female infertility

女性不孕症
  • 文章类型: Journal Article
    建立了氧化应激与女性不孕症发病机制之间的相关性,氧化平衡评分(OBS)可以作为个体内总体氧化应激负荷的量度。以前的报道没有解决OBS和女性不孕症之间的关系。本研究试图调查女性不孕风险与OBS之间的关系。
    分析的重点是2013-2018年全国健康和营养检查调查的数据。OBS由16种饮食成分和4种生活方式成分确定。采用多因素logistic回归分析OBS与女性不孕症的关系。进行了进一步的分层分析,以检查各个亚组之间的关联。为了阐明女性不孕风险与OBS之间的剂量-反应关系,使用受限三次样条函数。
    该研究共纳入1410名参与者。通过加权多变量Logistic回归分析,我们观察到OBS与女性不孕症风险之间存在一致的负相关[OR(95%CI)=0.97(0.95,0.99),p=0.047]。当参与者根据OBS被分成四分位数时,最高四分位数的人有61%[OR(95%CI)=0.39(0.2,0.79),p=0.01]与OBS最低四分位数的患者相比,不孕风险降低。通过四分位数评估OBS的趋势测试也揭示了OBS与女性不孕症之间的关系。这种相关性在饮食和生活方式OBS中保持不变。此外,生活方式OBS与女性不孕症呈非线性关联。敏感性分析验证了我们研究结果的一致性。
    该研究发现,较高的OBS与较低的女性不孕症患病率有关。这些结果强调了氧化稳态在不孕症发病机理中的潜在作用,并强调了后续研究和预防策略的重要性。
    UNASSIGNED: The correlation between oxidative stress and female infertility pathogenesis was established, and the oxidative balance score (OBS) can serve as a measure of overall oxidative stress burden within an individual. Prior reports have not addressed the relationship between OBS and female infertility. This study endeavors to investigate the association between infertility risk in female and OBS.
    UNASSIGNED: The analysis focused on data from the National Health and Nutrition Examination Survey 2013-2018. OBS was determined from 16 dietary components and 4 lifestyle components. Multivariate logistic regression was employed to investigate the relationship between OBS and female infertility. Further stratified analysis was conducted to examine the associations across various subgroups. To elucidate the dose-response relationship between infertility risk in female and OBS, a restricted cubic spline function was employed.
    UNASSIGNED: The study included a total of 1410 participants. Through weighted multivariable logistic regression analysis, we observed a consistent inverse correlation between OBS and the risk of female infertility [OR (95% CI) = 0.97 (0.95, 0.99), p = 0.047]. When participants were segregated into quartiles based on OBS, those in the highest quartile had a 61% [OR (95% CI) = 0.39 (0.2, 0.79), p = 0.01] reduced risk of infertility compared to those in the lowest quartile of OBS. A trend test assessing OBS by quartile also revealed the relationship between OBS and female infertility. This correlation remained constant across both dietary and lifestyle OBS. Additionally, lifestyle OBS and female infertility exhibited a nonlinear association. A sensitivity analysis verified the consistency of our findings.
    UNASSIGNED: The study found that a higher OBS is associated with a lower prevalence of female infertility. These results emphasized the potential role of oxidative homeostasis in the pathogenesis of infertility and highlighted the importance of follow-up studies and prevention strategies.
