HIF-1α、VEGF及AMH在多囊卵巢综合征中的表达及其临床意义

秦薇; 黄筱竑; 黄慧莲

doi:10.16766/j.cnki.issn.1674-4152.002144

HIF-1α、VEGF及AMH在多囊卵巢综合征中的表达及其临床意义

doi: 10.16766/j.cnki.issn.1674-4152.002144

1.
湖州市中心医院，湖州师范学院附属中心医院妇产科，浙江湖州 313003
2.
湖州市中心医院，湖州师范学院附属中心医院中心实验室，浙江湖州 313003

基金项目:

浙江省医药卫生科技计划项目 2019ZH043

详细信息

通讯作者:
秦薇，E-mail: wei20032003@163.com

中图分类号: R711.75 R446
计量
- 文章访问数: 160
- HTML全文浏览量: 144
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2021-02-18
- 网络出版日期: 2022-02-15

Expression and clinical significance of HIF-1α, VEGF and AMH in patients with polycystic ovary syndrome

1.
Department of Obstetrics and Gynecology, Huzhou Central Hospital, Huzhou Normal College Affiliated Central Hospital, Huzhou, Zhejiang 313003, China

摘要

摘要: 目的研究缺氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)和抗苗勒管激素(AMH)在多囊卵巢综合征(PCOS)中的表达水平，探讨其临床意义。方法选择2018年6月—2020年6月湖州市中心医院收治的130例PCOS患者为观察组，同期100例健康女性为对照组，采用免疫化学发光法检测卵泡刺激素(FSH)、黄体生成素(LH)、泌乳素(PRL)、睾酮(T)、孕酮(P)和雌二醇(E2)水平，酶联免疫吸附法检测血清HIF-1α、VEGF和AMH水平，分析HIF-1α、VEGF和AMH的相关性及对PCOS的预测价值。结果观察组患者的FSH[(5.81±0.92)mU/mL]、LH[(10.54±0.72)mU/mL]、PRL[(398.55±80.47)ng/mL]、T[(7.76±2.27)nmol/L]、P[(5.29±0.92)nmol/L]、E2[(118.63±42.78)pmol/L]显著高于对照组(t值为3.179、12.150、4.284、11.223、43.724、3.955，均P＜0.05)。观察组患者HIF-1α[(163.12±25.17)pg/L]、VEGF[(257.03±30.45)pg/L]和AMH[(7.29±1.02)pg/L]显著高于对照组(t值为42.592、31.612、47.194，均P < 0.05)。HIF-1α与VEGF、AMH水平均呈正相关(r=0.811、0.848、0.762，均P < 0.05)。血清HIF-1α、VEGF及AMH曲线下面积分别为0.764、0.731、0.742，95%CI分别为0.681~0.852、0.634~0.819、0.649~0.827。结论 PCOS患者HIF-1α、VEGF及AMH水平显著升高，对PCOS具有较高的预测价值，可作为临床诊断的指标。
- 多囊卵巢综合征 /
- 低氧诱导因子-1α /
- 血管内皮生长因子 /
- 抗苗勒管激素
Abstract: Objective To study the expression of hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) and anti-Mullerian hormone (AMH) in polycystic ovary syndrome (PCOS) and to explore their clinical significance. Methods A total of 130 cases of PCOS patients in our hospital from June 2018 to June 2020 were selected as the observation group, and 100 healthy women were recruited as the control group. The levels of follicle stimulating hormone (FSH), luteinising hormone (LH), prolactin (PRL), testosterone (T), progesterone (P) and estradiol (E2) were measured by immunochemiluminescence. The serum HIF-1α, VEGF and AMH levels were detected by enzyme-linked immunosorbent assay. The correlation between HIF-1α, VEGF and AMH and the predictive value of PCOS clinical significance were analysed. Results The levels of FSH [(5.81±0.92) mU/mL], LH [(10.54±0.72) mU/mL], PRL [(398.55±80.47) ng/mL], T [(7.76±2.27) nmol/L], P [(5.29±0.92) nmol/L] and E2 [(118.63±42.78) pmol/L] in the observation group were significantly higher than those in the control group (t=3.179, 12.150, 4.284, 11.223, 43.724 and 3.955, all P < 0.05). The levels of HIF-1α [(163.12±25.17) pg/L], VEGF [(257.03±30.45) pg/L] and AMH [(7.29±1.02) pg/L] in the observation group were significantly higher than those in the control group (t=42.592, 31.612 and 47.194, all P < 0.05). HIF-1α was positively correlated with VEGF and AMH levels (r=0.811, 0.848 and 0.762, all P < 0.05). The areas under the curve of serum HIF-1α, VEGF and AMH were 0.764, 0.731 and 0.742, and 95% confidence intervals were 0.681-0.852, 0.634-0.819 and 0.649-0.827, respectively. Conclusion The levels of HIF-1α, VEGF and AMH in patients with PCOS are significantly increased, which have high predictive value for PCOS and can be used as clinical diagnostic indicators.
- Polycystic ovary syndrome /
- Hypoxia-inducible factor-1α /
- Vascular endothelial growth factor /
- Anti-Mullerian hormone

