| Objective:To detect the plasma kisspeptin concentration in different gestational weeks in patients with recurrent spontaneous abortion,and to explore the predictive effect of plasma kisspeptin level on the outcome of re-pregnancy in patients with recurrent spontaneous abortion,in order to provide a reference for clinical diagnosis and treatment.Method:Selected 205 early-pregnant women who attended the outpatient clinic of the Reproductive Center of the First Affiliated Hospital of Anhui Medical University from December 2019 to October 2020 as the research subjects.According to the past history of spontaneous abortion and the outcome of this pregnancy,Twenty-nine recurrent spontaneous abortion patients were in the abortion group,78 recurrent spontaneous abortion patients who had not been miscarried were the continuous pregnancy group,and 98 pregnant women who had no history of spontaneous abortion were the control group.Enzyme-linked immunosorbent assay(ELISA)and chemiluminescence were used to detect plasma kisspeptin and serum β-h CG levels in the three groups at 5-9weeks gestation.The plasma kisspeptin and the serum β-h CG levels at different gestational weeks between the three groups was analyzed and compared.Finally,draw the ROC curve of different indicators for predicting re-abortion in patients with recurrent spontaneous abortion,obtain the area under the curve and the best cut-off value,analyze and compare its predictive value for early pregnancy miscarriage in patients with recurrent spontaneous abortion.Result:(1)There were no statistically significant differences in age,height,weight,BMI,and and number of births between the continuous pregnancy group,the abortion group and the control group(P>0.05);The pregnancy times of the continuous pregnancy group and the abortion group are higher than the control group,the difference is statistically significant(P<0.0001);the pregnancy times and the number of spontaneous abortions in the abortion group are higher than the continuous pregnancy group,the difference is statistically significant(P < 0.05);The three groups of people have different ways of getting pregnant,and the difference is statistically significant(P < 0.001).The proportion of embryo transfer in the control group is higher than that of the continuous pregnancy group and the abortion group(P < 0.001),while there is no difference between the continuous pregnancy group and the abortion group(P>0.05).(2)The β-h CG level in the abortion group at 5,6,7,and 8 weeks of gestation was lower than that of the continuous pregnancy group and the control group at the corresponding gestational week,the difference was statistically significant(P<0.05);The continuous pregnancy group compared with the control group at 5,6,and 7 weeks of pregnancy,there was no significant difference in the β-h CG level(P>0.05).At 8weeks of gestation,the β-h CG level of the continuous pregnancy group was lower than that of the control group(P<0.05).(3)The kisspeptin levels in the abortion group at 5,6,7,8,and 9 weeks of gestation were lower than the control group and the continuous pregnancy group at the corresponding gestational week,and the difference was statistically significant(P <0.01).At 5,6,and 8 weeks of gestation,the kisspeptin levels in the continuous pregnancy group were not significantly different from those in the control group(P>0.05),while at 7 and 9 weeks of pregnancy,the kisspeptin levels in the continuous pregnancy group is lower than the control group(P<0.05).(4)The plasma kisspeptin levels of the three groups all increased with the increase in the number of weeks of pregnancy,and the two were positively correlated(r>0,P<0.001).(5)ROC curve analysis showed that plasma kisspeptin,serum β-h CG,kisspeptin combined with β-h CG measurements at 5,6,and 7 weeks of pregnancy had good predictive value for re-abortion in patients with recurrent spontaneous abortion(P <0.0001).(6)At 5 weeks of gestation,kisspeptin,kisspeptin combined with β-h CG have a better predictive value for RSA patients’ re-abortion(P<0.05),while kisspeptin,kisspeptin combined with β-h CG measurement have similar predictive effects(P<0.05).At 6 and7 weeks of gestation,the predictive effects of the three indicators were equivalent,and the difference was not statistically significant(P>0.05).Conclusions(1)The level of plasma kisspeptin increases with the increase of gestational weeks,and the two are positively correlated.(2)Plasma kisspeptin levels have varying degrees of difference between the abortion group,the continuous pregnancy group,and the control group,which can be used as an index to predict the outcome of recurrent pregnancy in patients with recurrent spontaneous abortion.(3)The measurement of plasma kisspeptin,serum β-h CG,kisspeptin combined withβ-h CG at 5,6,and 7 weeks of gestation has a good predictive value for re-abortion in patients with recurrent spontaneous abortion.(4)At 5 weeks of gestation,kisspeptin and kisspeptin combined with β-h CG are better than β-h CG in predicting re-abortion in RSA patients,while kisspeptin and kisspeptin combined with β-h CG have the same predictive effect.Objective: To analyze the clinical data of patients with recurrent spontaneous abortion,including body mass index(BMI),fasting plasma glucose(FPG),fasting insulin(FINS)levels and their distribution characteristics.At the same time,the relationship between recurrent spontaneous abortion(RSA)and different BMI,insulin resistance and abnormal glucose metabolism were discussed.Methods:The 876 women with recurrent spontaneous abortion who attended the outpatient clinic of the Reproductive Center of the First Affiliated Hospital of Anhui Medical University from April 2017 to October 2020 were selected as the case group(RSA group),and1397 women who underwent assisted reproductive technology due to male factors during the same period were selected as the control group.The clinical data were collected,and the body mass index(BMI),fasting insulin(FINS),fasting plasma glucose(FPG)levels of the two groups were analyzed.At the same time,the BMI level was divided into 4 intervals,and the distribution characteristics of insulin and blood glucose in the two groups under different intervals were compared.Result:(1)The FPG,FINS,and HOMA-IR indexes of the RSA group were higher than those of the control group(P<0.01).(2)The detection rates of impaired fasting blood glucose(IFG),insulin resistance(IR)in the RSA group were higher than those in the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference in the detection rate of diabetes between the two groups(P>0.05).(3)The occurrence rate of abnormal BMI and glucose metabolism in the RSA group was higher than that in the control group(P<0.05).(4)The generation rate of abnormal glucose metabolism in overweight and obese patients in the RSA group was higher than that in the control group(P<0.05).(5)The detection rate of IR in normal weight patients in the RSA group was higher than that in the control group(P<0.01).Conclusions:(1)The occurrence of RSA is related to insulin resistance and abnormal glucose metabolism.(2)There was no significant difference in the interval distribution of BMI between patients with recurrent spontaneous abortion and the control group.(3)Compared with the control group,overweight or obese patients with recurrent spontaneous abortion are more likely to have glucose metabolism disorders,and patients with normal weight recurrent miscarriage are more likely to develop insulin resistance.Attention should be paid to the insulin level and glucose metabolism status of patients with recurrent spontaneous abortion of different weights. |
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