Chen Yiming, Li Yuanyuan, Zhang Bo, Xia Wei, Feng Xingliang
Department of Urology, The First People'S Hospital of Changzhou, Changzhou, Jiangsu, China.
Department of Urology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China.
Sci Rep. 2025 Apr 17;15(1):13334. doi: 10.1038/s41598-025-97243-5.
Female infertility is a prevalent condition closely linked with obesity. Current evaluation metrics like body mass index (BMI) and waist circumference (WC) have limitations. Relative fat mass (RFM) is a newer, more accurate obesity metric, but its relationship with infertility lacks research. Data from 3489 female participants aged 18-45 years from the NHANES 2013-2020 cycles were extracted and analyzed. Infertility was assessed based on participants' pregnancy attempts and medical consultations. The primary exposure variables were BMI, WC, and RFM. Survey-weighted logistic regression models were conducted to compare their associations with infertility, expressed as odds ratios (ORs). RFM was further categorized into quartiles for additional regression analysis. Subgroup analyses were conducted to evaluate whether the association between RFM and infertility differs across key demographic and clinical factors, including age, race, PIR, education level, BMI, smoking status, DM, hypertension, age at menarche, and history of pelvic inflammatory disease (PID). Restricted cubic splines (RCS) were employed for robustness and linearity assessments. Our results showed an infertility prevalence of 13.41%, with affected women being older and having higher BMI. The OR (1.039, 95% CI: 1.010, 1.068) for RFM in regression analysis of fully adjusted Model was higher than for BMI (1.020, 95% CI: 1.002, 1.039) and WC (1.014, 95% CI: 1.006, 1.022), indicating that each unit increase in RFM correlates with a higher risk of infertility. Similarly, quartile analysis of fully adjusted Model indicated increased infertility risk with higher RFM quartiles (Q2: OR = 1.66, 95% CI: 1.05, 2.64; Q3: OR = 1.79, 95% CI: 1.16, 2.74; Q4: OR = 2.23, 95% CI: 1.38, 3.60). Additionally, results were consistent in the supplementary subgroup analysis without interaction, and RCS confirmed a linear relationship. Our findings demonstrate a significant association between RFM and female infertility in a population-based sample, supporting the hypothesis that excess adiposity may play a role in reproductive health. Further research is needed to explore the mechanisms and broader applications of RFM in female reproductive health.
女性不孕症是一种与肥胖密切相关的普遍病症。当前的评估指标，如体重指数（BMI）和腰围（WC）存在局限性。相对脂肪量（RFM）是一种更新的、更准确的肥胖指标，但其与不孕症的关系缺乏研究。我们提取并分析了来自2013 - 2020年美国国家健康与营养检查调查（NHANES）周期的3489名18 - 45岁女性参与者的数据。根据参与者的受孕尝试和医疗咨询情况评估不孕症。主要暴露变量为BMI、WC和RFM。进行了调查加权逻辑回归模型，以比较它们与不孕症的关联，以优势比（OR）表示。RFM进一步分为四分位数进行额外的回归分析。进行亚组分析以评估RFM与不孕症之间的关联在关键人口统计学和临床因素（包括年龄、种族、贫困收入比、教育水平、BMI、吸烟状况、糖尿病、高血压、初潮年龄和盆腔炎病史（PID））之间是否存在差异。采用受限立方样条（RCS）进行稳健性和线性评估。我们的结果显示不孕症患病率为13.41%，受影响的女性年龄更大且BMI更高。在完全调整模型的回归分析中，RFM的OR（1.039，95%可信区间：1.010，1.068）高于BMI（1.020，95%可信区间：1.002，1.039）和WC（1.014，95%可信区间：1.006，1.022），表明RFM每增加一个单位与不孕症风险更高相关。同样，完全调整模型的四分位数分析表明，RFM四分位数越高，不孕症风险增加（Q2：OR = 1.66，95%可信区间：l.05，2.64；Q3：OR = l.79，95%可信区间：1.16，2.74；Q4：OR = 2.23，95%可信区间：1.38，3.60）。此外，在无交互作用的补充亚组分析中结果一致，并且RCS证实了线性关系。我们的研究结果表明，在基于人群的样本中，RFM与女性不孕症之间存在显著关联，支持了肥胖过多可能在生殖健康中起作用的假设。需要进一步研究以探索RFM在女性生殖健康中的机制和更广泛的应用。