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  • 文章类型: Journal Article
    2型糖尿病(T2D)与女性不孕症(FI)有关。然而,我们对分子标志和潜在机制的理解仍然难以捉摸。这篇研究文章旨在寻找集线器基因,通路,转录因子,和miRNA参与。对于这项研究,像细胞景观这样的软件,字符串,Enrichr,FFL回路,等。,被利用。本研究使用差异表达基因(DEGs)来鉴定多个生物学靶标,以了解T2D与女性不孕症(FI)之间的关联。在T2D和FI之间,我们发现3869个差异表达基因。我们还分析了不同的途径,如甲状腺激素信号通路,AGE-RAGE信号通路在糖尿病并发症和泛素介导的蛋白水解中的作用.此外,hub基因MED17,PRKCG,THRA,FOXO1,NCOA2,PLCG2,COL1A1,CXCL8,PRPF19,ANAPC5,UBE2I,已确定XIAP和KEAP1。此外,这些hub基因被用于鉴定T2D相关女性不育症特异性miRNA-mRNA调控网络.在FFL研究(前馈回路)中,转录因子(SP1,NFKB1,RELA和FOX01),miRNA(has-mir-7-5p,has-let-7a-5p,hsa-mir-16-5p,hsa-mir-155-5p,has-mir-122-5p,has-let-7b-5p,has-mir-124-3p,has-mir-34a-5p,has-mir-130a-3p,has-let-7i-5p,和hsa-mir-27a-3p)和六个基因(XIAP,THRA,13个关键基因中的NCOA2,MED17,FOXO1和COL1A1)被认为是调节剂和抑制剂。我们的分析表明,这些基因可以作为与2型糖尿病相关的女性不孕症的重要生物标志物。通过候选基因的优先排序。这项研究使我们深入了解T2D相关FI的分子和细胞机制。这一发现有助于开发新的治疗方法,并将提高疗效并减少治疗的副作用。这项研究需要对主要目标进行进一步的实验研究。
    Type 2 diabetes mellitus (T2D) has been linked with female infertility (FI). Nevertheless, our understanding of the molecular hallmarks and underlying mechanisms remains elusive. This research article aimed to find the hub genes, pathways, transcription factors, and miRNA involved. For this study, softwares like cytoscape, string, Enrichr, FFL loop, etc., were utilized. This research article employed differentially expressed genes (DEGs) to identify multiple biological targets to understand the association between T2D and female infertility (FI). Between T2D and FI, we found 3869 differentially expressed genes. We have also analyzed different pathways like thyroid hormone signaling pathways, AGE-RAGE signaling pathways in diabetic complications and ubiquitin-mediated proteolysis through pathway analysis. Moreover, hub genes MED17, PRKCG, THRA, FOXO1, NCOA2, PLCG2, COL1A1, CXCL8, PRPF19, ANAPC5, UBE2I, XIAP and KEAP1 have been identified. Additionally, these hub genes were subjected to identify the miRNA-mRNA regulation network specific to T2D-associated female infertility. In the FFL study (Feed Forward Loop), transcription factor (SP1, NFKB1, RELA and FOX01), miRNA (has-mir-7-5p, has-let-7a-5p, hsa-mir-16-5p, hsa-mir-155-5p, has-mir-122-5p, has-let-7b-5p, has-mir-124-3p, has-mir-34a-5p, has-mir-130a-3p, has-let-7i-5p, and hsa-mir-27a-3p) and six genes (XIAP, THRA, NCOA2, MED17, FOXO1, and COL1A1) among the thirteen key genes were recognized as regulator and inhibitor. Our analysis reveals that these genes can serve as a significant biomarker for female infertility linked with Type 2 Diabetes, through the prioritization of candidate genes. This study gives us insight into the molecular and cellular mechanism of T2D-associated FI. This finding helps in developing novel therapeutic approaches and will improve efficacy and reduce side effects of the treatment. This research requires further experimental investigation of the principal targets.
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  • 文章类型: Journal Article
    女性对衣原体感染和生殖道问题的反应存在明显的个体间差异。白细胞介素-10(IL-10)基因中的女性遗传变异与沙眼衣原体感染反应的变异有关。本研究旨在证明IL-10与不孕症的深刻关联,并证明IL-10(-592C/Ars1800872)和(-1082A>Grs1800896)单核苷酸多态性(SNP)基因在沙眼衣原体感染的易感性和严重程度中的作用。
    在这项评估研究中,采用酶联免疫吸附试验(ELISA)对134例不孕症患者和50例健康志愿者进行血清IL-10浓度测定。进行四扩增难治性突变系统PCR(T-ARMS-PCR)分析以检测rs1800872和rs1800896SNP基因的基因分型。
    两个女性组抗衣原体IgM抗体阳性,但不同病例的反应强度不同。同时,通过PCR检测,不育妇女生殖器沙眼衣原体的发病率为46.2%.除子宫内膜异位症(Endo)不孕症外,所有组的不育妇女的血清IL10浓度均低于健康参与者,而不育沙眼衣原体阳性妇女的血清IL10浓度高于不育沙眼衣原体阴性。在rs1800872中,CA基因型和C等位基因与不孕风险增加有关,除了多囊卵巢综合征(PCOS),是A等位基因.在rs1800896病例中,AG基因型和G等位基因显示出更大的不育风险。
    我们的结果证实rs1800872和rs1800896基因多态性与沙眼衣原体感染的风险增加有关。
    UNASSIGNED: There is evident inter-individual variability in women\'s responses to Chlamydial infections and reproductive tract problems. Women\'s genetic variations within the Interleukin-10 (IL-10) gene have been linked to variances in response to Chlamydia trachomatis infection. This study was aimed to demonstrate the profound association of IL-10 with infertility and demonstrate the role of IL-10 (-592 C/A rs1800872) and (-1082 A>G rs1800896) single nucleotide polymorphism (SNPs) gene in the susceptibility and severity of a C. trachomatis infection.