HTML全文

图 1 血清HIF-1α、VEGF及AMH水平对PCOS的预测价值

下载: 全尺寸图片幻灯片

表 1 2组研究对象一般资料比较(x ±s)

组别	例数	年龄(岁)	身高(cm)	体重(kg)	BMI
对照组	100	32.12±4.25	159.64±8.61	62.09±6.12	24.36±2.86
观察组	130	31.97±4.86	160.11±9.03	63.18±6.54	24.61±3.12
t值		0.245	0.399	1.288	0.624
P值		0.807	0.690	0.199	0.533

下载: 导出CSV

表 2 2组研究对象内分泌代谢指标比较(x ±s)

组别	例数	FSH(mU/mL)	LH(mU/mL)	PRL(ng/mL)	T(nmol/L)	P(nmol/L)	E2(pmol/L)
对照组	100	5.43±0.87	9.12±1.05	351.27±86.12	4.81±1.51	1.01±0.38	98.12±33.41
观察组	130	5.81±0.92	10.54±0.72	398.55±80.47	7.76±2.27	5.29±0.92	118.63±42.78
t值		3.179	12.150	4.284	11.223	43.724	3.955
P值		0.002	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 3 2组研究对象HIF-1α、VEGF及AMH比较(x ±s，pg/L)

组别	例数	HIF-1α	VEGF	AMH
对照组	100	37.26±17.64	141.38±23.11	2.17±0.42
观察组	130	163.12±25.17	257.03±30.45	7.29±1.02
t值		42.592	31.612	47.194
P值		< 0.001	< 0.001	< 0.001

下载: 导出CSV

表 4 血清HIF-1α、VEGF及AMH的ROC分析结果

项目	AUC	截断值(pg/L)	敏感度(%)	特异度(%)	95%CI
HIF-1α	0.764	135.17	64.62	80.77	0.681~0.852
VEGF	0.731	204.21	72.31	73.08	0.634~0.819
AMH	0.742	5.98	66.92	83.85	0.649~0.827

下载: 导出CSV

参考文献(19)

