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Correlation between Neutrophil-to-Lymphocyte Ratio and Diabetic Neuropathy in Chinese Adults with Type 2 Diabetes Mellitus Using Machine Learning Methods. 利用机器学习方法研究中国成人 2 型糖尿病患者中性粒细胞与淋巴细胞比率与糖尿病神经病变的相关性
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-31 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7044644
Lijie Zhu, Yang Liu, Bingyan Zheng, Danmeng Dong, Xiaoyun Xie, Liumei Hu
<p><strong>Objective: </strong>One of the most frequent consequences of diabetes mellitus has been identified as diabetic peripheral neuropathy (DPN), and numerous inflammatory disorders, including diabetes, have been documented to be reflected by the neutrophil-to-lymphocyte ratio (NLR). This study aimed to explore the correlation between peripheral blood NLR and DPN, and to evaluate whether NLR could be utilized as a novel marker for early diagnosis of DPN among those with type 2 Diabetes Mellitus (T2DM).</p><p><strong>Methods: </strong>We reviewed the medical records of 1154 diabetic patients treated at Tongji Hospital Affiliated to Tongji University from January 2022 to March 2023. These patients did not have evidence of acute infections, chronic inflammatory status within the past three months. The information included the clinical, laboratory, and demographic characteristics of the patient. Finally, a total of 442 T2DM individuals with reliable, complete, and accessible medical records were recruited, including 216 T2DM patients without complications (DM group) and 226 T2DM patients with complications of DPN (DPN group). One-way ANOVA and multivariate logistic regression were applied to analyze data from the two groups, including peripheral blood NLR values and other biomedical indices. The cohort was divided in a 7 : 3 ratio into training and internal validation datasets following feature selection and data balancing. Based on machine learning, training was conducted using extreme gradient boosting (XGBoost) and support vector machine (SVM) methods. K-fold cross-validation was applied for model assessment, and accuracy, precision, recall, <i>F</i>1-score, and the area under the receiver operating characteristic curve (AUC) were used to validate the models' discrimination and clinical applicability. Using Shapley Additive Explanations (SHAP), the top-performing model was interpreted.</p><p><strong>Results: </strong>The values of 24-hour urine volume (24H UV), lower limb arterial plaque thickness (LLAB thickness), carotid plaque thickness (CP thickness), D-dimer and onset time were significantly higher in the DPN group compared to the DM group, whereas the values of urine creatinine (UCr), total cholesterol (TC), low-density lipoprotein (LDL), alpha-fetoprotein (AFP), fasting c-peptide (FCP), and nerve conduction velocity and wave magnitude of motor and sensory nerve shown in electromyogram (EMG) were considerably lower than those in the DM group (<i>P</i> < 0.05, respectively). NLR values were significantly higher in the DPN group compared to the DM group (2.60 ± 4.82 versus 1.85 ± 0.98, <i>P</i> < 0.05). Multivariate logistic regression analysis revealed that NLR (<i>P</i> = 0.008, <i>C</i> = 0.003) was a risk factor for DPN. The multivariate logistic regression model scores were 0.6241 for accuracy, 0.6111 for precision, 0.6667 for recall, 0.6377 for <i>F</i>1, and 0.6379 for AUC. Machine learning methods, XGBoost and SVM, built predictio
目的:糖尿病最常见的后遗症之一是糖尿病周围神经病变(DPN),而包括糖尿病在内的许多炎症性疾病都可以通过中性粒细胞与淋巴细胞的比率(NLR)反映出来。本研究旨在探讨外周血 NLR 与 DPN 之间的相关性,并评估 NLR 是否可用作早期诊断 2 型糖尿病(T2DM)患者 DPN 的新型标记物:我们回顾了同济大学附属同济医院自2022年1月至2023年3月收治的1154名糖尿病患者的病历。这些患者在过去三个月内没有急性感染和慢性炎症的迹象。资料包括患者的临床、实验室和人口统计学特征。最后,共招募了 442 名具有可靠、完整和可获取的医疗记录的 T2DM 患者,其中包括 216 名无并发症的 T2DM 患者(DM 组)和 226 名有 DPN 并发症的 T2DM 患者(DPN 组)。采用单因素方差分析和多变量逻辑回归分析两组的数据,包括外周血 NLR 值和其他生物医学指标。队列以 7 :经过特征选择和数据平衡后,按 7 : 3 的比例将队列分为训练数据集和内部验证数据集。在机器学习的基础上,使用极梯度提升(XGBoost)和支持向量机(SVM)方法进行训练。模型评估采用了 K 倍交叉验证,准确度、精确度、召回率、F1 分数和接收器工作特征曲线下面积(AUC)用于验证模型的区分度和临床适用性。利用夏普利相加解释(SHAP)对表现最佳的模型进行了解释:结果:与 DM 组相比,DPN 组的 24 小时尿量(24H UV)、下肢动脉斑块厚度(LLAB 厚度)、颈动脉斑块厚度(CP 厚度)、D-二聚体和发病时间的数值均显著升高,而尿肌酐(UCr)、总胆固醇(TC)、低密度脂蛋白胆固醇(TC)、低密度脂蛋白胆固醇(TC)和低密度脂蛋白胆固醇(TC)的数值均显著升高、而DPN组的尿肌酐(UCr)、总胆固醇(TC)、低密度脂蛋白(LDL)、甲胎蛋白(AFP)、空腹c肽(FCP)、肌电图(EMG)显示的运动神经和感觉神经的神经传导速度和波幅均明显低于DM组(P < 0.05)。与 DM 组相比,DPN 组的 NLR 值明显更高(2.60 ± 4.82 对 1.85 ± 0.98,P < 0.05)。多变量逻辑回归分析显示,NLR(P = 0.008,C = 0.003)是DPN的一个危险因素。多变量逻辑回归模型的准确度为 0.6241,精确度为 0.6111,召回率为 0.6667,F1 为 0.6377,AUC 为 0.6379。机器学习方法 XGBoost 和 SVM 建立的预测模型表明,NLR 可以预测 DPN 的发病。XGBoost 的准确度为 0.6541,精确度为 0.6316,召回率为 0.7273,F1 值为 0.6761,AUC 值为 0.690。SVM 的准确度为 0.5789,精确度为 0.5610,召回率为 0.6970,F1 值为 0.6216,AUC 值为 0.6170:我们的研究结果表明,NLR与DPN高度相关,是DPN的一个独立风险因素。NLR 可能是早期诊断 DPN 的一个新指标。XGBoost和SVM模型具有很好的预测性能,可作为早期预测T2DM患者DPN的可靠工具。本试验注册号为ChiCTR2400087019。
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引用次数: 0
Chemerin Enhances Migration and Invasion of OC Cells via CMKLR1/RhoA/ROCK-Mediated EMT. Chemerin通过CMKLR1/RhoA/ROCK介导的EMT增强OC细胞的迁移和侵袭。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-26 eCollection Date: 2024-01-01 DOI: 10.1155/2024/7957018
Xiaojing Sun, Yi Guo

