多囊卵巢综合征患者血清miR-143-3p、miR-222-3p及抗苗勒管激素水平检测及其临床价值

林燕玲; 王瑛; 黄颀; 康灵; 邢维珍

doi:10.16766/j.cnki.issn.1674-4152.002726

多囊卵巢综合征患者血清miR-143-3p、miR-222-3p及抗苗勒管激素水平检测及其临床价值

doi: 10.16766/j.cnki.issn.1674-4152.002726

上海儿童医学中心三亚市妇女儿童医院妇科，海南三亚 572000

基金项目:

海南省医药卫生科研基金项目 19A200193

海南省临床医学中心建设项目琼卫(2021)75号

详细信息

通讯作者:
林燕玲, E-mail: lyl_841220@163.com

中图分类号: R711.75 R446.11
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出版历程
- 收稿日期: 2022-05-02
- 网络出版日期: 2022-12-30

Detection and clinical value of serum levels of miR-143-3p, miR-222-3p and AMH in patients with polycystic ovary syndrome

Department of Gynecology, Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center, Sanya, Hainan 572000, China

摘要

摘要: 目的探讨血清miR-143-3p、miR-222-3p水平联合抗苗勒管激素(AMH)在多囊卵巢综合征(PCOS)中的表达及临床价值。方法选取2018年1月—2022年3月三亚市妇女儿童医院收治的128例PCOS患者(PCOS组)和50例健康女性(对照组)。PCOS患者根据胰岛素抵抗指数(HOMA-IR)分为胰岛素抵抗组(83例，HOMA-IR≥2.69)和非胰岛素抵抗组(45例，HOMA-IR＜2.69)；根据BMI分为肥胖组(40例，BMI≥28)和非肥胖组(88例，BMI＜28)；根据睾酮水平分为高雄激素组(71例，睾酮≥0.7 ng/mL)及非高雄激素组(57例，睾酮＜0.7 ng/mL)。采用实时定量PCR法检测血清miR-143-3p及miR-222-3p水平和电化学发光法检测AMH水平。ROC曲线分析miR-143-3p、miR-222-3p联合AMH对PCOS的诊断价值。相关性分析采用Pearson相关分析。结果 PCOS组血清miR-143-3p、miR-222-3p及AMH水平均明显高于对照组，肥胖组明显高于非肥胖组，高雄激素组明显高于非高雄激素组，胰岛素抵抗组明显高于非胰岛素抵抗组，差异均有统计学意义(均P＜0.001)。ROC曲线显示，miR-143-3p、miR-222-3p及AMH三项联合诊断PCOS的曲线下面积最大(AUC=0.910，95% CI：0.852~0.974)。PCOS患者血清miR-143-3p、miR-222-3p水平与AMH均呈正相关关系(r=0.842、0.795，均P＜0.001)。结论 PCOS患者血清miR-143-3p、miR-222-3p及AMH水平明显升高，三项联合检测对PCOS诊断具有较高的价值。
- 多囊卵巢综合征 /
- 微小核糖核酸-143-3p /
- 微小核糖核酸-222-3p /
- 抗苗勒管激素 /
- 诊断价值
Abstract: Objective To investigate the expression and clinical value of serum miR-143-3p, miR-222-3p levels combined with anti-Mullerian hormone (AMH) in polycystic ovary syndrome (PCOS). Methods Total 128 patients with PCOS (PCOS group) treated in Sanya Women and Children's Hospital from January 2018 to March 2022 and 50 healthy women (control group) were selected. According to insulin resistance index (HOMA-IR), PCOS patients were divided into insulin resistance group (n=83, HOMA-IR≥2.69) and non-insulin resistance group (n=45, HOMA-IR < 2.69). According to BMI, PCOS patients were divided into obesity group (n=40, BMI≥28) and non-obesity group (n=88, BMI < 28). According to the level of testosterone, they were divided into hyperandrogen group (n=71, testosterone≥0.7 ng/mL) and non-hyperandrogen group (n=57, testosterone < 0.7 ng/mL). The serum levels of miR-143-3p and miR-222-3p were detected by real-time quantitative PCR, and AMH was detected by electrochemiluminescence. The diagnostic value of miR-143-3p, miR-222-3p combined with AMH in PCOS were analyzed by receiver operating characteristic (ROC) curve. Pearson correlation analysis was used for correlation analysis. Results The serum levels of miR-143-3p, miR-222-3p and AMH in PCOS group were significantly higher than those in control group, those in obesity group was significantly higher than that in non-obesity group, those in hyperandrogen group was significantly higher than that in non-hyperandrogen group, and insulin resistance group was significantly higher than that in non-insulin resistance group, with statistical significance (all P < 0.001). ROC curve showed that the combined diagnosis of PCOS by miR-143-3p, miR-222-3p and AMH had the largest area under the curve (AUC=0.910, 95% CI: 0.852-0.974). The serum levels of miR-143-3p and miR-222-3p in PCOS patients were positively correlated with AMH (r=0.842, 0.795, all P < 0.001). Conclusion The serum levels of miR-143-3p, miR-222-3p and AMH were significantly increased in PCOS patients, and the detection of the three items were helpful for the diagnosis of PCOS.
- Polycystic ovary syndrome /
- MicroRNA-143-3p /
- MicroRNA-222-3p /
- Anti-Mullerian hormone /
- Diagnostic value

