Relationship between Homocysteine,Uterine Artery Blood Flow Parameters and Insulin Resistance and Pregnancy Outcome in Patients with Recurrent Pregnancy Loss
Objective:To investigate the relationship between homocysteine(Hcy),uterine artery blood flow parameters and insulin resistance and pregnancy outcome in patients with recurrent pregnancy loss(RPL).Methods:162 RPL patients admitted to Kunming Maternal and Child Health Hospital from June 2020 to October 2022 were selected as the RPL group and 82 healthy pregnant women underwent regular prenatal examinations during the same period as the control group.RPL patients were divided into live birth group(85 cases)and abortion group(77 cases)according to the pregnancy outcome.Serum Hcy level,insulin resistance index(HOMA-IR),uterine artery blood flow parameters,including uterine artery peak systolic/end diastolic velocity(S/D),pulsatility index(PI)and blood flow resistance index(RI)were detected.The correlation between Hcy,uterine artery blood flow parameters and HOMA-IR were analyzed by Pearson correlation analysis.The influencing factors of pregnancy outcomes in RPL patients were analyzed by multivariate Logistic regression analysis.The predictive value of Hcy and uterine artery blood flow parameters on the pregnancy outcome of RPL patients was analyzed by receiver operating characteristic(ROC)curve.Results:The serum Hcy level,S/D,PI,RI and HOMA-IR in RPL group were higher than those in control group(P＜0.05).The serum Hcy,S/D,PI and RI in RPL group were positively correlated with HOMA-IR(P＜0.05).The serum Hcy level,S/D,PI,RI and HOMA-IR in abortion group were higher than those in live birth group(P＜0.05).Multivariate Logistic regression analysis showed that high HOMA-IR,high Hcy,high S/D,high RI and chromosomal abnormalities were risk factors for abortion in RPL patients(P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of combined Hcy,S/D and RI in predicting abortion in RPL patients was 0.849,which was higher than that of single prediction.Conclusion:The levels of uterine artery blood flow parameters S/D,RI,PI and serum Hcy in RPL patients were increased,high S/D,RI and Hcy were relate to insulin resistance and increased risk of abortion in RPL patients.Combined S/D,RI and Hcy could improve the efficacy of RPL abortion risk assessment.
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NSTL
万方数据
维普