[1]	MANN A, SAGILI H, SUBBAIAH M. Pregnancy outcome in women with polycystic ovary syndrome[J]. J Obstet Gynaecol India, 2020, 70(5): 360-365. doi: 10.1007/s13224-020-01356-y
[2]	刘洪娟, 易蕾, 岳进, 等. 朱琏针法治疗肥胖型多囊卵巢综合征的疗效及对患者生活质量的影响[J]. 中华全科医学, 2019, 17(4): 601-604.
[3]	WANG J, WU X H. The effects of mitochondrial dysfunction on energy metabolism switch by HIF-1α signalling in granulosa cells of polycystic ovary syndrome[J]. Endokrynol Pol, 2020, 71(2): 134-145. doi: 10.5603/EP.a2020.0002
[4]	BAO L, SYED R, ALOAHD M S. Analysis of VEGF gene polymorphisms and serum VEGF protein levels contribution in polycystic ovary syndrome of patients[J]. Mol Biol Rep, 2019, 46(6): 5821-5829. doi: 10.1007/s11033-019-05015-y
[5]	GOMES M K O, ANTONINO D C, BALARIN M A S, et al. Haplotype analysis of VEGF gene polymorphisms in polycystic ovary syndrome[J]. Gynecol Endocrinol, 2019, 35(10): 847-850. doi: 10.1080/09513590.2019.1604659
[6]	KUYUCU Y, SENCAR L, TAP Ö, et al. Investigation of the effects of vitamin D treatment on the ovarian AMH receptors in a polycystic ovary syndrome experimental model: An ultrastructural and immunohistochemical study[J]. Reprod Biol, 2020, 20(1): 25-32. doi: 10.1016/j.repbio.2020.01.001
[7]	CALZADA M, LOPEZ N, NOGUERA J A, et al. AMH in combination with SHBG for the diagnosis of polycystic ovary syndrome[J]. J Obstet Gynaecol, 2019, 39(8): 1130-1136. doi: 10.1080/01443615.2019.1587604
[8]	BELOSI C, SELVAGGI L, APA R, et al. Is the PCOS diagnosis solved by ESHRE/ASRM 2003 consensus or could it include ultrasound examination of the ovarian stroma?[J]. Hum Reprod, 2006, 21(12): 3108-3115. doi: 10.1093/humrep/del306
[9]	中华医学会妇产科学分会内分泌学组及指南专家组. 多囊卵巢综合征中国诊疗指南[J]. 中华妇产科杂志, 2018, 53(1): 2-6. doi: 10.3760/cma.j.issn.0529-567x.2018.01.002
[10]	胡斌. 抗苗勒管激素和内分泌代谢指标在多囊卵巢综合征诊断中的应用[J]. 当代医学, 2020, 26(26): 153-154. doi: 10.3969/j.issn.1009-4393.2020.26.066
[11]	叶娅琼, 蒋瑶枝, 陈君霞, 等. 子宫内膜预处理对多囊卵巢综合征不孕患者的促排卵疗效[J]. 中华全科医学, 2020, 18(9): 1530-1533. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202009029.htm
[12]	乔杰, 齐新宇, 徐雅兰, 等. 关注影响女性健康的重要生殖内分泌疾病多囊卵巢综合征[J]. 中国实用妇科与产科杂志, 2020, 36(1): 1-9. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF202001001.htm
[13]	王笑颜, 王海燕, 沈翠芬, 等. 多囊卵巢综合征人群血清胰岛素抵抗与内分泌激素的临床分析[J]. 中国卫生检验杂志, 2020, 30(7): 843-845. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWJZ202007022.htm
[14]	BAHRAMREZAIE M, AMIDI F, ALEYASIN A, et al. Effects of resveratrol on VEGF & HIF1 genes expression in granulosa cells in the angiogenesis pathway and laboratory parameters of polycystic ovary syndrome: A triple-blind randomized clinical trial[J]. J Assist Reprod Genet, 2019, 36(8): 1701-1712. doi: 10.1007/s10815-019-01461-6
[15]	金纬纬, 蔡平生, 方轶萍, 等. 多囊卵巢综合征患者子宫内膜HIF-1α表达及与子宫内膜容受性的关系[J]. 浙江中西医结合杂志, 2016, 26(7): 612-614, 626. doi: 10.3969/j.issn.1005-4561.2016.07.006
[16]	张莉. 血清ES、VEGF水平和多囊卵巢综合征患者血清胰岛素及卵巢间质血流的相关性分析[J]. 中国性科学, 2020, 29(2): 78-81. https://www.cnki.com.cn/Article/CJFDTOTAL-XKXZ202002025.htm
[17]	蒋雪霞, 尹道英, 李晓玲, 等. 血清VEGF、ES水平与多囊卵巢综合征患者卵巢间质血流的关系[J]. 中国医药导报, 2019, 16(15): 85-87, 99. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY201915022.htm
[18]	KUREK E M, SAHIN E G, YAYLA A C, et al. Association between circulating neuregulin 4 levels and metabolic, aterogenic, and AMH profile of polycystic ovary syndrome[J]. J Obstet Gynaecol, 2019, 39(7): 975-980. doi: 10.1080/01443615.2019.1581754
[19]	丁娇, 邵军晖, 简皓, 等. 抗苗勒氏管激素(AMH)与多囊卵巢综合征相关性的临床研究[J]. 当代医学, 2018, 24(28): 93-95. doi: 10.3969/j.issn.1009-4393.2018.28.037