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图 1 miR-143-3p、miR-222-3p及AMH诊断PCOS的ROC曲线

Figure 1. ROC curve of diagnosing PCOS with miR-143-3p, miR-222-3p and AMH levels

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表 1 PCOS组和对照组临床资料比较(x±s)

Table 1. Comparison of clinical data between PCOS group and control group (x±s)

组别	例数	年龄(岁)	BMI	腰围(cm)	臀围(cm)	收缩压(mm Hg)	舒张压(mm Hg)
对照组	50	28.95±4.12	23.37±2.45	72.40±8.27	86.35±5.34	116.83±12.26	71.42±7.68
PCOS组	128	29.72±4.83	23.84±2.62	75.93±9.05	89.16±7.18	119.40±12.53	74.25±9.46
t值		0.962	1.105	1.594	1.353	0.672	0.735
P值		0.328	0.264	0.152	0.176	0.479	0.430

组别	例数	空腹血糖(mmol/L)	HOMA-IR	LH(mIU/mL)	FSH(mIU/mL)	LH/FSH	睾酮(ng/mL)
对照组	50	5.20±0.53	1.76±0.45	5.63±0.64	8.74±0.90	0.62±0.07	0.47±0.14
PCOS组	128	5.74±1.65	4.60±2.57	8.40±0.75	6.91±0.38	1.26±0.15	1.77±0.38
t值		1.183	6.894	5.537	3.896	6.724	5.952
P值		0.241	＜0.001	＜0.001	0.012	＜0.001	＜0.001
注：1 mm Hg=0.133 kPa。

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表 2 PCOS组和对照组血清miR-143-3p、miR-222-3p及AMH水平比较(x±s)

Table 2. Comparison of serum miR-143-3p, miR-222-3p and AMH levels between PCOS group and control group (x±s)

组别	例数	miR-143-3p	miR-222-3p	AMH(ng/mL)
对照组	50	0.91±0.24	0.68±0.15	3.38±1.35
PCOS组	128	2.96±1.17	1.73±0.66	9.86±2.74
t值		17.582	14.305	14.713
P值		＜0.001	＜0.001	＜0.001

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表 3 肥胖组、非肥胖组和对照组血清miR-143-3p、miR-222-3p及AMH水平比较(x±s)

Table 3. Comparison of serum miR-143-3p, miR-222-3p and AMH levels between obese group and non obese group (x±s)

组别	例数	miR-143-3p	miR-222-3p	AMH(ng/mL)
对照组	50	0.91±0.24	0.68±0.15	3.38±1.35
非肥胖组	88	1.16±0.35	0.75±0.20	4.20±1.46
肥胖组	40	4.85±1.63^ab	2.79±1.08^ab	15.58±5.24^ab
F值		21.152	16.625	19.583
P值		＜0.001	＜0.001	＜0.001
注：与对照组比较，^aP＜0.001；与非肥胖组比较，^bP＜0.001。

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表 4 高雄激素组、非高雄激素组和对照组血清miR-143-3p、miR-222-3p及AMH水平比较(x±s)

Table 4. Comparison of serum miR-143-3p, miR-222-3p and AMH levels between hyperandrogen group and non hyperandrogen group (x±s)

组别	例数	miR-143-3p	miR-222-3p	AMH(ng/mL)
对照组	50	0.91±0.24	0.68±0.15	3.38±1.35
非高雄激素组	57	1.83±0.71^a	1.42±0.46^a	7.30±2.17^a
高雄激素组	71	4.06±1.45^ab	2.02±0.84^ab	12.69±4.18^ab
F值		19.216	14.973	19.542
P值		＜0.001	＜0.001	＜0.001
注：与对照组比较，^aP＜0.001；与非高雄激素组，^bP＜0.001。

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表 5 胰岛素抵抗组、非胰岛素抵抗组和对照组血清miR-143-3p、miR-222-3p及AMH水平比较(x±s)

Table 5. Comparison of serum miR-143-3p, miR-222-3p and AMH levels between insulin resistance group and non insulin resistance group (x±s)

组别	例数	miR-143-3p	miR-222-3p	AMH(ng/mL)
对照组	50	0.91±0.24	0.68±0.15	3.38±1.35
非胰岛素抵抗组	45	1.79±0.68^a	1.38±0.43^a	7.60±2.24^a
胰岛素抵抗组	83	4.13±1.47^ab	2.10±0.86^ab	12.42±4.13^ab
F值		20.763	15.810	16.284
P值		＜0.001	＜0.001	＜0.001
注：与对照组比较，^aP＜0.001；与非胰岛素抵抗组，^bP＜0.001。

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表 6 血清miR-143-3p、miR-222-3p及AMH水平对PCOS的诊断价值

Table 6. Diagnostic value of serum levels of miR-143-3p, miR-222-3p and AMH in PCOS

项目	最佳截断值	AUC	95% CI	灵敏度(%)	特异度(%)	阳性预测值(%)	阴性预测值(%)
miR-143-3p	2.04	0.834	0.776~0.895	85.8	80.2	83.5	82.4
miR-222-3p	1.28	0.787	0.731~0.850	81.6	74.8	72.0	79.5
AMH(ng/mL)	6.97	0.814	0.755~0.871	83.5	76.0	79.2	80.8
三项联合		0.910	0.852~0.974	96.0	78.7	83.0	92.4

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