Ding Ziyin, Liao Kai, Liang Kun, Zhang Shuo, Pei Zhenle, Zhang Feifei, Zhou Liming, Xu Congjian
Center for Reproductive Medicine, Women and Children's Hospital of Ningbo University, Ningbo, China.
Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Front Endocrinol (Lausanne). 2025 Jul 30;16:1629837. doi: 10.3389/fendo.2025.1629837. eCollection 2025.
To investigate the associations between triglyceride glucose-body mass index (TyG-BMI) and reproductive outcomes in women with polycystic ovary syndrome (PCOS) undergoing frozen embryo transfer (FET).
This retrospective cohort study included PCOS women undergoing their first fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle followed by FET from January 2018 to January 2024 at a single reproductive medicine center. Patients were categorized into four groups according to the quartiles of TyG-BMI. Multivariable logistic regression, restricted cubic splines (RCS) and stratified analyses were used to evaluate the associations between TyG-BMI and reproductive outcomes. LASSO regression was performed to identify predictors for miscarriage and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive power.
A total of 744 women were included in the analysis. After adjusting for covariates, TyG-BMI showed a negative correlation with live birth rate and positive correlations with the risks of miscarriage and gestational diabetes mellitus (GDM) (all P trend < 0.05). RCS models demonstrated linear relationships of TyG-BMI with miscarriage rate, GDM risk and large for gestational age risk (P-overall < 0.05, P-nonlinear > 0.05). These associations remained consistent across all subgroups of the population (all P-interaction > 0.05). ROC analysis revealed that TyG-BMI was predictive of miscarriage (area under the curve (AUC) = 0.627, P < 0.001) with a cutoff value of 180.4. Combined with other identified risk factors, including basal luteinizing hormone, basal follicle stimulating hormone, total cholesterol, testosterone, infertility type and controlled ovarian stimulation protocols, the AUC value increased (AUC = 0.667, P < 0.001) and this model showed good miscarriage prediction performance in most subgroups (AUC > 0.650, P < 0.05), especially in patients with normal or low weight (BMI < 24 kg/m, AUC = 0.743, P < 0.001).
Higher TyG-BMI levels are independently associated with an increased risk of adverse reproductive outcomes in women with PCOS undergoing FET. Additionally, TyG-BMI proves to be a cost-effective tool for the early identification of high-risk groups among PCOS patients, enabling personalized interventions prior to IVF to optimize reproductive outcomes in this population.
探讨多囊卵巢综合征（PCOS）患者在接受冻融胚胎移植（FET）时，甘油三酯葡萄糖-体重指数（TyG-BMI）与生殖结局之间的关联。
这项回顾性队列研究纳入了2018年1月至2024年1月在一家生殖医学中心接受首次体外受精（IVF）或卵胞浆内单精子注射（ICSI）周期并随后进行FET的PCOS女性。根据TyG-BMI的四分位数将患者分为四组。采用多变量逻辑回归、受限立方样条（RCS）和分层分析来评估TyG-BMI与生殖结局之间的关联。进行LASSO回归以确定流产的预测因素，并使用受试者工作特征（ROC）曲线分析来评估预测能力。
共有744名女性纳入分析。在调整协变量后，TyG-BMI与活产率呈负相关，与流产风险和妊娠期糖尿病（GDM）风险呈正相关（所有P趋势<0.05）。RCS模型显示TyG-BMI与流产率、GDM风险和大于胎龄风险呈线性关系（总体P<0.05，非线性P>0.05）。这些关联在所有亚组人群中均保持一致（所有P交互作用>0.05）。ROC分析显示，TyG-BMI可预测流产（曲线下面积（AUC）=0.627，P<0.001），截断值为180.4。结合其他已确定的风险因素，包括基础促黄体生成素、基础促卵泡生成素、总胆固醇、睾酮、不孕类型和控制性卵巢刺激方案，AUC值增加（AUC=0.667，P<0.001），该模型在大多数亚组中显示出良好的流产预测性能（AUC>.650，P<0.05），尤其是在体重正常或偏低（BMI<24kg/m）的患者中（AUC=0.743，P<0.001）。
较高的TyG-BMI水平与接受FET的PCOS女性不良生殖结局风险增加独立相关。此外，TyG-BMI被证明是一种具有成本效益的工具，可用于早期识别PCOS患者中的高危人群，从而在IVF前进行个性化干预，以优化该人群的生殖结局。