Chemerin is a newly described adipokine with significant effects on obesity, metabolic disorders, and immune trafficking. Recently, chemerin has gained prominence for its potential roles in cancer and tumorigenesis with pro- or antitumor effects. To date, most referenced multifunctions of chemerin are attributed to the chemokine-like receptor 1 (CMKLR1), distributing broadly in many tissues. This study investigates the in vitro roles of chemerin treatment on migration and invasion of ovarian carcinoma cells (OVCAR-3 and SK-OV-3) and potential underlying mechanisms. Herein, exogenous chemerin treatment promotes growth and invasion of SK-OV-3 cells but has no significant effects on OVCAR-3 cells. SK-OV-3 cells undergo morphological elongation characterized by epithelial-to-mesenchymal transition (EMT) and Ras homologous genome members A (RhoA)/Rho protein-related curl spiral kinase-1 (ROCK1) activation. Furthermore, chemerin-enhanced invasion and EMT of SK-OV-3 cells are effectively blocked by C3 transferase (C3T) and Y27632 and RhoA and ROCK1 inhibitor, respectively. More importantly, RhoA/ROCK1-EMT-mediated SK-OV-3 cell invasion is orchestrated by CMKLR1 upregulation after chemerin treatment (50 ng/mL). The silencing of CMKLR1 significantly (P < 0.0001) reverses the chemerin-enhanced invasion, EMT, and RhoA/ROCK1 activation of SK-OV-3 cells. Our study indicates that chemerin promotes invasion of OC cells via CMKLR1-RhoA/ROCK1-mediated EMT, offering a novel potential target for metastasis of OC.

螯合素是一种新描述的脂肪因子,对肥胖、新陈代谢紊乱和免疫贩运有重要影响。最近,螯合素因其在癌症和肿瘤发生中的潜在作用而备受瞩目,具有促癌或抗癌作用。迄今为止,大多数被提及的螯合素多功能作用都归因于广泛分布于许多组织的趋化因子样受体 1(CMKLR1)。本研究探讨了螯合素对卵巢癌细胞(OVCAR-3 和 SK-OV-3)迁移和侵袭的体外作用及其潜在的内在机制。在本研究中,外源螯合素处理可促进SK-OV-3细胞的生长和侵袭,但对OVCAR-3细胞无明显影响。SK-OV-3细胞会发生形态伸长,其特征是上皮向间质转化(EMT)和Ras同源基因组成员A(RhoA)/Rho蛋白相关卷曲螺旋激酶-1(ROCK1)激活。此外,C3转移酶(C3T)和Y27632以及RhoA和ROCK1抑制剂可分别有效阻断螯合素增强的SK-OV-3细胞侵袭和EMT。更重要的是,Chemerin处理(50 ng/mL)后,RhoA/ROCK1-EMT介导的SK-OV-3细胞侵袭是由CMKLR1上调协调的。沉默CMKLR1可显著(P < 0.0001)逆转螯合素增强的SK-OV-3细胞侵袭、EMT和RhoA/ROCK1激活。我们的研究表明,螯合素通过CMKLR1-RhoA/ROCK1介导的EMT促进OC细胞的侵袭,为OC的转移提供了一个新的潜在靶点。
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引用次数: 0
Association between Dietary Potassium Intake and Nonalcoholic Fatty Liver Disease and Advanced Hepatic Fibrosis in U.S. Adults. 美国成年人膳食钾摄入量与非酒精性脂肪肝和晚期肝纤维化之间的关系。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-07-15 eCollection Date: 2024-01-01 DOI: 10.1155/2024/5588104
Hao-Kai Chen, Qi-Wen Lan, Yu-Jia Li, Qing Xin, Run-Qi Luo, Jun-Jie Wang

Introduction: The correlation between potassium and nonalcoholic fatty liver disease (NAFLD) is currently still poorly understood. We conducted this study to explore the correlation between dietary potassium intake and NAFLD, as well as advanced hepatic fibrosis (AHF). The study also sought to identify any potential interactions.

