Correlation Analysis between Serum NRG-1,NRG-4 and Chronic Low-Grade Inflammation Status and Insulin Resistance in Patients with Polycystic Ovary Syndrome and Their Influence for Pregnancy Outcomes
Objective:To analyze the correlation between serum neuregulin-1(NRG-1),neuregulin-4(NRG-4)and chronic low-grade inflammation status and insulin resistance in patients with polycystic ovary syndrome(PCOS),and to explore the influence for pregnancy outcomes.Methods:161 patients with PCOS(PCOS group)who were admitted to Beijing Boai Hospital of China Rehabilita-tion Research Center from January 2018 to October 2021 were selected,another 100 healthy women with age as control(control group)who were came to the hospital for physical examination during the same period were selected.The serum NRG-1,NRG-4,white blood cell count(WBC),C-reactive protein(CRP)levels and homeostasis model assessment-insulin resistance index(HOMA-IR)in the sub-jects were detected,and the correlation between NRG-1,NRG-4,WBC,CRP,and HOMA-IR was analyzed.The pregnancy outcomes in patients with PCOS were tracked,they were divided into poor pregnancy outcomes group and good pregnancy outcomes group.Univari-ate and multivariate logistic regression were used to analyze the influencing factors of adverse pregnancy outcomes.The predictive value of NRG-1,NRG-4,CRP,and HOMA-IR in adverse pregnancy outcomes used receiver operating characteristic(ROC)curve analysis.Results:Compared with control group,the NRG-1,NRG-4,CRP,WBC and HOMA-IR levels increased in PCOS group(P＜0.05).Pear-son correlation analysis showed that NRG-1 and NRG-4 were positively correlated with CRP,WBC,and HOMA-IR(P＜0.05).The results of single factor analysis showed that the serum NRG-1,NRG-4,CRP,WBC,and HOMA-IR levels in poor pregnancy outcomes group were higher than those in good pregnancy outcomes group(P＜0.05).Multivariate logistic regression analysis showed that NRG-1＞10.55 pg/mL,NRG-4＞27.20 pg/m,CRP＞7.51 mg/L and HOMA-IR＞3.35 were all risk factors for poor pregnancy outcomes in PCOS patients(P＜0.05).The ROC-AUC(0.95CI)of NRG-1,NRG-4,CRP,and HOMA-IR when used alone or in combination were 0.706(0.429～0.980),0.709(0.405～0.988),0.749(0.535～0.938),0.747(0.496～0.988),and 0.850(0.739～0.959),respectively,Joint prediction was greater than a single indicator.Conclusions:The serum NRG-1 and NRG-4 levels are high in patients with PCOS,which are posi-tively correlated with chronic low-grade inflammatory status and insulin resistance indicators,and they are risk factors for affects poor pregnancy outcomes.The combination of NRG-1,NRG-4,CRP,and HOMA-IR has a high predictive value for poor pregnancy outcomes in PCOS patients.
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