYES1276. eCollection 2024.

Abstract

OBJECTIVES

The study was designed to investigate the correlation between body mass index (BMI) along with both ovulation effect and clinical pregnancy rate in patients with polycystic ovary syndrome (PCOS), as well as to analyze the factors influencing the clinical pregnancy rate.

METHODS

In the retrospective study, data from 122 patients were collected. The patients were classified into three groups based on their pre-pregnancy BMI: normal weight, overweight group, and obese group. The analysis focused on examining the ovulation indicators, ovulation rates, and clinical pregnancy rates across different groups. Furthermore, both univariate and multivariate analyses were conducted to identify factors influencing the clinical pregnancy rate.

RESULTS

The obese group exhibited significantly higher fasting plasma glucose (FPG) levels compared to the overweight and normal-weight groups (P<0.0001); but no significant difference was found between the overweight and normal-weight groups (P>0.05). Both the obese and overweight groups had elevated levels of low-density lipoprotein cholesterol (LDL-C) compared to the normal-weight group (P<0.0001), with no significant difference between the obese and overweight groups (P>0.05). The obese group exhibited significantly lower levels of high-density lipoprotein cholesterol (HDL-C) compared to the normal-weight group (P<0.05); but no significant difference in HDL-C levels was observed between the overweight and normal-weight groups (P>0.05). Both the overweight group and obese group showed notably higher endometrial thickness and diameter of mature follicles than the normal weight group (P<0.05), as well as notably fewer mature follicles (P<0.05). Furthermore, the obese group demonstrated a significantly lower number of mature follicles compared to the overweight group (P<0.05). Conversely, the diameter of mature follicles was found to be significantly higher in the obese group than in the overweight group (P<0.05). The endometrial thickness showed a positive correlation with BMI (r=0.657, P<0.001), while the number of mature follicles exhibited a negative correlation with BMI (r=-0.547, P<0.001). Additionally, the diameter of mature follicles demonstrated a positive correlation with BMI (r=0.681, P<0.001). Relatively high BMI, advanced maternal age, and elevated FPG were identified as independent risk factors associated with low clinical pregnancy rate in patients with PCOS.

CONCLUSIONS

Relatively high BMI, advanced maternal age, and elevated FPG are independent risk factors associated with a decreased likelihood of achieving clinical pregnancy in patients. Therefore, in clinical practice, assisting obese patients in weight reduction to maintain a BMI within the normal range of 18.5-23.9 kg/m and lowering blood glucose levels can contribute to better pregnancy outcomes.

摘要

目的

本研究旨在探讨多囊卵巢综合征(PCOS)患者的体重指数(BMI)与排卵效果及临床妊娠率之间的相关性,并分析影响临床妊娠率的因素。

方法

在这项回顾性研究中,收集了122例患者的数据。根据孕前BMI将患者分为三组:正常体重组、超重组和肥胖组。分析重点在于检查不同组的排卵指标、排卵率和临床妊娠率。此外,还进行了单因素和多因素分析以确定影响临床妊娠率的因素。

结果

肥胖组的空腹血糖(FPG)水平显著高于超重组和正常体重组(P<0.0001);但超重组和正常体重组之间无显著差异(P>0.05)。肥胖组和超重组的低密度脂蛋白胆固醇(LDL-C)水平均高于正常体重组(P<0.0001),肥胖组和超重组之间无显著差异(P>0.05)。肥胖组的高密度脂蛋白胆固醇(HDL-C)水平显著低于正常体重组(P<0.05);但超重组和正常体重组的HDL-C水平无显著差异(P>0.05)。超重组和肥胖组的子宫内膜厚度和成熟卵泡直径均显著高于正常体重组(P<0.05),而成熟卵泡数量显著少于正常体重组(P<0.05)。此外,肥胖组的成熟卵泡数量显著低于超重组(P<0.05)。相反,肥胖组的成熟卵泡直径显著高于超重组(P<0.05)。子宫内膜厚度与BMI呈正相关(r=0.657,P<0.001),而成熟卵泡数量与BMI呈负相关(r=-0.547,P<0.001)。此外,成熟卵泡直径与BMI呈正相关(r=0.681,P<0.001)。较高的BMI、高龄产妇和升高的FPG被确定为PCOS患者临床妊娠率低的独立危险因素。

结论

较高的BMI、高龄产妇和升高的FPG是与患者临床妊娠可能性降低相关的独立危险因素。因此,在临床实践中,帮助肥胖患者减轻体重以维持BMI在18.5-23.9 kg/m的正常范围内并降低血糖水平有助于获得更好的妊娠结局。

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