Preconception serum lipids and lipophilic micronutrient levels are associated with live birth rates after IVF
Preconception serum lipids and lipophilic micronutrient levels are associated with live birth rates after IVF
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DOI：
10.1016/j.rbmo.2019.06.004
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发表时间：
2019-10-01
影响因子：
4
通讯作者：
Fujimoto, Victor Y.
中科院分区：
文献类型：
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作者：
Jamro, Erica L.;Bloom, Michael S.;Fujimoto, Victor Y.
研究问题：孕前血脂和亲脂性微量营养素的混合物与临床妊娠和活产相关吗？设计图：在这项前瞻性队列研究中，收集了180名在学术生殖健康中心接受IVF的妇女在取卵当天的血清。使用诊断试剂盒和高效液相色谱法测定脂质（磷脂、总胆固醇、高密度和低密度脂蛋白和甘油三酯）和亲脂性微量营养素（α-、δ-和γ-生育酚、视黄醇、β-和α-胡萝卜素、β-隐黄素、叶黄素和番茄红素）的浓度。Poisson回归与稳健方差估计一起用于评估血清脂质和亲脂性微量营养素浓度混合物的Z分数变化，作为胚胎植入、临床妊娠和活产的预测因子，调整年龄、体重指数（BMI）、种族、吸烟状况、不孕症诊断、卵巢刺激方案和其他测量的脂质和亲脂性微量营养素浓度。血清甘油三酯浓度每升高一个SD，活产的机会就降低一个（RR 0.54; 95% CI 0.33 - 0.90）而血清α-生育酚浓度升高1 SD（作为血清脂质和亲脂性微量营养素混合物的一部分）与活产可能性升高相关（RR 1.61; 95% CI 1.11 - 2.36）。血清β-胡萝卜素浓度与活产在一个非线性的方式;低β-胡萝卜素与活产的机会较低，高β-胡萝卜素与活产的机会较高livebirth.Conclusion：虽然成分的脂质和亲脂性微量营养素的混合物与体外受精后的活产结局，一个更大的调查是必要的，以充分评估潜在的临床意义。
Research question: Is a mixture of preconception serum lipids and lipophilic micronutrients associated with clinical pregnancy and live births?Design: In this prospective cohort study, blood serum was collected on the day of oocyte retrieval for 180 women undergoing IVF at an academic reproductive health centre. Concentrations of lipids (phospholipids, total cholesterol, high- and low-density lipoproteins, and triglycerides) and lipophilic micronutrients (alpha-, delta- and gamma-tocopherols, retinol, beta- and alpha-carotenes, beta-cryptoxanthin, lutein and lycopene) were determined using diagnostic reagent kits and high-performance liquid chromatography. Poisson regression was used with robust variance estimation to evaluate changes in Z-scores for the mixture of serum lipid and lipophilic micronutrient concentrations as predictors of embryo implantation, clinical pregnancy and live birth, adjusted for age, body mass index (BMI), race, smoking status, infertility diagnosis, ovarian stimulation protocol and other measured lipid and lipophilic micronutrient concentrations.Results: Each SD higher serum triglyceride concentration was associated with a lower chance of live birth (RR 0.54; 95% CI 0.33 to 0.90) whereas a 1 SD higher serum a-tocopherol concentration, as part of a mixture of serum lipids and lipophilic micronutrients, was associated with a higher likelihood for a live birth (RR 1.61; 95% CI 1.11 to 2.36). Serum beta-carotene concentrations were associated with live birth in a non-linear fashion; low beta-carotene was associated with a lower chance of live birth and high beta-carotene with a higher chance of live birth.Conclusion: Although components of a mixture of lipids and lipophilic micronutrients were associated with live birth outcomes after IVF, a larger investigation is necessary to fully evaluate the potential clinical implications.