    UNASSIGNED: In this evaluation study, serum IL-10 concentration was measured in 134 women diagnosed with infertility and 50 healthy volunteers by enzyme-linked immunosorbent assay (ELISA). The tetra-amplification refractory mutation system-PCR (T-ARMS-PCR) analysis was performed to detect the genotyping of the rs1800872 and rs1800896 SNPs genes.
    UNASSIGNED: Both female groups were positive for anti-chlamydial IgM antibody, but the intensity of response differed between cases. At the same time, the incidence of genital C. trachomatis by PCR was 46.2% in infertile women. The serum concentration of IL10 was lower in infertile women than healthy participants and higher in infertile C. trachomatis -positive women compared to infertile C. trachomatis-negative in all groups except endometriosis (Endo) infertility. In rs1800872, the CA genotype and C allele are associated with an increased risk for infertility, except in polycystic ovarian syndrome (PCOS), which is an A allele. In the case of rs1800896, the AG genotype and G allele show a greater risk for infertility.
    UNASSIGNED: Our results confirmed that rs1800872 and rs1800896 gene polymorphisms were associated with an increased risk of C. trachomatis infection.
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  • 文章类型: Journal Article
    目的:与年龄相关的排卵数量和卵子质量下降是女性不孕的主要原因,据报道,干细胞在组织再生中有效。然而,目前的治疗方式是不够的。本研究探讨脂肪间充质干细胞(ASCs)对老龄小鼠卵巢功能的影响。
    方法:在使用流式细胞术表征ASC之后,ASC对排卵数量的影响,受精率,和囊胚形成率进行了调查。此外,检测卵巢卵泡数和血清抗苗勒管激素(AMH)水平。用Kusabira橙标记的ASC用于检查细胞施用后的位置。使用下一代RNA测序分析排卵卵母细胞的质量。
    结果:ASCs表现出间充质干细胞的特性,分布于各器官,包括卵巢间质.移植导致卵巢中卵母细胞数量和排卵增加,AMH值增加。遗传分析显示卵母细胞质量改善,受精和胚泡形成率增加。
    结论:ASC治疗可有效改善老年妇女的生育能力。
    OBJECTIVE: Age-related decline in the number of ovulations and ovum quality are major causes of female infertility, and stem cells have been reported to be effective in tissue regeneration. However, current therapeutic modalities are inadequate. This study investigated the effects of adipose-derived mesenchymal stem cells (ASCs) on ovarian functions in aged mice.
    METHODS: Following the characterization of ASCs using flow cytometry, the effects of ASCs on the number of ovulations, fertilization rate, and blastocyst-formation rate were investigated. In addition, the number of ovarian follicles and serum anti-Müllerian hormone (AMH) levels were examined. ASCs marked with Kusabira Orange were used to examine the location after cell administration. The quality of ovulated oocytes was analyzed using next-generation RNA sequencing.
    RESULTS: ASCs showed characteristics of mesenchymal stem cells and were distributed to various organs, including the ovarian stroma. The transplantation resulted in increased number of oocytes and ovulation in the ovaries and increased AMH values. Genetic analysis revealed improved oocyte quality and increased fertilization and blastocyst-formation rates.
    CONCLUSIONS: ASC therapy may be effective in improving fertility in older women.