Methods: The data employed in this study were obtained from the National Health and Nutrition Examination Survey (NHANES) program, encompassing a period from 2007 to 2018. Employing the multiple logistic regression analysis, we evaluated the association of dietary potassium intake with NAFLD and AHF. Subsequently, stratification analysis, based on demographic variables, was constructed so as to assess the stability of the results. In addition, potential interaction effects were assessed by interaction tests.

Results: A total of 9443 participants were included in the analysis. The mean age of the participants was 50.4 years, and their daily mean dietary potassium and vitamin C intake was 2556.49 mg and 82.93 mg, respectively. Following comprehensive statistical analyses, the findings indicated a negative correlation between dietary potassium intake and both NAFLD and AHF. Participants in Q4 group with dietary potassium intake exhibited a 31% and 42% reduction in the odds of developing NAFLD and AHF, respectively, in comparison to Q1 group. An interaction effect of dietary vitamin C intake was observed in the association between dietary potassium intake and NAFLD. The results imply that high dietary vitamin C intake augment the inverse relationship between dietary potassium intake and NAFLD.

Conclusion: Dietary potassium intake was found to have an inverse association with the odds of both NAFLD and AHF. The association between dietary potassium intake and NAFLD was amplified by the presence of vitamin C in the diet.

导言:目前,人们对钾与非酒精性脂肪肝(NAFLD)之间的相关性还知之甚少。我们开展了这项研究,以探讨膳食钾摄入量与非酒精性脂肪肝以及晚期肝纤维化(AHF)之间的相关性。该研究还试图找出任何潜在的相互作用:本研究采用的数据来自美国国家健康与营养调查(NHANES)项目,时间跨度为2007年至2018年。通过多元逻辑回归分析,我们评估了膳食钾摄入量与非酒精性脂肪肝和AHF的关系。随后,我们根据人口统计学变量进行了分层分析,以评估结果的稳定性。此外,还通过交互检验评估了潜在的交互效应:共有 9443 名参与者参与了分析。参与者的平均年龄为 50.4 岁,每日平均膳食钾摄入量为 2556.49 毫克,维生素 C 摄入量为 82.93 毫克。综合统计分析结果表明,膳食钾摄入量与非酒精性脂肪肝和脂肪肝之间存在负相关。与 Q1 组相比,膳食钾摄入量为 Q4 组的参与者罹患 NAFLD 和 AHF 的几率分别降低了 31% 和 42%。在膳食钾摄入量与非酒精性脂肪肝之间的关系中,观察到膳食维生素 C 摄入量的交互效应。结果表明,膳食维生素 C 摄入量高会增强膳食钾摄入量与非酒精性脂肪肝之间的反向关系:结论:研究发现,膳食钾摄入量与非酒精性脂肪肝和急性脂肪肝的发生几率呈反向关系。膳食中的维生素 C 会增强膳食钾摄入量与非酒精性脂肪肝之间的关系。
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引用次数: 0
Intersection of Aging and Particulate Matter 2.5 Exposure in Real World: Effects on Inflammation and Endocrine Axis Activities in Rats. 现实世界中衰老与微粒物质 2.5 暴露的交集:对大鼠炎症和内分泌轴活动的影响。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI: 10.1155/2024/8501696
Cuiying Liu, Jian Yang, Longfei Guan, Liwei Jing, Shuqin Xiao, Liu Sun, Baohui Xu, Heng Zhao

Exposure to particulate matter 2.5 (PM2.5) is detrimental to multiple organ systems. Given the factor that aging also alters the cellularity and response of immune system and dysfunction of hypothalamic-pituitary-adrenal, -gonad and -thyroid axes, it is imperative to investigate whether chronic exposure to PM2.5 interacts with aging in these aspects. In this study, two-months-old Sprague-Dawley rats were exposed to real world PM2.5 for 16 months. PM2.5 exposure diminished the relative numbers of CD4+ T cells and CD8+ T cells and increased the relative number of B cells in the peripheral blood of male rats. Conversely, only reduced relative number of CD4+ T cells was seen in the blood of female rats. These shifts resulted in elevated levels of proinflammatory factors interleukin-6 and tumor necrosis factor-α in the circulatory systems of both sex, with females also evidencing a rise in interleukin-1β levels. Moreover, heightened interleukin-6 was solely discernible in the hippocampus of female subjects, while increased tumor necrosis factor-α concentrations were widespread in female brain regions but confined to the male hypothalamus. Notable hormonal decreases were observed following PM2.5 exposure in both sex. These comprised declines in biomolecules such as corticotrophin-releasing hormone and cortisol, generated by the hypothalamic-pituitary-adrenal axis, and thyroid-releasing hormone and triiodothyronine, produced by the hypothalamic-pituitary-thyroid axis. Hormonal elements such as gonadotropin-releasing hormone, luteinizing hormone, and follicle-stimulating hormone, derived from the hypothalamic-pituitary-gonad axis, were also diminished. Exclusive to male rats was a reduction in adrenocorticotropic hormone levels, whereas a fall in thyroid-stimulating hormone was unique to female rats. Decreases in sex-specific hormones, including testosterone, estradiol, and progesterone, were also noted. These findings significantly enrich our comprehension of the potential long-term health repercussions associated with PM2.5 interaction particularly among the aging populace.

