Is elevated baseline SHBG associated with increased ovulation?
Is elevated baseline SHBG associated with increased ovulation?
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DOI：
10.1080/09513590.2023.2263085
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发表时间：
2023-12-14
影响因子：
2
通讯作者：
Wu，Xiaoke
中科院分区：
文献类型：
--
作者：
Chang，Hui;Ge，Hang;Wu，Xiaoke
性激素结合球蛋白(SHBG)与内分泌和生殖系统有关。我们的目的是研究SHBG在生殖过程中的作用。因此，我们对多囊卵巢综合征与针灸临床试验(PCOS Act)研究进行了二次分析，研究涉及中国的21个站点，共1,000名多囊卵巢综合征患者。在这些人中，954名患有SHBG的女性被纳入分析。通过对排卵预测因素的多因素分析，发现年龄、体重指数、雌二醇、睾酮和SHBG对排卵均有正向预测价值(p= 分别为0.0211、0.0011、0.0211、0.0029、0.0434)。然而，促黄体生成素/促卵泡刺激素比值具有负向预测价值(p= 0.0539)。SHBG四分位数越高，排卵率越高，每四分位数增加有统计学意义(HR=1.138，95%CI[1.054，1.229])。即使在调整了睾酮因素后，这种相关性仍然显著(HR=1.263，95%CI[1.059，1.507])。另一方面，四分位数的睾酮和雌二醇没有表现出任何明显的排卵倾向。SHBG显示出预测排卵、受孕、妊娠和活产的能力(p<； 0.05)，在调整干预措施后，这种相关性仍然显著。Kaplan-Meier曲线显示SHBG水平升高是高排卵率、妊娠率和妊娠率的一个因素。与其他性激素相比，SHBG基线水平较高与排卵增加有关。
Sexual hormone binding globulin (SHBG) is associated with the endocrine and reproductive systems. We aimed to investigate the role of SHBG in the reproductive process. Therefore, we conducted a secondary analysis of the PCOSAct (Polycystic Ovary Syndrome and Acupuncture Clinical Trial) study, which involved 21 sites in China and a total of 1000 women with PCOS. Out of these, 954 women with SHBG were included in the analysis. Through multivariate analysis of ovulation predictors, we found that age, BMI, estradiol, testosterone, and SHBG all showed a positive predictive value for ovulation (p= 0.0211, 0.0011, 0.0211, 0.0029, 0.0434, respectively). However, the LH to FSH ratio had a negative predictive value (p= 0.0539). Higher quartiles of SHBG were associated with a higher rate of ovulation, and per quartile increased was statistically significant (HR = 1.138, 95%CI [1.054,1.229]). The association remained significant even after adjusting for testosterone (HR = 1.263, 95%CI [1.059, 1.507]). On the other hand, quartiles of testosterone and estradiol did not exhibit any significant tendency toward ovulation. SHBG demonstrated predictive ability for ovulation, conception, pregnancy, and live birth (p< 0.05), and this correlation remained significant after adjusting intervention. Kaplan-Meier curves illustrated that increased levels of SHBG were a factor in high rates of ovulation, conception, and pregnancy. In comparison to other sexual hormones, a higher baseline level of SHBG was related to increased ovulation.