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  • 文章类型: Case Reports
    多囊卵巢综合征(PCOS)是一种影响育龄妇女的内分泌疾病,其特征是荷尔蒙失衡导致代谢和生殖失调。此病例报告围绕着一位30岁的丈夫和他27岁的伴侣。男性伴侣有正常精子症,女性配偶患有PCOS,根据这对夫妇的诊断评估。女性患者接受卵巢刺激专门用于辅助PCOS,然后将回收的卵母细胞在体外成熟。卵胞浆内单精子注射(ICSI)后,受精和胚胎发育成功。PCOS相关不孕症的治疗面临许多挑战,并讨论了体外成熟(IVM)及其作为有效辅助生育方法的潜力。为了优化治疗结果,结论显示了IVM和其他辅助生殖技术对不孕症的重要性.它还侧重于必要的持续研究和临床经验。通过测量血清β-人绒毛膜促性腺激素(β-hCG)水平,然后进行超声检查(USG)来确认临床妊娠,这表明胎儿的生长速度正常。
    Polycystic ovary syndrome (PCOS) is an endocrinological disorder affecting women of reproductive age, characterized by hormonal imbalance leading to metabolic and reproductive dysregulations. This case report revolves around a 30-year-old husband and his 27-year-old partner. The male partner had normozoospermia, and the female spouse had PCOS, according to the couple\'s diagnostic evaluations. The female patient received ovarian stimulation specifically to assist with PCOS, and the retrieved oocytes were then matured in vitro. After intracytoplasmic sperm injection (ICSI), fertilization and embryonic development were successful. Treatment of PCOS-related infertility presents many challenges, and in vitro maturation (IVM) and its potential as an effective assisted fertility method are discussed. To optimize treatment outcomes, the conclusion shows the importance of IVM and other assisted reproductive techniques for infertility. It also focuses on the necessary continuous research and clinical experience. Clinical pregnancy was confirmed by measuring serum beta-human chorionic gonadotropin (β-hCG) levels followed by ultrasound sonography (USG), which showed a normal growth rate of the fetus.
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  • 文章类型: Journal Article
    阴道微生物群的生态失调被认为是导致女性不孕的潜在潜在因素。本研究旨在比较不育和育龄妇女的阴道微生物组,以探讨其与不育的关系。
    使用扩增子16S和宏基因组学鸟枪测序方法对来自5个不育个体和5个可育个体的样品进行宏基因组分析。
    在不育组中,细菌群落主要由三个主要细菌属代表:乳酸杆菌(79.42%),加德纳菌(12.56%)和普雷沃氏菌(3.33%),然而,可育组表现出更多样化的组成,有超过8个主要细菌属,伴随着乳酸杆菌(48.79%)和加德纳菌(6.98%)的丰度显着降低。在物种层面,较高的L.iners丰度,在不育组中观察到L.gasseri和G.vaginalis。关于微生物组组成,只有一个肥沃的受试者和两个不育的受试者表现出最健康的社区状态类型,CST-1,而CST-3在两名不育和一名可育受试者中观察到,和CST-4在另外三个可育和一个不育的受试者中。总的来说,α多样性指标表明,对照(肥沃)组的多样性更大,物种丰富度更低,而不育组表现出相反的趋势。然而,β多样性分析没有显示与任何特定群体相关的样本的明显聚类;相反,它展示了CST类型特定的聚类。猎枪宏基因组学进一步证实了Firmicutes的优势,在不育组中有更多的乳酸杆菌。具体来说,L.iners和G.vaginalis被确定为不育组中最主要和高度丰富的。真菌仅在对照组中被发现,以柑橘青霉为主(62.5%)。宏基因组组装基因组(MAGs)证实了基于读取的分类学分析,与分类单元L.johnsonii仅在疾病样本中鉴定。这两个群体共有的MAG身份包括沙蒙达正双打病毒,L.crispatus,人类内源性逆转录病毒K113,L.iners,和阴道G.有趣的是,在这项研究中测序的健康微生物群包含两个簇,青霉和溶血葡萄球菌,在公共数据集中找不到。总之,这项研究表明,较低的物种多样性与较高的L.iners丰度,L.gasseri和G.vaginalis,在我们的研究数据集中可能导致女性不孕。然而,需要更大的样本量来进一步评估这种关联。
    UNASSIGNED: The dysbiosis of vaginal microbiota is recognized as a potential underlying factor contributing to infertility in women. This study aimed to compare the vaginal microbiomes of infertile and fertile women to investigate their relationship with infertility.
    UNASSIGNED: Metagenomic analysis was conducted on samples from 5 infertile and 5 fertile individuals using both amplicon 16S and metagenomics shotgun sequencing methods.
