Center for Reproductive Medicine, Yantaishan Hospital, Yantai, Shandong, China.
PLoS One. 2024 Oct 7;19(10):e0311618. doi: 10.1371/journal.pone.0311618. eCollection 2024.
Infertility is a significant national public health concern, and the World Health Organization (WHO) predicts that it will rank as the third most prevalent disease following tumors, cardiovascular and cerebrovascular diseases. The impact of dysfunctional lipoproteins on female infertility remains relatively understudied; therefore, the research focuses on exploring the relationship between serum high-density lipoprotein (HDL) concentration and infertility.
This is a retrospective cross-sectional study where we employed multivariate logistic regression analysis to examine the association between serum HDL concentrations and female infertility. The strength of association was quantified using odds ratios (OR) along with their corresponding 95% confidence intervals and statistical significance was evaluated at a level of P < 0.05 (two-tailed).
The study found that there was a significant correlation between serum HDL and infertility without adjusting the model (OR = 0.62, 95%CI 0.48-0.82, P<0.001). After adjusting for covariates, a weak correlation between HDL and infertility remained (OR = 0.70, 95%CI 0.49-1.00). When HDL concentrations were divided into quartiles, there was a trend of strengthened correlation between HDL and infertility risk with the increase in HDL concentrations. Specifically, individuals in the highest concentration quartile exhibited a 44.0% lower risk of infertility compared to those in the lowest concentration quartile (95% CI 0.38-0.84). In the age-stratified analysis, after adjusting for covariates, the correlation between HDL and infertility was statistically insignificant across all age groups. Furthermore, after categorizing HDL levels into quartiles, we observed a dose-dependent trend between HDL and the reduction of female infertility risk in the adjusted models of the secondary infertility group. Specifically, in the adjusted model, the high-concentration group exhibited a 67.0% lower risk of infertility compared to the low-concentration group (OR = 0.33; 95% CI: 0.12-0.940, P = 0.04).
Our research findings suggest weak negative correlation between serum HDL and female infertility. However, upon stratified analysis by age, the correlation between HDL and infertility did not attain statistical significance. In cases of secondary infertility, a subtle dose-dependent trend was observed between serum HDL and infertility.
不孕是一个重大的国家公共卫生问题，世界卫生组织（WHO）预测，它将成为继肿瘤、心血管和脑血管疾病之后的第三大常见疾病。脂蛋白功能障碍对女性不孕的影响仍相对研究不足；因此，本研究重点探讨血清高密度脂蛋白（HDL）浓度与不孕之间的关系。
这是一项回顾性的横断面研究，我们采用多变量逻辑回归分析来检查血清 HDL 浓度与女性不孕之间的关系。使用优势比（OR）及其相应的 95%置信区间来量化关联的强度，并使用 P<0.05（双侧）评估统计学意义。
研究发现，在不调整模型的情况下，血清 HDL 与不孕之间存在显著相关性（OR=0.62，95%CI 0.48-0.82，P<0.001）。在调整协变量后，HDL 与不孕之间仍存在弱相关性（OR=0.70，95%CI 0.49-1.00）。当 HDL 浓度分为四分位时，HDL 与不孕风险之间的相关性呈增强趋势，随着 HDL 浓度的升高而增强。具体来说，与最低浓度四分位组相比，最高浓度四分位组的不孕风险降低了 44.0%（95%CI 0.38-0.84）。在年龄分层分析中，在调整协变量后，HDL 与不孕之间的相关性在所有年龄组均无统计学意义。此外，在将 HDL 水平分为四分位后，我们在调整后的继发不孕组模型中观察到 HDL 与降低女性不孕风险之间存在剂量依赖性趋势。具体来说，在调整模型中，与低浓度组相比，高浓度组的不孕风险降低了 67.0%（OR=0.33；95%CI：0.12-0.940，P=0.04）。
我们的研究结果表明，血清 HDL 与女性不孕之间存在微弱的负相关。然而，在按年龄分层分析时，HDL 与不孕之间的相关性没有达到统计学意义。在继发不孕的情况下，血清 HDL 与不孕之间存在微妙的剂量依赖性趋势。