暴露于颗粒物 2.5(PM2.5)会对多个器官系统造成损害。鉴于衰老也会改变免疫系统的细胞性和反应以及下丘脑-垂体-肾上腺、性腺和甲状腺轴的功能障碍,研究长期暴露于PM2.5是否会在这些方面与衰老发生相互作用势在必行。在这项研究中,两个月大的Sprague-Dawley大鼠暴露于真实世界的PM2.5中长达16个月。接触 PM2.5 会减少雄性大鼠外周血中 CD4+ T 细胞和 CD8+ T 细胞的相对数量,增加 B 细胞的相对数量。相反,在雌性大鼠的血液中只看到 CD4+ T 细胞相对数量的减少。这些变化导致雌雄大鼠循环系统中的促炎因子白细胞介素-6 和肿瘤坏死因子-α 水平升高,其中雌性大鼠的白细胞介素-1β 水平也有所升高。此外,只有在女性受试者的海马体中才能看到白细胞介素-6的升高,而肿瘤坏死因子-α浓度的升高在女性脑区很普遍,但仅限于男性的下丘脑。暴露于PM2.5后,男女受试者体内的荷尔蒙都明显减少。其中包括由下丘脑-垂体-肾上腺轴产生的促肾上腺皮质激素释放激素和皮质醇,以及由下丘脑-垂体-甲状腺轴产生的甲状腺释放激素和三碘甲状腺原氨酸等生物大分子的减少。由下丘脑-垂体-性腺轴产生的促性腺激素释放激素、黄体生成素和卵泡刺激素等激素成分也减少了。雄性大鼠的促肾上腺皮质激素水平下降,而雌性大鼠的促甲状腺激素水平下降。此外,睾酮、雌二醇和孕酮等性别特异性荷尔蒙也出现下降。这些发现极大地丰富了我们对与PM2.5相互作用相关的潜在长期健康影响的理解,尤其是在老龄人口中。
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引用次数: 0
Nonalcoholic Fatty Liver Disease as a Potential Risk Factor for Cardiovascular Disease in Patients with Type 2 Diabetes: A Prospective Cohort Study. 作为 2 型糖尿病患者心血管疾病潜在风险因素的非酒精性脂肪肝:一项前瞻性队列研究
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-26 eCollection Date: 2024-01-01 DOI: 10.1155/2024/5328965
Mohammad Dehghani Firouzabadi, Amirhossein Poopak, Ali Sheikhy, Fatemeh Dehghani Firouzabadi, Fatemeh Moosaie, Soghra Rabizadeh, Sara Momtazmanesh, Manouchehr Nakhjavani, Alireza Esteghamati

Methods and results: In this prospective cohort study, 1197 patients with type 2 diabetes (T2D) were divided into two groups (360 patients with NAFLD and 847 without NAFLD) and were followed for a median of 5 years for the incidence of CVD. Cox regression analysis was used to assess the association between NAFLD, liver enzyme level, aspartate aminotransferase to platelet ratio index (APRI), and the incidence risk of CVD and its subgroups (i.e., myocardial infarction, chronic heart disease, coronary artery bypass grafting, and percutaneous coronary intervention). There was a significant positive association between CVD incidence and NAFLD (HR = 1.488, 95% CI = 1.041-2.124, p value = 0.029). Although patients with NAFLD had higher levels of ALT and AST levels (p value = <0.001), there was no significant association between liver enzymes and the incidence risk of CVD when adjusted for different variables. Furthermore, NAFLD was associated with NAFLD APRI Q (2), APRI Q (3), and APRIQ (4) (1.365 (1.046-1.781), 1.623 (1.234-2.135), and 3.373 (2.509-4.536)), respectively.

Conclusion: NAFLD increased the incidence risk of CVD in T2D. However, there was no association between liver enzymes (ALT, AST, ALK-P, and GGT) and a higher incidence risk of CVD in T2D when adjusted for confounding variables.

方法和结果:在这项前瞻性队列研究中,1197 名 2 型糖尿病(T2D)患者被分为两组(360 名患有非酒精性脂肪肝的患者和 847 名未患有非酒精性脂肪肝的患者),并对他们的心血管疾病发病率进行了中位 5 年的随访。Cox回归分析用于评估非酒精性脂肪肝、肝酶水平、天冬氨酸氨基转移酶与血小板比值指数(APRI)与心血管疾病及其亚组(即心肌梗死、慢性心脏病、冠状动脉搭桥术和经皮冠状动脉介入治疗)发病风险之间的关系。心血管疾病发病率与非酒精性脂肪肝之间存在明显的正相关(HR = 1.488,95% CI = 1.041-2.124,P 值 = 0.029)。尽管非酒精性脂肪肝患者的谷丙转氨酶和谷草转氨酶水平较高(P值=Q(2)、APRI Q(3)和APRIQ(4)分别为1.365(1.046-1.781)、1.623(1.234-2.135)和3.373(2.509-4.536)):结论:非酒精性脂肪肝增加了T2D患者心血管疾病的发病风险。结论:非酒精性脂肪肝会增加 T2D 患者的心血管疾病发病风险,但在对混杂变量进行调整后,肝酶(ALT、AST、ALK-P 和 GGT)与 T2D 患者的心血管疾病发病风险之间并无关联。
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引用次数: 0
Association between Serum Phosphorus Levels and Diabetic Retinopathy: A Cross-Sectional Study. 血清磷水平与糖尿病视网膜病变之间的关系:一项横断面研究
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-06-11 eCollection Date: 2024-01-01 DOI: 10.1155/2024/3830246
Jintao Chen, Chuanfeng Liu, Cunwei Sun, Jia Zeng, Jingwei Chi, Kui Che, Yangang Wang

