肥胖型多囊卵巢综合征孕妇血清 25（OH）D、 SHBG水平变化及对不良妊娠的预测价值.

Objective To investigate the changes in serum 25-hydroxyvitamin D ［25（OH）D］ and sex hormone-binding globulin （SHBG） levels in pregnant women with obese polycystic ovary syndrome （PCOS) and their predictive value for adverse pregnancy. Methods Totally 125 pregnant women with obese PCOS （PCOS group) and 52 healthy pregnant women in the same period （control group) were selected, and the pregnant women with obese PCOS were divided into the adverse pregnancy group （48) and good pregnancy group （77) according to the pregnancy outcome. Serum 25（OH）D and SHBG levels were measured by enzyme-linked immunosorbent assay. Factors of adverse pregnancy in the obese pregnant women with PCOS were analyzed by multifactorial Logistic regression, and the predictive value of serum 25（OH）D and SHBG levels for adverse pregnancy in pregnant women with PCOS was analyzed by receiver operating characteristic （ROC） curve. Results Compared with the control group, serum 25（OH）D and SHBG levels were reduced in the PCOS group （both P<0. 05). The incidence of adverse pregnancy in 125 pregnant women with obese PCOS was 38. 40% （48/ 125）. Serum 25（OH）D and SHBG levels were lower in the adverse pregnancy group than those in the good pregnancy group （both P<0. 05). Elevated luteinizing hormone/follicle-stimulating hormone, elevated testosterone, elevated low-density lipoprotein cholesterol, and elevated homeostasis model assessment-insulin resistance were independent risk factors for adverse pregnancy in pregnant women with obese PCOS, and elevated 25（OH）D and elevated SHBG were independent protective factors （all P<0. 05). The area under the curve of serum 25（OH）D combined with SHBG in predicting obese PCOS was 0. 882, which was greater than that （0. 783 and 0. 775） of serum 25（OH）D and SHBG levels alone （both P<0. 05）. Conclusion Serum 25（OH）D and SHBG levels in pregnant women with obese PCOS decrease, which are closely associated with adverse pregnancy, and the combined detection of serum 25（OH）D and SHBG is of high value in predicting adverse pregnancy in pregnant women with obese PCOS. [ABSTRACT FROM AUTHOR]