    UNASSIGNED: In the infertile group, the bacterial community was primarily represented by three major bacterial genera: Lactobacillus (79.42%), Gardnerella (12.56%) and Prevotella (3.33%), whereas, the fertile group exhibited a more diverse composition with over 8 major bacterial genera, accompanied by significantly reduced abundance of Lactobacillus (48.79%) and Gardnerella (6.98%). At the species level, higher abundances of L. iners, L. gasseri and G. vaginalis were observed in the infertile group. Regarding the microbiome composition, only one fertile and two infertile subjects exhibited the healthiest Community State Types, CST-1, while CST-3 was observed among two infertile and one fertile subject, and CST-4 in three other fertile and one infertile subject. Overall, alpha diversity metrics indicated greater diversity and lower species richness in the control (fertile) group, while the infertile group displayed the opposite trend. However, beta-diversity analysis did not show distinct clustering of samples associated with any specific group; instead, it demonstrated CST-type specific clustering. Shotgun metagenomics further confirmed the dominance of Firmicutes, with a greater abundance of Lactobacillus species in the infertile group. Specifically, L. iners and G. vaginalis were identified as the most dominant and highly abundant in the infertile group. Fungi were only identified in the control group, dominated by Penicillium citrinum (62.5%). Metagenome-assembled genomes (MAGs) corroborated read-based taxonomic profiling, with the taxon L. johnsonii identified exclusively in disease samples. MAG identities shared by both groups include Shamonda orthobunyavirus, L. crispatus, Human endogenous retrovirus K113, L. iners, and G. vaginalis. Interestingly, the healthy microbiomes sequenced in this study contained two clusters, Penicillium and Staphylococcus haemolyticus, not found in the public dataset. In conclusion, this study suggests that lower species diversity with a higher abundance of L. iners, L. gasseri and G. vaginalis, may contribute to female infertility in our study datasets. However, larger sample sizes are necessary to further evaluate such association.
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  • 文章类型: Journal Article
    EXOC5是大型多亚基系链复合体的重要组成部分,外囊复合体,这是分泌囊泡与质膜融合所必需的。Exoc5删除小鼠作为早期胚胎死亡。因此,为了确定EXOC5在卵泡和卵母细胞发育中的作用,有必要产生有条件的敲除(cKO),Zp3-Exoc5-CKO,其中Exoc5仅在卵母细胞中删除。第一波卵泡发生在组织学上表现正常,并发展到窦阶段。然而,正常精子体外受精后,从第一波(超排卵的21天大的cKO小鼠)收集的卵母细胞显示出发育无能。成年卵泡波没有进展到经历凋亡的次级卵泡阶段。雌性cKO小鼠不育。总的来说,这些数据表明,第一波卵泡发生对卵母细胞特异性Exoc5丢失的敏感性较低,但由此产生的配子的发育能力降低.相比之下,随后的卵泡发生波需要卵母细胞特异性Exoc5才能在腔前卵泡阶段发育。Zp3-Exoc5-CKO小鼠提供了用于破坏卵泡发生的模型,该模型还能够在卵泡发生的第一波和随后波之间进行分离。
    EXOC5 is a crucial component of a large multi-subunit tethering complex, the exocyst complex, that is required for fusion of secretory vesicles with the plasma membrane. Exoc5 deleted mice die as early embryos. Therefore, to determine the role of EXOC5 in follicular and oocyte development, it was necessary to produce a conditional knockout (cKO), Zp3-Exoc5-cKO, in which Exoc5 was deleted only in oocytes. The first wave of folliculogenesis appeared histologically normal and progressed to the antral stage. However, after IVF with normal sperm, oocytes collected from the first wave (superovulated 21-day-old cKO mice) were shown to be developmentally incompetent. Adult follicular waves did not progress beyond the secondary follicle stage where they underwent apoptosis. Female cKO mice were infertile. Overall, these data suggest that the first wave of folliculogenesis is less sensitive to oocyte-specific loss of Exoc5, but the resulting gametes have reduced developmental competence. In contrast, subsequent waves of folliculogenesis require oocyte-specific Exoc5 for development past the preantral follicle stage. The Zp3-Exoc5-cKO mouse provides a model for disrupting folliculogenesis that also enables the separation between the first and subsequent waves of folliculogenesis.
