| 摘要: |
| ［摘要］ 目的 研究不同分型的多囊卵巢综合征（PCOS）不孕症患者血清25-羟基维生素D［25（OH）D］和热休克蛋白70（HSP70）水平差异。方法 选择2022年1月至2024年12月于大理大学第一附属医院生殖医学科就诊的250例不孕症患者作为研究对象。其中输卵管性不孕症患者50例（对照组），PCOS不孕症患者200例（PCOS组）。依据PCOS鹿特丹诊断与分型标准将PCOS不孕症患者分为PCOS-A型、PCOS-B型、PCOS-C型和PCOS-D型，各50例。根据血清25（OH）D水平将人体维生素D水平划分为缺乏（<20 ng/mL）、不足（20～30 ng/mL）及充足（>30 ng/mL）。比较各组血清基础性激素、25（OH）D、HSP70水平。结果 PCOS组25（OH）D、促卵泡激素（FSH）水平低于对照组，体质量指数（BMI）及HSP70、促黄体生成素（LH）、睾酮（T）、抗苗勒管激素（AMH）水平高于对照组，差异有统计学意义（P<0.05）。两组25（OH）D水平分布情况比较差异有统计学意义（P<0.05），PCOS组维生素D缺乏率较高。不同分型PCOS不孕症患者25（OH）D水平分布情况比较差异无统计学意义（P>0.05）。不同分型PCOS不孕症患者LH、FSH、T、AMH、HSP70水平比较差异有统计学意义（P<0.05），PCOS-A型患者的LH水平显著高于PCOS-B型、PCOS-C型、PCOS-D型（P<0.05），而PCOS-A型患者的FSH水平显著低于PCOS-C型（P<0.05），PCOS-A型、PCOS-B型患者的HSP70水平显著高于PCOS-D型（P<0.05）。结论 与输卵管性不孕症患者相比，PCOS不孕症患者血清HSP70、LH、T及AMH水平显著升高，而25（OH）D与FSH水平显著降低。HSP70的升高呈现显著的表型差异，在典型高雄激素表型（PCOS-A型、PCOS-B型）中显著高于非高雄激素表型（PCOS-D型）。维生素D缺乏在四种PCOS分型间的分布无显著差异，HSP70的高表达与高雄激素血症特征具有关联性，而维生素D缺乏则是PCOS不孕症患者普遍存在的代谢改变，与具体临床分型无关。 |
| 关键词: 维生素D 25-羟基维生素D 热休克蛋白70 多囊卵巢综合征 |
| DOI：10.3969/j.issn.1674-3806.2026.01.06 |
| 分类号:R 711.75 |
| 基金项目:国家自然科学基金项目（编号：82260309） |
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| Study on the differences in serum 25-hydroxyvitamin D and heat shock protein 70 levels among female infertility patients with different types of polycystic ovary syndrome |
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XU Anli1, ZHU Li1, QIU Yunlin1, TONG Yinyin1, WANG Shilian2, ZHANG Ruopeng3,4
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1.Department of Reproductive Medicine, the First Affiliated Hospital of Dali University, Dali 671000, China; 2.School of Public Health, Dali University, Dali 671000, China; 3.Kunming Maternal and Child Health Hospital(Graduate Training Base of Dali University at Kunming Maternal and Child Health Hospital), Kunming 650000, China; 4.Dongguan Songshan Lake Central Hospital of Guangdong Medical University, Dongguan 523000, China
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| Abstract: |
| ［Abstract］ Objective To study the differences in serum 25-Hydroxyvitamin D［25(OH)D］ and heat shock protein 70(HSP70) levels among female infertility patients with different types of polycystic ovary syndrome(PCOS). Methods A total of 250 female infertility patients who visited the doctors at Department of Reproductive Medicine, the First Affiliated Hospital of Dali University from January 2022 to December 2024 were selected as the research subjects. Among the 250 patients, there were 50 patients with tubal infertility(control group) and 200 patients with infertility due to PCOS(PCOS group). According to the Rotterdam diagnostic and typing criteria for PCOS, the infertile patients with PCOS were classified into PCOS-A type(n=50), PCOS-B type(n=50), PCOS-C type(n=50) and PCOS-D type(n=50). According to different serum 25(OH)D levels, the vitamin D levels of the patients were classified as deficiency(<20 ng/mL), insufficiency(20-30 ng/mL), and sufficiency(>30 ng/mL). The levels of serum basic sex hormones, 25(OH)D and HSP70 were compared among the groups. Results The levels of 25(OH)D and follicle-stimulating hormone(FSH) in the PCOS group were lower than those in the control group, and the body mass index(BMI) as well as the levels of HSP70, luteinising hormone(LH), testosterone(T) and anti-Müllerian hormone(AMH) in the PCOS group were higher than those in the control group, with statistically significant differences between the two groups(P<0.05). There was a statistically significant difference in the distribution of 25(OH)D levels between the two groups(P<0.05). The rate of vitamin D deficiency in the PCOS group was higher. There were no statistically significant differences in the distributions of 25(OH)D levels among the patients with different types of PCOS(P>0.05). There were statistically significant differences in the levels of LH, FSH, T, AMH and HSP70 among the infertile patients with different types of PCOS(P<0.05). The LH level of the patients with PCOS-A type was significantly higher than that of the patients with PCOS-B type, PCOS-C type and PCOS-D type(P<0.05), while the FSH level of the patients with PCOS-A type was significantly lower than that of the patients with PCOS-C type(P<0.05). The HSP70 levels of the patients with PCOS-A type and PCOS-B type were significantly higher than those of the patients with PCOS-D type(P<0.05). Conclusion Compared with those in the tubal infertility patients, the levels of serum HSP70, LH, T and AMH in the infertile patients with PCOS are significantly increased, while the levels of 25(OH)D and FSH are significantly decreased in the infertile patients with PCOS. The increase of HSP70 in the infertile patients with PCOS shows significant phenotypic differences, with significantly higher levels in the infertile patients with typical hyperandrogenic phenotypes of PCOS(including PCOS-A type and PCOS-B type) compared with those with non-hyperandrogenic phenotypes of PCOS(PCOS-D type). There are no significant differences in the distributions of vitamin D deficiency among the patients with four phenotypes of PCOS. High expression of HSP70 is associated with hyperandrogenemia features, whereas vitamin D deficiency is a common metabolic alteration in the infertile patients with PCOS patients and is unrelated to specific clinical phenotypes. |
| Key words: Vitamin D 25-Hydroxyvitamin D［25(OH)D］ Heat shock protein 70(HSP70) Polycystic ovary syndrome(PCOS) |
