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山东大学学报 (医学版) ›› 2020, Vol. 1 ›› Issue (7): 60-66.doi: 10.6040/j.issn.1671-7554.0.2020.0538

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胰岛素样生长因子II在84例多囊卵巢综合征患者颗粒细胞中的表达和促排卵结局的相关性

丁祥云1,于清梅1,张文芳2,庄园1,郝晶3   

  • 出版日期:2020-07-20 发布日期:2020-07-10
  • 通讯作者: 郝晶. E-mail:haojing@sdu.edu.cn
  • 基金资助:
    山东省高等学校科技计划项目(J16LL07);山东省高等学校科技计划项目(J18KA296)

Correlation of the expression of insulin-like growth factor II in granulosa cells and ovulation induction outcomes of 84 patients with polycystic ovary syndrome

DING Xiangyun1, YU Qingmei1, ZHANG Wenfang2, ZHUANG Yuan1, HAO Jing3   

  1. 1. Department of Histology and Embryology, Shandong Medical College, Linyin 276000, Shandong, China;
    2. Department of Reproductive Medicine, Linyi Women and Childrens Health Hospital, Linyin 276000, Shandong, China;
    3. Department of Anatomy and Histoembryology, School of Basic Medical Sciences, Shandong University, Jinan 250012, Shandong, China
  • Online:2020-07-20 Published:2020-07-10

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摘要： 目的 检测胰岛素样生长因子II(IGF-II)在多囊卵巢综合征(PCOS)患者卵巢颗粒细胞中的表达水平及与促排卵结局的相关性。 方法 采用实时荧光定量PCR(qRT-PCR)检测42例 PCOS正常反应患者(PCOS正常反应组)、42例PCOS高反应患者(PCOS高反应组)及90例对照组(因输卵管或男方因素助孕者)颗粒细胞中IGF-II的表达,对比分析各组IGF-II的表达及促排卵相关参数的差异,并进行关联性分析。 结果 IGF-II在对照组、PCOS正常反应组和PCOS高反应组相对表达量的中位数分别为1.3(0.5~1.8)、1.7(1.4~2.2)及3.2(2.5~4.3),3组间比较差异有统计学意义(F=88.7, P<0.001),其中PCOS正常反应组和PCOS高反应组均高于对照组(P均<0.001),PCOS高反应组高于PCOS正常反应组(P<0.001)。在PCOS高反应组,注射人绒毛膜促性腺素(HCG)日雌二醇(E2)、直径≥14 mm的卵泡数、获卵数、2原核受精卵(2PN)数、优质胚胎数、卵裂数及可移植胚胎数均高于对照组及PCOS正常反应组,差异有统计学意义(P均<0.05),HCG日黄体生成素(LH)、获卵率、受精率及可利用卵子率均低于对照组和PCOS正常反应组(P均<0.05);在PCOS正常反应组,促性腺激素(Gn)总量(P=0.02)及E2值(P<0.001)均低于对照组。相关性分析结果显示,颗粒细胞上IGF-II的相对表达量与HCG日E2值(r=0.163, P=0.032)、HCG日≥14 mm的卵泡数(r=0.286, P<0.001)、2PN数(r=0.246, P<0.001)、卵裂数(r=0.296, P<0.001)、优质胚胎数(r=0.286, P<0.001)、获卵数(r=0.386, P<0.001)、可移植胚胎数(r=0.252, P<0.001)及优质胚胎率(r=0.155, P=0.041)呈正相关;多重线性回归分析结果显示,PCOS患者颗粒细胞上IGF-II的相对表达量与获卵数(β=0.921, P<0.001)及优质胚胎率(β=0.285, P<0.001)呈正相关,与卵裂数(β=-0.283, P<0.001)呈负相关。 结论 IGF-II在接受辅助生殖技术治疗的PCOS患者颗粒细胞中高表达,与获卵数及优质胚胎率密切相关,有促进卵泡和早期胚胎发育的潜能。

关键词: 胰岛素样生长因子II, 多囊卵巢综合征, 颗粒细胞, 促排卵

Abstract: Objective To detect the expression of insulin-like growth factor II(IGF-II)in ovarian granulosa cells of patients with polycystic ovary syndrome(PCOS)and to explore its relationship with ovulation induction outcomes. Methods A total of 84 PCOS patients divided into high response group(n=42)and normal response group(n=42)and 90 controls(the control group)with assisted reproduction treatment due to tubal or male factors were enrolled. The expression of IGF-II in each group was detected with real-time quantitative reverse transcription PCR(qRT-PCR). The differences in IGF-II expressions and ovulation induction related parameters were compared, and the correlation was analyzed. Results The median relative expressions of IGF-II in the control group, PCOS normal response group and PCOS high response group were 1.3(0.5-1.8), 1.7(1.4-2.2)and 3.2(2.5-4.3), respectively. There were statistically significant differences among the three groups(F=88.7, P<0.001). The expression of IGF-II was higher in PCOS normal response group and PCOS high response group than that in the control group(both P<0.001), and the expression of IGF-II was higher in PCOS high response group than in PCOS normal response group(P<0.001). On the day when human chorionic gonadotrophin(HCG)was injected, in PCOS high response group, estradiol(E2)level, number of follicles ≥14 mm, number of oocytes obtained, number of 2 pronucleus(2PN)zygotes, number of high quality embryos, number of cleavages and number of transplantable embryos were significantly higher than those in the control group and PCOS normal response group(P<0.05); however, the luteotropic hormone(LH)level, oocyte recovery rate, fertilization rate and available oocyte rate were significantly lower than those in the control group and PCOS normal response group(P<0.05). In the PCOS normal response group, gonadotropin(Gn)level(P=0.02)and E2 level(P<0.001)were lower than those in the control group. Correlation analysis showed that the expression of IGF-II was positively correlated with E2 level(r=0.163, P=0.032), number of follicles ≥14 mm on HCG day(r=0.286, P<0.001), number of 2PN(r=0.246, P<0.001), number of cleavages(r=0.296, P<0.001), number of high quality embryos(r=0.286, P<0.001), number of oocytes obtained(r=0.386, P<0.001), number of transplantable embryos(r=0.252, P<0.001), and rate of high-quality embryos(r=0.155, P=0.041). Multivariate linear regression analysis revealed that the expression of IGF-II was positively correlated with the number of oocytes obtained(β=0.921, P<0.001)and rate of high-quality embryos(β=0.285, P<0.001), while negatively correlated with number of cleavages(β=-0.283, P<0.001). Conclusion IGF-II is highly expressed in the granulosa cells of PCOS patients undergoing assisted reproductive technology, which is closely related to the number of oocytes obtained and rate of high-quality embryos, and has the potential to promote the development of follicles and early embryos.

Key words: Insulin-like growth factor II, Polycystic ovary syndrome, Granulosa cell, Induced ovulation

中图分类号: 

  • R711.75
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