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  • 文章类型: Journal Article
    目的:卵巢衰老与卵泡储备和卵母细胞质量下降密切相关。这些还原的精确分子机制尚未完全阐明。在这里,我们研究了负责DNA双链断裂(DSB)修复的关键蛋白在卵巢早期到老年的时空分布.功能研究表明,γH2AX,RAD51,BRCA1和RPA70蛋白在基于HR的修复途径中起着不可或缺的作用,而KU80和XRCC4蛋白对于成功操作cNHEJ途径至关重要。
    方法:雌性Balb/C小鼠分为以下五组:青春期前(3周龄;n=6),青春期(7周龄;n=7),青春期后(18周龄;n=7),早期年龄(52周龄;n=7),和晚期(60周龄;n=7)。DSB修复蛋白的表达,使用免疫组织化学在卵巢中评估细胞衰老(β-GAL)和凋亡(cCASP3)标记。
    结果:β-GAL和cCASP3水平从青春期前到老年组逐渐升高(P<0.05)。值得注意的是,γH2AX水平在腔前卵泡和腔卵泡中存在差异(P<0.05)。在老年群体中,RAD51、BRCA1、KU80和XRCC4水平升高(P<0.05),而RPA70水平较其他组降低(P<0.05)。
    结论:观察到的改变主要归因于卵泡和其他卵巢细胞的卵母细胞和颗粒细胞表达的改变。因此,研究结果表明,这些DSB修复蛋白可能在早期至老年卵巢细胞的修复过程甚至其他相关细胞事件中发挥作用.
    OBJECTIVE: Ovarian aging is closely related to a decrease in follicular reserve and oocyte quality. The precise molecular mechanisms underlying these reductions have yet to be fully elucidated. Herein, we examine spatiotemporal distribution of key proteins responsible for DNA double-strand break (DSB) repair in ovaries from early to older ages. Functional studies have shown that the γH2AX, RAD51, BRCA1, and RPA70 proteins play indispensable roles in HR-based repair pathway, while the KU80 and XRCC4 proteins are essential for successfully operating cNHEJ pathway.
    METHODS: Female Balb/C mice were divided into five groups as follows: Prepuberty (3 weeks old; n = 6), puberty (7 weeks old; n = 7), postpuberty (18 weeks old; n = 7), early aged (52 weeks old; n = 7), and late aged (60 weeks old; n = 7). The expression of DSB repair proteins, cellular senescence (β-GAL) and apoptosis (cCASP3) markers was evaluated in the ovaries using immunohistochemistry.
    RESULTS: β-GAL and cCASP3 levels progressively increased from prepuberty to aged groups (P < 0.05). Notably, γH2AX levels varied in preantral and antral follicles among the groups (P < 0.05). In aged groups, RAD51, BRCA1, KU80, and XRCC4 levels increased (P < 0.05), while RPA70 levels decreased (P < 0.05) compared to the other groups.
    CONCLUSIONS: The observed alterations were primarily attributed to altered expression in oocytes and granulosa cells of the follicles and other ovarian cells. As a result, the findings indicate that these DSB repair proteins may play a role in the repair processes and even other related cellular events in ovarian cells from early to older ages.
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  • 文章类型: Journal Article
    尽管观察到血清尿酸(SUA)之间存在联系,性激素相关表型,和女性不孕症,这些关联背后的因果关系仍然不确定。
    本研究利用双向双样本和调解孟德尔随机化来探索性激素结合球蛋白(SHBG)的因果关系和调解作用,总睾酮(TT),和雌二醇在这些关联上。
    我们使用来自欧洲人群的大规模GWAS的数据,分析了与SUA和性激素水平相关的单核苷酸多态性(SNP)。女性不孕症数据来自FinnGen联盟的6,481例和75,450例对照。我们采用了包括逆方差加权(IVW)、加权中位数,和MR-Egger回归评估因果关系。
    我们发现SUA水平升高会增加女性不孕的风险(IVWOR:1.13,P=0.047)。升高的SUA水平显着降低SHBG水平(β=-0.261;P=2.177e-04),SHBG介导了SUA对不孕症的影响的27.93%(OR=0.854;95CI,0.793-0.920;P=2.853e-05)。此外,TT水平升高,与SUA水平降低相关(β=-0.127),对SUA介导的不孕症有间接影响(β=-0.0187;95%CI,-0.041至-0.003;P=0.046)。
    我们的研究结果表明,高SUA与由SHBG和TT等激素因素介导的女性不孕风险增加之间存在因果关系。这些见解为不孕症治疗提供了新的途径,并强调了对这些机制进行进一步研究的必要性。
    UNASSIGNED: Despite observational links between serum uric acid (SUA), sex hormone-related phenotypes, and female infertility, the causality behind these associations remains uncertain.