Background and aims: The aim of this study was to investigate the association between serum phosphate levels and diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM).

Methods and results: The study sample consisted of 1657 T2DM patients hospitalized between 2017 and 2019. Patients were categorized into quartiles based on their serum phosphate levels (Q1-Q4). An increasing trend in the prevalence of DR was observed across these quartiles. Subsequently, logistic regression analysis was employed to adjust for potential confounders, such as gender, age, BMI, and duration of diabetes, and to evaluate the odds ratios (ORs) associated with these quartiles. The prevalence of DR showed an increasing trend with elevated serum phosphate levels. Logistic regression further confirmed that serum phosphate levels remain an independent risk factor for DR.

Conclusion: Elevated serum phosphate levels are closely associated with the prevalence of DR in hospitalized T2DM patients. Further studies are needed to establish causality. This trial is registered with chiCTR2000032374.

背景与目的本研究旨在探讨2型糖尿病(T2DM)患者血清磷酸盐水平与糖尿病视网膜病变(DR)之间的关联:研究样本包括2017年至2019年间住院的1 657名T2DM患者。根据血清磷酸盐水平(Q1-Q4)将患者分为四分位。在这些四分位数中,观察到DR患病率呈上升趋势。随后,采用逻辑回归分析来调整潜在的混杂因素,如性别、年龄、体重指数和糖尿病病程,并评估与这些四分位数相关的几率比(ORs)。随着血清磷酸盐水平的升高,DR患病率呈上升趋势。逻辑回归进一步证实,血清磷酸盐水平仍然是导致 DR 的独立风险因素:结论:血清磷酸盐水平升高与住院 T2DM 患者的 DR 患病率密切相关。结论:血清磷酸盐水平升高与住院 T2DM 患者的 DR 患病率密切相关,需要进一步研究以确定因果关系。本试验已在 chiCTR2000032374 注册。
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引用次数: 0
Comparison of HCG Trigger versus Dual Trigger in Improving Pregnancy Outcomes in Patients with Different Ovarian Responses: A Retrospective Study HCG 触发器与双重触发器在改善不同卵巢反应患者妊娠结局方面的比较:一项回顾性研究
IF 2.8 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-31 DOI: 10.1155/2024/2507026
Ke Xu, Jinrong Wang, Shuangshuang Yang, Zhenjing Wang, Ning Hou, Mei Sun
<i>Objective</i>. During in vitro fertilization-embryo transfer (IVF-ET) treatment, the reproductive endocrine regulatory mechanisms hold pivotal importance. Specifically, the serum estradiol (<span><svg height="11.8174pt" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 13.0189 11.8174" width="13.0189pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"></path></g></svg>)</span> level during ovulation emerges as a critical factor influencing pregnancy outcomes. This retrospective study aimed to comprehensively compare two common clinical regimens based on the grouping of serum <svg height="11.8174pt" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 13.0189 11.8174" width="13.0189pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-70"></use></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><use xlink:href="#g50-51"></use></g></svg> levels and the number of oocytes retrieved on the trigger day. Our objective was to evaluate the pregnancy outcomes in IVF-ET patients across different ovarian response groups, exploring the efficacy of the dual-trigger and single-trigger regimens to provide valuable insights for optimizing clinical strategies in the context of IVF-ET. <i>Methods</i>. A retrospective analysis was conducted on the clinical data of 2778 infertile patients who underwent ART (IVF/ICSI). Subsequently, a detailed statistical analysis was performed on 1032 patients following an antagonist regimen. Participants were categorized into single-trigger and dual-trigger groups based on real-world trigger protocols, considering different ovarian responses. Comprehensive statistical assessments were conducted on baseline characteristics, ovulation induction, and pregnancy outcomes. <i>Results</i>. Baseline characteristics and cycle parameters among the three patient groups (high ovarian response, normal response, and poor response) exhibited no significant differences between the dual-trigger and single-trigger regimen groups. Despite the dual-trigger regimen utilizing a significantly lower HCG dose, no notable discrepancies were observed in laboratory results and pregnancy outcomes (embryo transfer rate, pregnancy rate, and live birth rate) for normal and high responders. Remarkably, <svg height="11.8174pt" style="vertical-align:-3.1815pt" version="1.1" viewbox="-0.0498162 -8.6359 13.0189 11.8174" width="13.0189pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-70"></use></g><g transform="matrix(.0091,0,0,-0.0091,7.943,3.132)"><use xlink:href="#g50-51"></use></g></svg> levels were higher in the dual-trigger group compared to the single-trigger group. In high and normal r
