| 摘要: |
| 目的 探讨血清孕激素受体膜组分1（PGRMC1）、生长分化因子-8（GDF-8）水平与多囊卵巢综合征（PCOS）孕妇妊娠结局的相关性。方法 按照2:1比例前瞻性选取2023年4月～2024年5月邢台市中心医院产科收治的PCOS孕妇160例（PCOS组）和同期健康孕妇80例（对照组），根据妊娠结局将PCOS孕妇分为不良组和良好组。检测血清PGRMC1、GDF-8水平和计算稳态模型评估-胰岛素抵抗指数（HOMA-IR）。通过Spearman相关分析PCOS孕妇血清PGRMC1、GDF-8水平与HOMA-IR的相关性；多因素Logistic回归分析PCOS孕妇妊娠结局的因素，ROC曲线分析血清PGRMC1、GDF-8水平对PCOS孕妇妊娠结局不良的预测能效。结果 与对照组比较，PCOS组血清PGRMC1、GDF-8水平和HOMA-IR升高（P＜0.05）。PCOS孕妇血清PGRMC1、GDF-8水平与HOMA-IR呈正相关（rs＝0.690、0.683，P＜0.001）。160例PCOS孕妇妊娠结局不良率为40.63%（65/160）。与良好组比较，不良组血清PGRMC1、GDF-8水平和HOMA-IR升高（P＜0.05）。PCOS孕妇妊娠结局不良的独立危险因素为黄体生成素/促卵泡生成素、HOMA-IR、低密度脂蛋白胆固醇、PGRMC1、GDF-8（P＜0.05）。血清PGRMC1、GDF-8水平及二者联合预测PCOS孕妇妊娠结局不良的曲线下面积为0.834、0.814、0.910，二者联合优于血清PGRMC1、GDF-8水平单独预测能效（P＜0.05）。结论 PCOS孕妇血清PGRMC1、GDF-8水平升高，与IR加重及不良妊娠结局相关，血清PGRMC1、GDF-8水平联合对妊娠结局的预测能效较高。 |
| 关键词: 多囊卵巢综合征 孕激素受体膜组分1 生长分化因子-8 胰岛素抵抗 妊娠结局 |
| DOI： |
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| 基金项目:1、河北省卫生健康委科研基金项目（20200444） 2、邢台市重点研发计划自筹项目（2023ZC100） |
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| Correlation Between Serum PGRMC1, GDF-8 Levels and Pregnancy Outcomes in Pregnant Women with Polycystic Ovary Syndrome |
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孔玉玲, lijuan, zhaogang, dongshuxiao
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Xingtai Central Hospital
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| Abstract: |
| Objective To investigate the correlation between serum levels of progesterone receptor membrane component 1 (PGRMC1) and growth differentiation factor-8 (GDF-8) and pregnancy outcomes in women with polycystic ovary syndrome (PCOS). Methods A total of 160 pregnant women with PCOS who were admitted to the Department of Obstetrics at Xingtai Central Hospital from April 2023 to May 2024 were prospectively enrolled as the PCOS group, and 80 healthy pregnant women during the same period were selected as the control group at a 2:1 ratio. Based on pregnancy outcomes, the PCOS group was further divided into the poor outcome group and the good outcome group. Serum PGRMC1 and GDF-8 levels were measured using enzyme-linked immunosorbent assay, and the homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. Spearman correlation analysis was used to assess the relationship between serum PGRMC1, GDF-8 levels, and HOMA-IR in PCOS patients. Multivariate logistic regression was conducted to identify independent factors associated with adverse pregnancy outcomes. Multivariate logistic regression and ROC analysis were performed to identify factors associated with pregnancy outcomes and to evaluate the predictive efficacy of serum PGRMC1 and GDF-8 levels. Results Serum PGRMC1, GDF-8 levels, and HOMA-IR were significantly higher in the PCOS group compared to the control group (P＜0.05). In PCOS patients, serum PGRMC1 and GDF-8 levels were positively correlated with HOMA-IR (rs＝0.690, 0.683, P＜0.001). The incidence of adverse pregnancy outcomes among PCOS patients was 40.63% (65/160). Compared to the favorable outcome group, the adverse outcome group showed significantly elevated levels of PGRMC1, GDF-8, and HOMA-IR (P＜0.05). Luteinizing hormone/follicle-stimulating hormone ratio, HOMA-IR, low-density lipoprotein cholesterol, PGRMC1, and GDF-8 were identified as independent risk factors for adverse pregnancy outcomes in PCOS patients (P＜0.05). The area under the curve (AUC) for predicting adverse pregnancy outcomes using serum PGRMC1, GDF-8, and their combination was 0.834, 0.814, and 0.910, respectively, with the combined model showing superior predictive performance (P＜0.05). Conclusion Elevated serum levels of PGRMC1 and GDF-8 in PCOS pregnant women are associated with increased insulin resistance and adverse pregnancy outcomes. The combination of serum PGRMC1 and GDF-8 levels demonstrates high predictive efficacy for adverse pregnancy outcomes. |
| Key words: Polycystic ovary syndrome Progesterone receptor membrane component 1 Growth differentiation factor-8 Insulin resistance Pregnancy outcomes |