PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the effects of β-cell dysfunction on IVF outcomes in women with PCOS.
UNASSIGNED: This retrospective cohort study includes 1,212 women with PCOS undergoing their first IVF cycle between September 2010 and December 2019. Beta-cell dysfunction was measured by homeostasis model assessment of β-cell function (HOMA-β) index.
UNASSIGNED: In quartiles of HOMA-β, the incidence of miscarriage dramatically increased from 10.2% (Q1) to 31.1% (Q4) (P for trend <0.001). Likewise, the incidence of miscarriage in quartiles of HOMA-β also showed a similar trend (P for trend <0.001). After adjusting for confounding factors, logistic regression analyses showed that high HOMA-IR values were independently associated with a high risk of miscarriage, with the odds ratios (OR) and 95% confidence intervals for quartiles 2-4 versus quartile 1 were 1.30 (0.69-2.46), 1.82 (0.97-3.43), and 3.57 (1.86-6.85), respectively (P for trend <0.001). When analyzed jointly, women in the highest HOMA-IR and highest HOMA-β group exhibited the highest risk for miscarriage compared with all other groups. Furthermore, higher HOMA-IR values were associated with higher risks of miscarriage among PCOS women regardless of HOMA-β values.
UNASSIGNED: β-cell dysfunction is independently associated with increased miscarriage rate and decreased live birth rate in women with PCOS. It also plays a synergistic role with IR in terms of the reproductive outcomes, while the influence of IR overweighs that of β-cell dysfunction.
UNASSIGNED: This retrospective cohort study includes 1,212 women with PCOS undergoing their first IVF cycle between September 2010 and December 2019. Beta-cell dysfunction was measured by homeostasis model assessment of β-cell function (HOMA-β) index.
UNASSIGNED: In quartiles of HOMA-β, the incidence of miscarriage dramatically increased from 10.2% (Q1) to 31.1% (Q4) (P for trend <0.001). Likewise, the incidence of miscarriage in quartiles of HOMA-β also showed a similar trend (P for trend <0.001). After adjusting for confounding factors, logistic regression analyses showed that high HOMA-IR values were independently associated with a high risk of miscarriage, with the odds ratios (OR) and 95% confidence intervals for quartiles 2-4 versus quartile 1 were 1.30 (0.69-2.46), 1.82 (0.97-3.43), and 3.57 (1.86-6.85), respectively (P for trend <0.001). When analyzed jointly, women in the highest HOMA-IR and highest HOMA-β group exhibited the highest risk for miscarriage compared with all other groups. Furthermore, higher HOMA-IR values were associated with higher risks of miscarriage among PCOS women regardless of HOMA-β values.
UNASSIGNED: β-cell dysfunction is independently associated with increased miscarriage rate and decreased live birth rate in women with PCOS. It also plays a synergistic role with IR in terms of the reproductive outcomes, while the influence of IR overweighs that of β-cell dysfunction.
摘要：
■研究β细胞功能障碍对PCOS女性IVF结局的影响。
这项回顾性队列研究包括2010年9月至2019年12月期间接受第一个IVF周期的1,212名PCOS女性。通过稳态模型评估β细胞功能（HOMA-β）指数来测量β细胞功能障碍。
■在HOMA-β的四分位数中，流产的发生率从10.2％（Q1）急剧增加到31.1％（Q4）（P<0.001）。同样，HOMA-β四分位数的流产发生率也显示出相似的趋势（P<0.001）。在调整混杂因素后，Logistic回归分析显示，高HOMA-IR值与流产的高风险独立相关，四分位数2-4与四分位数1的比值比(OR)和95%置信区间为1.30(0.69-2.46)，1.82（0.97-3.43），和3.57（1.86-6.85），分别(趋势P<0.001)。当联合分析时，与所有其他组相比,HOMA-IR最高和HOMA-β最高组的女性流产风险最高.此外，无论HOMA-β值如何,PCOS女性较高的HOMA-IR值与较高的流产风险相关.
■β细胞功能障碍与PCOS女性流产率增加和活产率降低独立相关。它还与IR在生殖结果方面发挥协同作用，而IR的影响超过β细胞功能障碍的影响。
这项回顾性队列研究包括2010年9月至2019年12月期间接受第一个IVF周期的1,212名PCOS女性。通过稳态模型评估β细胞功能（HOMA-β）指数来测量β细胞功能障碍。
■在HOMA-β的四分位数中，流产的发生率从10.2％（Q1）急剧增加到31.1％（Q4）（P<0.001）。同样，HOMA-β四分位数的流产发生率也显示出相似的趋势（P<0.001）。在调整混杂因素后，Logistic回归分析显示，高HOMA-IR值与流产的高风险独立相关，四分位数2-4与四分位数1的比值比(OR)和95%置信区间为1.30(0.69-2.46)，1.82（0.97-3.43），和3.57（1.86-6.85），分别(趋势P<0.001)。当联合分析时，与所有其他组相比,HOMA-IR最高和HOMA-β最高组的女性流产风险最高.此外，无论HOMA-β值如何,PCOS女性较高的HOMA-IR值与较高的流产风险相关.
■β细胞功能障碍与PCOS女性流产率增加和活产率降低独立相关。它还与IR在生殖结果方面发挥协同作用，而IR的影响超过β细胞功能障碍的影响。