目的。在体外受精-胚胎移植(IVF-ET)治疗过程中,生殖内分泌调节机制至关重要。具体而言,排卵期血清雌二醇()水平是影响妊娠结局的关键因素。这项回顾性研究旨在根据血清水平分组和触发日取回的卵母细胞数量,全面比较两种常见的临床方案。我们的目标是评估 IVF-ET 患者不同卵巢反应组的妊娠结局,探讨双触发和单触发方案的疗效,为优化 IVF-ET 临床策略提供有价值的见解。研究方法对2778名接受人工授精(IVF/ICSI)的不孕患者的临床数据进行回顾性分析。随后,对使用拮抗剂方案的 1032 名患者进行了详细的统计分析。根据真实世界的触发方案,考虑到不同的卵巢反应,参与者被分为单触发组和双触发组。对基线特征、促排卵和妊娠结果进行了全面的统计评估。结果三组患者(卵巢反应高、反应正常和反应差)的基线特征和周期参数在双触发方案组和单触发方案组之间无明显差异。尽管双触发方案使用的 HCG 剂量明显较低,但在实验室结果和妊娠结果(胚胎移植率、妊娠率和活产率)方面,正常反应者和高反应者并无明显差异。值得注意的是,与单触发组相比,双触发组的水平更高。在高反应和正常反应者中,双触发方案显示卵母细胞计数和卵母细胞获取率增加,同时因卵巢过度刺激综合征(OHSS)而取消移植的比率降低。耐人寻味的是,卵巢反应不佳的患者在任何一组中都没有因预防卵巢过度刺激综合征而取消移植。结论对于卵巢反应高和卵巢反应正常的患者,在触发日使用双触发方案可有效降低OHSS的风险。我们的大样本研究支持双触发方案可替代单触发方案,且不会影响妊娠结局。然而,这一结论并不适用于卵巢反应不佳的患者。这项研究的结果突出表明,有必要根据患者的卵巢反应采取定制化和个体化的治疗方法。此外,考虑到内分泌环境在影响妊娠结局和OHSS发生方面的关键作用,有必要进一步探讨不同触发方案对内分泌参数的影响。这些研究将有助于提高 IVF-ET 技术的生殖效果。
{"title":"Comparison of HCG Trigger versus Dual Trigger in Improving Pregnancy Outcomes in Patients with Different Ovarian Responses: A Retrospective Study","authors":"Ke Xu, Jinrong Wang, Shuangshuang Yang, Zhenjing Wang, Ning Hou, Mei Sun","doi":"10.1155/2024/2507026","DOIUrl":"https://doi.org/10.1155/2024/2507026","url":null,"abstract":"&lt;i&gt;Objective&lt;/i&gt;. During in vitro fertilization-embryo transfer (IVF-ET) treatment, the reproductive endocrine regulatory mechanisms hold pivotal importance. Specifically, the serum estradiol (&lt;span&gt;&lt;svg height=\"11.8174pt\" style=\"vertical-align:-3.1815pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 13.0189 11.8174\" width=\"13.0189pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;g transform=\"matrix(.013,0,0,-0.013,0,0)\"&gt;&lt;/path&gt;&lt;/g&gt;&lt;g transform=\"matrix(.0091,0,0,-0.0091,7.943,3.132)\"&gt;&lt;/path&gt;&lt;/g&gt;&lt;/svg&gt;)&lt;/span&gt; level during ovulation emerges as a critical factor influencing pregnancy outcomes. This retrospective study aimed to comprehensively compare two common clinical regimens based on the grouping of serum &lt;svg height=\"11.8174pt\" style=\"vertical-align:-3.1815pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 13.0189 11.8174\" width=\"13.0189pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;g transform=\"matrix(.013,0,0,-0.013,0,0)\"&gt;&lt;use xlink:href=\"#g113-70\"&gt;&lt;/use&gt;&lt;/g&gt;&lt;g transform=\"matrix(.0091,0,0,-0.0091,7.943,3.132)\"&gt;&lt;use xlink:href=\"#g50-51\"&gt;&lt;/use&gt;&lt;/g&gt;&lt;/svg&gt; levels and the number of oocytes retrieved on the trigger day. Our objective was to evaluate the pregnancy outcomes in IVF-ET patients across different ovarian response groups, exploring the efficacy of the dual-trigger and single-trigger regimens to provide valuable insights for optimizing clinical strategies in the context of IVF-ET. &lt;i&gt;Methods&lt;/i&gt;. A retrospective analysis was conducted on the clinical data of 2778 infertile patients who underwent ART (IVF/ICSI). Subsequently, a detailed statistical analysis was performed on 1032 patients following an antagonist regimen. Participants were categorized into single-trigger and dual-trigger groups based on real-world trigger protocols, considering different ovarian responses. Comprehensive statistical assessments were conducted on baseline characteristics, ovulation induction, and pregnancy outcomes. &lt;i&gt;Results&lt;/i&gt;. Baseline characteristics and cycle parameters among the three patient groups (high ovarian response, normal response, and poor response) exhibited no significant differences between the dual-trigger and single-trigger regimen groups. Despite the dual-trigger regimen utilizing a significantly lower HCG dose, no notable discrepancies were observed in laboratory results and pregnancy outcomes (embryo transfer rate, pregnancy rate, and live birth rate) for normal and high responders. Remarkably, &lt;svg height=\"11.8174pt\" style=\"vertical-align:-3.1815pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.6359 13.0189 