Cao Yacong, Ding Miao, Chen Jingbo, Zhang Chaofan, He Fengyi, Li Xiaojia, Jiang Sushi, Zou Yanting, Yang Dongzi, Zhao Xiaomiao
Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Reproductive Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Medicine (Baltimore). 2025 May 30;104(22):e42373. doi: 10.1097/MD.0000000000042373.
This study aimed to investigate the association between insulin resistance (IR) and recurrent pregnancy loss (RPL) in patients undergoing assisted reproductive technology (ART). A retrospective analysis compared glucose and insulin indices (including fasting insulin [FINS], Homeostatic Model Assessment for Insulin Resistance [HOMA-IR], Homeostatic Model Assessment for Beta-Cell Function [HOMA-β], and area under the curve for insulin [AUCI] between RPL (n = 279) and non-RPL (n = 246) groups. Adjusted logistic regression models evaluated the correlation between IR-related indices and RPL risk. Compared with the non-RPL group, the RPL group exhibited significantly higher levels of FINS (10.67 vs. 8.57; P < .001), 1-hour insulin (1hINS) (110.86 vs. 74.75; P = .005), 2-hour insulin (2hINS) (89.47 vs. 67.94, P = .023), AUCI (117.08 vs. 114.16; P = .004), HOMA-IR (2.5 vs. 1.94; P < .001), HOMA-β (138.31 vs. 107.84; P < .001), the incidence of insulin resistance (63.47% vs. 47.03%; P < .001), and the incidence of HOMA-IR ≥ 2.14 (61.9% vs. 40.27%; P < .001). After adjusting for other factors, patients with IR had a higher risk of developing RPL compared with those without IR, with an odds ratio (OR) of 1.87 (95% CI: 1.18-2.94). Furthermore, an increase in FINS, HOMA-IR, and HOMA-β was associated with a significantly higher incidence of RPL, with OR values (95% CI) of 1.07 (1.03-1.12), 1.23 (1.03-1.48), and 1.01 (1.0-1.01), respectively. IR is an independent risk factor for RPL in ART patients, emphasizing the need for pretreatment interventions (e.g., lifestyle modifications or metformin) to improve insulin sensitivity and reduce miscarriage risk.
本研究旨在调查接受辅助生殖技术（ART）的患者中胰岛素抵抗（IR）与复发性流产（RPL）之间的关联。一项回顾性分析比较了RPL组（n = 279）和非RPL组（n = 246）之间的血糖和胰岛素指标（包括空腹胰岛素[FINS]、胰岛素抵抗稳态模型评估[HOMA-IR]、β细胞功能稳态模型评估[HOMA-β]以及胰岛素曲线下面积[AUCI]）。调整后的逻辑回归模型评估了IR相关指标与RPL风险之间的相关性。与非RPL组相比，RPL组的FINS水平显著更高（10.67对8.57；P <.001）、1小时胰岛素（1hINS）水平（110.86对74.75；P =.005）、2小时胰岛素（2hINS）水平（89.47对67.94，P =.023）、AUCI（117.08对114.16；P =.004）、HOMA-IR（2.5对1.94；P <.001）、HOMA-β（138.31对107.
