【摘要】 目的 研究卵泡液中脂肪酸结合蛋白4（FABP4）与卵泡液局部炎症及脂代谢的关系，并分析其对卵母细胞功能的潜在影响。方法 本研究纳入2020年6月-2021年1月在青岛大学附属医院生殖医学科因单纯输卵管和（或）男性因素接受体外受精/卵胞质内单精子注射-胚胎移植受试者122例。根据受试者卵泡液中FABP4浓度的百分位数分为3个浓度组：A组(FABP4浓度≤24.56μg/L,P₀～P₂₅),B组(24.56μg/L<FABP4浓度≤48.36μg/L,P₂₆～P₇₅),C组(FABP4浓度>48.36μg/L,P₇₆～P₁₀₀)。比较3组受试者卵泡液中单核细胞趋化蛋白-1（MCP-1）、白细胞介素-6（IL-6）、氧化低密度脂蛋白（ox-LDL）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）及甘油三酯（TG）水平的差异。采用多重线性回归分析优质胚胎率的影响因素。结果 A、B和C组卵泡液中MCP-1、IL-6、ox-LDL水平随FABP4浓度增高而增高，组间比较差异有显著性（H=11.371～54.114,P<0.01）;两两比较结果显示，A组MCP-1、ox-LDL水平均显著低于B、C组（H=-65.017～-19.447,P<0.01）;A组IL-6水平显著低于C组（H=-30.633,P<0.01）;B组MCP-1、ox-LDL水平显著低于C组（H=-36.337、-44.331,P<0.01）;3组受试者卵泡液中LDL-C、TC和TG水平比较差异无显著性（P>0.05）。多重线性回归显示，卵泡液中FABP4是优质胚胎率的危险因素（β=-0.520,95%CI=-0.981～-0.059,P<0.05）,且该作用独立于卵泡液IL-6、ox-LDL、促性腺激素使用总量和体质量指数。结论 卵泡液中FABP4可能通过与MCP-1、IL-6和ox-LDL的相互作用参与局部炎症和氧化应激，并可能影响卵母细胞质量。更多还原

【Abstract】 Objective To investigate the relationship between fatty acid-binding protein 4（FABP4） with local inflammation and lipid metabolism in follicular fluid（FF）, as well as the potential influence of FABP4 on oocyte function. Methods A total of 122 patients who underwent in vitro fertilization/intracytoplasmic sperm injection-embryo transfer（IVF/ICSI-ET） due to simple fallopian tube and/or partner problems in the Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University from June 2020 to January 2021 were enrolled in this cross-sectional study. According to the FF FABP4 level, the patients were divided into group A(FABP4 level ≤24.56 μg/L,P₀-P₂₅), group B(24.56 μg/L <FABP4 level ≤48.36 μg/L,P₂₆-P₇₅), and group C(FABP4 level >48.36 μg/L,P₇₆-P₁₀₀). The three groups were compared in terms of the levels of FF monocyte chemoattractant protein-1（MCP-1）, interleukin-6（IL-6）, oxidized low-density lipoprotein（ox-LDL）, total cholesterol（TC）, low-density lipoprotein cholesterol（LDL-C）, and triglyceride（TG）. Afterwards, multivariate linear regression was used to analyze the influencing factors for high-quality embryo rate. Results The concentrations of FF MCP-1, IL-6, and ox-LDL significantly increased as the FABP4 level increased in groups A, B, and C（H=11.371-54.114,P<0.01）. The pairwise comparisons showed that group A had significantly lower levels of FF MCP-1 and ox-LDL compared with group B and C（H=-65.017--19.447,P<0.01） and a significantly lower level of FF IL-6 compared with group C（H=-30.633,P<0.01）; group B had significantly lower levels of FF MCP-1 and ox-LDL compared with group C（H=-36.337,-44.331,P<0.01）; but there were no significant differences in the concentrations of FF LDL-C, TC, and TG between the three groups（P>0.05）. The multivariate li-near regression showed that FF FABP4 was a risk factor for the high-quality embryo rate（β=-0.520,95%CI=-0.981--0.059,P<0.05）, which was independent of the FF IL-6 and ox-LDL levels, total dosage of gonadotropin, and body mass index. Conclusion FABP4 may be involved in local inflammation and oxidative stress in FF through its correlation with MCP-1, IL-6, and ox-LDL, and may affect the quality of oocytes.更多还原