血清TGF-β1、IL-17A、miR-21与非高龄卵巢功能减退不孕的关系探讨OA

Objective To investigate relationship between serum transforming growth factor β1(TGF-β1),interleukin-17A(IL-17A),microRNA-21(miR-21)and infertility in non-geriatric patients with diminished ovarian reserve(DOR),and to provide a favorable reference for clinical diagnosis and treatment.Methods A total of 134 non-geriatric female infertile patients with DOR who admitted to Kunming Municipal Maternal and Child Health Hospital from August 2022 to October 2023 were selected as observation group,and 100 healthy women with normal ovarian function in the same age group during the same period were selected as the control group.Serum levels of TGF-β1,IL-17A and miR-21 of the women were compared between the two groups.The clinical data,serum levels of sex hormones[basal follicle stimulating hormone(bFSH),basal estradiol(bE2),basal luteinizing hormone(bLH),anti-müllerian hormone(AMH)]and TGF-β1,IL-17A and miR-21 were compared among the patients with different ovarian responses to ovulation induction therapy in the observation group.Spearman/Pearson correlation coefficient methods were employed to explore correlations between serum TGF-β1,IL-17A,miR-21 and sex hormones,ovarian responses to ovulation induction treatment,in addition,receiver operating characteristic(ROC)curve was used to analyze predictive efficacy of serum TGF-β1,IL-17A and miR-21 levels for poor ovarian response to ovulation induction treatment in the non-geriatric patients with DOR-caused infertility,and Logistic regression analysis was used to analyze factors affecting infertility of these non-geriatric patients with DOR.Results The serum levels of TGF-β1,IL-17A and miR-21 of the infertile patients in the observation group were higher than those in the control group,the differences were statistically significant(t=9.676-37.579,all P<0.05).Compared with the normal ovarian response to ovulation induction treatment subgroup,the infertile patients in the poor ovarian response to ovulation induction treatment subgroup had higher serum levels of bFSH,bLH,TGF-β1,IL-17A and miR-21,while they had lower serum levels of bE2 and AMH(t=2.404-43.562,all P<0.05).The serum levels of TGF-β1,IL-17A and miR-21 were positively correlated with serum levels of bFSH and bLH(r=0.575-0.643,all P<0.05),and negatively correlated with serum levels of bE2 and AMH(r=-0.714--0.582,all P<0.05).Ovarian response was positively correlated with serum TGF-β1,IL-17 A and miR-21 levels(r=0.675-0.712,all P<0.05).The area under the curve(AUC)of combined detection of serum TGF-β1,IL-17 A and miR-21 for predicting poor ovarian response in the non-geriatric DOR-caused infertile patients was 0.936,which was greater than that of single prediction of the three indexes(Z value ranged from 3.225 to 3.817,P<0.05).Sex hormones bE2 and AMH were independent protective factors for infertility in the non-geriaric female DOR patients,while serum TGF-β1,IL-17A and miR-21 were the independent risk factors,and their OR values(95%CI)were 0.961(0.928-0.995),0.957(0.938-0.976),1.100(1.017-1.190),1.090(1.025-1.160)and 1.061(1.019-1.104)respectively.Conclusion The serum levels of TGF-β1,IL-17A and miR-21 of the non-geriatric female patients with DOR-caused infertility abnormally elevate,which are closely related to serum levels of sex hormones and ovarian response to ovulation induction treatment,so they have certain predictive values for poor ovarian response after ovulation induction.