11.8174\" width=\"13.0189pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"&gt;&lt;g transform=\"matrix(.013,0,0,-0.013,0,0)\"&gt;&lt;use xlink:href=\"#g113-70\"&gt;&lt;/use&gt;&lt;/g&gt;&lt;g transform=\"matrix(.0091,0,0,-0.0091,7.943,3.132)\"&gt;&lt;use xlink:href=\"#g50-51\"&gt;&lt;/use&gt;&lt;/g&gt;&lt;/svg&gt; levels were higher in the dual-trigger group compared to the single-trigger group. In high and normal r","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"22 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141191753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Development of Simple Scoring System to Predict Urinary Tract Infection (UTI) in Patients with Stroke 开发预测脑卒中患者尿路感染 (UTI) 的简易评分系统
IF 2.8 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-27 DOI: 10.1155/2024/2512824
In-Hui Pak, Se-Ryong Han, Chol-Ho Sin, Hyo-Song Kim, Un-Ryong Rim
Urinary tract infection is a frequent problem after stroke. Although prior scoring systems for UTI after stroke have been developed, we developed a simple scoring system for all types of stroke in our own. The study was designed on retrospective data. The population includes 1496 patients with stroke who had been admitted at the Neurology Department of Pyongyang Medical College Hospital between January 2010 and August 2019. The patients were diagnosed with confirmed CT and MRI. Urinary tract infection (UTI) was diagnosed through urine culture: more than 100,100 colony-forming units per millimeter in patients with signs and symptoms. The UTI prediction scoring system was developed by means of the variables available on admission. The variables with significant difference between the non-UTI group and the UTI group were age (non-UTI versus UTI, 56.4 ± 7.2 vs. 59.0 ± 12.8; <span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="-0.0498162 -8.34882 18.973 11.7782" width="18.973pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"></path></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"></path></g></svg><span></span><span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="22.555183800000002 -8.34882 28.184 11.7782" width="28.184pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.605,0)"></path></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"></path></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"></path></g></svg>),</span></span> female (244 (24.2) vs. 176 (36.1), <span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="-0.0498162 -8.34882 18.973 11.7782" width="18.973pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,0,0)"><use xlink:href="#g113-113"></use></g><g transform="matrix(.013,0,0,-0.013,11.342,0)"><use xlink:href="#g117-91"></use></g></svg><span></span><span><svg height="11.7782pt" style="vertical-align:-3.42938pt" version="1.1" viewbox="22.555183800000002 -8.34882 28.184 11.7782" width="28.184pt" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink"><g transform="matrix(.013,0,0,-0.013,22.605,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,28.845,0)"><use xlink:href="#g113-47"></use></g><g transform="matrix(.013,0,0,-0.013,31.809,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,38.049,0)"><use xlink:href="#g113-49"></use></g><g transform="matrix(.013,0,0,-0.013,44.289,0)"><use xlink:href="#g113-50"></use></g></svg>),</span></span> 300 ≦ SI (smoking index) (16 (2.4) vs. 48 (12.0), <span><sv
尿路感染是中风后的常见问题。虽然此前已有针对脑卒中后尿路感染的评分系统,但我们自己开发了一套适用于所有类型脑卒中的简单评分系统。该研究以回顾性数据为基础。研究对象包括 2010 年 1 月至 2019 年 8 月期间平壤医学院附属医院神经内科收治的 1496 名脑卒中患者。患者均经 CT 和 MRI 确诊。尿路感染(UTI)通过尿培养进行诊断:有症状和体征的患者每毫米尿培养菌落形成单位超过 100,100 个。尿路感染预测评分系统是通过入院时的可用变量开发的。非 UTI 组与 UTI 组之间存在明显差异的变量是年龄(非 UTI 与 UTI,56.4 ± 7.2 vs. 59.0 ± 12.8;)、女性(244 (24.2) vs. 176 (36.1),)、300 ≦ SI(吸烟指数)(16 (2.4) vs. 48 (12.0),)、酒精 > 25 克/天(292 (29.0) vs. 184 (37. 7), )、中风后(292 (29.0) vs. 184 (37. 7), )、尿液培养(每毫米 100,100 菌落总数单位)、尿量(每毫米 100,100 菌落总数单位)。7)、卒中后高血糖(120(10.3) vs. 163(33.4))、留置导尿管(157(15.6) vs. 351(72.0))、入院时 GCS(格拉斯哥昏迷量表)(11.入院时的 GCS(格拉斯哥昏迷量表)(11.2 ± 3.9 vs. 8.5 ± 4.0,)和 WFNS(世界神经外科医师联合会)(蛛网膜下腔出血)(2.9 ± 1.7 vs. 3.5 ± 1.5,)。尿毒症预测评分范围为 0-8 分,AUC(曲线下面积)为 0.800。最佳临界点为 2.5(灵敏度为 64.3%,特异度为 79.9%)。因此,评分≧ 3 是预测中风后尿毒症的最佳分数。
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引用次数: 0
