育龄女性睡眠质量与卵巢储备功能的相关性：一项横断面研究

Association between sleep quality and ovarian reserve in women of reproductive age: a cross-sectional study.

作者信息

Lin Yaoxiang, Chen Yongchao, Lin Ya, Xin Sijia, Ren An, Zhou Xiajing, Lin Xianhua, Li Xiangjuan

机构信息

Clinical Medical College, Hangzhou Normal University, Hangzhou, Zhejiang Province, People's Republic of China.

School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou, Zhejiang Province, People's Republic of China.

出版信息

Fertil Steril. 2025 Mar;123(3):520-528. doi: 10.1016/j.fertnstert.2024.09.018. Epub 2024 Sep 11.

DOI:10.1016/j.fertnstert.2024.09.018

PMID:39265649

Abstract

OBJECTIVE

To evaluate the association between sleep quality and ovarian reserve among women of reproductive age.

DESIGN

Cross-sectional study.

SUBJECTS

A total of 1,070 female participants aged 20-40 years enrolled from February 2023 to January 2024.

EXPOSURE

Not applicable.

MAIN OUTCOME MEASURES

A questionnaire was administered to the participants to collect baseline information related to reproductive and lifestyle factors. Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. The assessment was conducted on ovarian reserve, including total antral follicle count (AFC), antimüllerian hormone (AMH) level, and basal sex hormone level.

RESULTS

The study sample of 1,070 women had a mean age of 31.67 ± 4.41 years. A total of 314 participants (29.35%) were classified under the poor sleep group (PSQI score >5). Significant differences were observed in the follicle-stimulating hormone (FSH), luteinizing hormone, estradiol, testosterone, AFC, and AMH between the two groups. The poor sleep group exhibited significantly lower levels of AMH and AFC. The FSH levels in the poor sleep group were higher. After the adjustment for confounding factors, multivariate regression analysis results indicated that the per unit increase in PSQI score was associated with increased odds of diminished ovarian reserve (adjusted odds ratio [AOR] of 1.28 for AMH <1.1 ng/mL; 95% confidence interval [CI], 1.20-1.37; AFC <7; AOR, 1.34; 95% CI, 1.25-1.43; FSH ≥10 mIU/mL; AOR, 1.16; 95% CI, 1.08-1.25; AMH <1.1 ng/mL or AFC <7 or FSH ≥10 mIU/mL; AOR, 1.29; 95% CI, 1.22-1.37). Compared with the PSQI ≤5 group, subjects with PSQI >5 had increased odds of diminished ovarian reserve (odds ratio, 3.80; 95% CI, 2.82-5.13; AOR, 4.43; 95% CI, 3.22-6.14). After stratification by age and body mass index, compared with the PSQI ≤5 group, all subgroups of the PSQI >5 group had increased odds of diminished ovarian reserve, especially <35-year-old and body mass index ≤18.4 kg/m subgroups.

CONCLUSION

Poor sleep quality is associated with diminished ovarian reserve in women of reproductive age.

摘要

目的

评估育龄期女性睡眠质量与卵巢储备之间的关联。

设计

横断面研究。

研究对象

2023年2月至2024年1月共纳入1070名年龄在20 - 40岁的女性参与者。

暴露因素

不适用。

主要观察指标

向参与者发放问卷以收集与生殖和生活方式因素相关的基线信息。采用匹兹堡睡眠质量指数（PSQI）来衡量睡眠质量。对卵巢储备进行评估，包括窦卵泡总数（AFC）、抗苗勒管激素（AMH）水平和基础性激素水平。

结果

1070名女性的研究样本平均年龄为31.67±4.41岁。共有314名参与者（29.35%）被归类为睡眠质量差组（PSQI评分>5）。两组在促卵泡生成素（FSH）、黄体生成素、雌二醇、睾酮、AFC和AMH方面存在显著差异。睡眠质量差组的AMH和AFC水平显著较低。睡眠质量差组的FSH水平较高。在对混杂因素进行调整后，多因素回归分析结果表明，PSQI评分每增加一个单位，卵巢储备功能下降的几率增加（AMH<1.1 ng/mL时调整后的优势比[AOR]为1.28；95%置信区间[CI]，1.20 - 1.37；AFC<7时，AOR为1.34；95% CI，1.25 - 1.43；FSH≥10 mIU/mL时，AOR为1.16；95% CI，1.08 - 1.25；AMH<1.1 ng/mL或AFC<7或FSH≥10 mIU/mL时，AOR为1.29；95% CI，1.22 - 1.37）。与PSQI≤5组相比，PSQI>5的受试者卵巢储备功能下降的几率增加（优势比为3.80；95% CI，2.82 - 5.13；AOR为4.43；95% CI，3.22 - 6.14）。按年龄和体重指数分层后，与PSQI≤5组相比，PSQI>5组的所有亚组卵巢储备功能下降的几率均增加，尤其是年龄<35岁且体重指数≤18.4 kg/m²的亚组。