    UNASSIGNED: This study utilizes Bidirectional Two-Sample and Mediation Mendelian Randomization to explore the causal relationships and mediation effects of sex hormone-binding globulin (SHBG), total testosterone (TT), and estradiol on these associations.
    UNASSIGNED: We analyzed single-nucleotide polymorphisms (SNPs) associated with SUA and sex hormone levels using data from large-scale GWAS of European populations. Female infertility data were sourced from 6,481 cases and 75,450 controls in the FinnGen Consortium. We employed methods including Inverse Variance Weighted (IVW), Weighted Median, and MR-Egger regression to assess causality.
    UNASSIGNED: We found that elevated SUA levels causally increase the risk of female infertility (IVW OR: 1.13, P=0.047). Elevated SUA levels significantly decrease SHBG levels (β=-0.261; P=2.177e-04), with SHBG mediating 27.93% of the effect of SUA on infertility (OR=0.854; 95%CI, 0.793-0.920; P=2.853e-05). Additionally, elevated TT levels, which were associated with decreased SUA levels (β=-0.127), showed an indirect effect on infertility mediated by SUA (β=-0.0187; 95% CI, -0.041 to -0.003; P=0.046).
    UNASSIGNED: Our findings demonstrate causal links between high SUA and increased risk of female infertility mediated by hormonal factors such as SHBG and TT. These insights suggest new avenues for infertility treatment and highlight the need for further research into these mechanisms.
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  • 文章类型: Journal Article
    了解五年来加纳不孕妇女的子宫输卵管造影(HSG)发现模式和年度趋势。
    我们回顾性评估了2018年1月至2022年12月在加纳主要三级中心接受HSG治疗的不孕症妇女的医院病历。对数据进行统计学分析。
    受试者包括2324名被诊断患有临床不孕症的加纳妇女。HSG确定1685(72.5%)患有原发性不孕症,他们也是平均年龄为32.2±4.5岁的年轻女性。其余639名(27.5%)女性患有继发性不孕症,年龄较大(34.2±5.3岁;p<0.001)。原发不孕率随年龄增长而下降(p<0.001)。在701例(41.6%)原发性不孕症妇女和365例(57.1%)继发性不孕症妇女中发现了双侧输卵管阻塞。236名(10.2%)女性中存在Hydrosalpinx,菌毛粘连444例(19.1%),Asherman综合征占4人(0.2%),双侧串珠管/结核性输卵管炎5例(0.2%)。尽管有临床不孕,但在513名(22.1%)女性中,HSG无法检测到与不孕相关的异常。大多数患者(1502;64.6%)患有输卵管阻塞:双侧1066例(45.9%),单侧436例(18.8%)。
    多年来,加纳妇女的生育率呈加速上升趋势。原发性不孕症在年轻女性中更为普遍。输卵管和宫颈异常是最常见的HSG发现。
    UNASSIGNED: To understand the pattern of hysterosalpingographic (HSG) findings and annual trends among Ghanaian women with infertility over a five-year period.
    UNASSIGNED: We retrospectively evaluated the hospital medical records of women with infertility who underwent HSG at a major tertiary center in Ghana between January 2018 and December 2022. The data was statistically analyzed.
    UNASSIGNED: The subjects comprised of 2324 Ghanaian women diagnosed with clinical infertility. HSG identified 1685 (72.5%) with primary infertility and they were also younger women with a mean age of 32.2±4.5 years. The remaining 639 (27.5%) women had secondary infertility and were older (34.2±5.3 years; p < 0.001). Primary infertility rate decreased with increasing age (p < 0.001). Bilateral tubal blockage was seen in 701 (41.6%) women with primary infertility and 365 (57.1%) women with secondary infertility. Hydrosalpinx was present in 236 (10.2%) women, fimbrial adhesions in 444 (19.1%), Asherman\'s syndrome in four (0.2%), and bilateral beaded tubes/tubercular salpingitis in five (0.2%). HSG was unable to detect infertility-related abnormalities in 513 (22.1%) women despite their clinical infertility. The majority of patients (1502; 64.6%) had tubal blockage: bilateral in 1066 (45.9%) and unilateral in 436 (18.8%).
    UNASSIGNED: Infertility rates among Ghanaian women increased at an accelerating rate over the years. Primary infertility was significantly more prevalent among younger women. Tubal and cervical abnormalities were the most prevalent HSG findings.
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