A study on the correlation between adrenomedullin levels in microenvironment and ovarian function and inflammatory status in patients with polycystic ovary syndrome
Objective To explore the expression levels of adrenomedullin(ADM)in follicular fluid of patients with polycystic ovary syndrome(PCOS)and its correlation with ovarian function and inflammation.Methods To conduct a cohort study,the data on infertile couples who received an antagonistic regimen of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI)to promote ovulation from March to December 2023 at the Reproductive Medicine Center of Shanxi Children's Hospital(Shanxi Maternal and Child Health Hospital)were collected.PCOS patients were selected as the PCOS group,and patients who underwent IVF/ICSI assisted pregnancy solely due to tubal and/or male factors during the same period were selected as control group.The general clinical data of two groups of patients were analyzed,and the expression of ADM,interleukin 1β(IL-1β),IL-18,transforming growth factor β(TGF-β)in the follicular fluid were compared between the two groups of patients.And taking the concentration of ADM in follicular fluid as the main research indicator,correlation and multiple linear regression analysis were conducted with other indicators.Simultaneously the ADM mRNA expression,cell cycle and cell apoptosis of granulosa cells were compared between the two groups.Results This study included 20 cases in the PCOS group and 20 cases in control group.Compared with control group,the expression of ADM in follicular fluid and granulosa cells of patients with PCOS were significantly lower(both P<0.001),while its testosterone,the ratio of luteinizing hormone and follicle-stimulating hormone,antral follicle count(AFC),number of retrieved eggs,ovarian sensitivity index,as well as IL-1β,IL-18 and TGF-β in follicular fluid were higher and negatively correlated with ADM(r=-0.37,P=0.019;r=-0.32,P=0.047;r=-0.50,P<0.001;r=-0.38,P=0.017;r=-0.38,P=0.016;r=-0.44,P=0.005;r=-0.37,P=0.018;r=-0.54,P<0.001).Multiple linear regression showed that AFC,gonadotropin initiation dose,IL-1β and TGF-β were the independent related factors that affect local ADM levels(r=-0.37,P=0.008;r=-0.27,P=0.035;r=-0.28,P=0.028;r=-0.45,P<0.001).There was no statistically significant difference in the cell cycle of granulocytes between the two groups(P>0.05),but the apoptosis rate(AR)of granulocytes was higher in the PCOS group than in control group(median AR in the PCOS group was 46.07%,median AR in control group was 28.57%,n=10,P=0.036).Conclusion The decreased expression of ADM in follicles of PCOS patients is related to ovarian endocrine disorders,multiple vesicles,high ovarian responsiveness and local inflammatory status.
NETL
NSTL
万方数据