Clinical Features and Analysis in Pituitary Stalk Interruption Syndrome 垂体柄中断综合征的临床特征与分析
IF 2.8 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-24 DOI: 10.1155/2024/2493083
Qiuxuan Guo, Jing Zhao, Shuang Yu
Objective. Pituitary stalk interruption syndrome (PSIS) is characterized by the absence of pituitary stalk, pituitary hypoplasia, and ectopic posterior pituitary. Because the etiology and clinical cognition of PSIS remain elusive, we analyzed the clinical features of PSIS in Chinese patients. Methods. A retrospective analysis was conducted on the clinical presentation, laboratory data, imaging examination, and management of 24 PSIS inpatients from our center over 10 years. Results. Among the 24 PSIS patients, there were 22 males (91.7%) and 2 females (8.3%). Growth hormone deficiency was present in all 24 cases (100%), hypogonadism in 24 cases (100%), secondary adrenal insufficiency in 22 cases (91.2%), and hypothyroidism in 21 cases (87.5%). 20 cases (83.3%) of PSIS patients exhibited deficiencies in four anterior pituitary hormones, 3 cases (12.5%) exhibited deficiencies in three anterior pituitary hormones, and 1 case (4.2%) exhibited deficiencies in two anterior pituitary hormones, with none exhibiting deficiencies in posterior pituitary hormones. Among the 24 PSIS patients, 12 had a history of growth hormone therapy before admission, and 12 had no such history. Additionally, 19 cases (79.2%) with PSIS were complicated by dyslipidemia, 15 cases (62.5%) were complicated by nonalcoholic fatty liver disease, and 9 cases (37.5%) were complicated by hyperuricemia. Conclusions. PSIS often presents with growth retardation and hypogonadotropic hypogonadism, but in some cases, short stature is not exhibited. PSIS is prone to complications such as dyslipidemia, nonalcoholic fatty liver disease, and hyperuricemia, increasing the risk of cardiovascular and cerebrovascular diseases. In clinical practice, the diagnostic ability of PSIS should be improved, and pituitary function and complications should be evaluated in a timely manner to avoid delayed treatment.
目的:垂体柄中断综合征(PSIS垂体柄中断综合征(PSIS)以垂体柄缺失、垂体发育不良和垂体后叶异位为特征。由于 PSIS 的病因和临床认知仍不明确,我们分析了中国患者 PSIS 的临床特征。研究方法我们对本中心 24 例 PSIS 住院患者 10 年来的临床表现、实验室数据、影像学检查和处理进行了回顾性分析。结果。在 24 名 PSIS 患者中,男性 22 名(占 91.7%),女性 2 名(占 8.3%)。所有 24 例(100%)均存在生长激素缺乏症,24 例(100%)存在性腺功能减退症,22 例(91.2%)存在继发性肾上腺功能不全,21 例(87.5%)存在甲状腺功能减退症。20 例 PSIS 患者(83.3%)表现出四种垂体前叶激素缺乏,3 例(12.5%)表现出三种垂体前叶激素缺乏,1 例(4.2%)表现出两种垂体前叶激素缺乏,没有人表现出垂体后叶激素缺乏。在 24 例 PSIS 患者中,12 例在入院前曾接受过生长激素治疗,12 例没有此类病史。此外,19 例 PSIS 患者(79.2%)并发血脂异常,15 例(62.5%)并发非酒精性脂肪肝,9 例(37.5%)并发高尿酸血症。结论。PSIS 常表现为生长迟缓和性腺功能减退,但有些病例并不表现为身材矮小。PSIS 易引起血脂异常、非酒精性脂肪肝和高尿酸血症等并发症,增加心脑血管疾病的风险。在临床实践中,应提高 PSIS 的诊断能力,及时评估垂体功能和并发症,避免延误治疗。
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引用次数: 0
Causal Relationships between Homocysteine and the Polycystic Ovary Syndrome: A Mendelian Randomization Analysis 高半胱氨酸与多囊卵巢综合征之间的因果关系:孟德尔随机分析
IF 2.8 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-05-07 DOI: 10.1155/2024/3090797
Xianping Lin, Yaojuan Jin, Shihao Hong
Background. Polycystic ovary syndrome (PCOS) is an endocrine disease attributed to multiple genetic variants and environmental factors. We aimed to find the causal association of homocysteine (Hcy) with PCOS. Methods. A two-sample Mendelian randomization (MR) analysis was performed. We selected 14 single-nucleotide polymorphisms (SNPs) as instrumental variables to predict the risk of PCOS from genome-wide association studies (GWAS). The summary statistics of PCOS were obtained from 3 large genome-wide association studies in the European population, involving 4,138 cases and 20,129 controls, 3,609 cases and 229,788 controls, 994 cases and 165,817 controls, separately. Results. The IVM analyses revealed that plasma Hcy levels were not causally associated with the risk of PCOS in the meta-analysis (combined effect = 1.032, 95% confidence interval (CI): 0.885–1.203, ). Conclusions. There was no sufficient evidence to support the causal association of the Hcy with the risk of PCOS.
背景。多囊卵巢综合征(PCOS)是一种由多种遗传变异和环境因素引起的内分泌疾病。我们旨在寻找同型半胱氨酸(Hcy)与多囊卵巢综合征的因果关系。研究方法进行了双样本孟德尔随机化(MR)分析。我们从全基因组关联研究(GWAS)中选择了 14 个单核苷酸多态性(SNPs)作为工具变量来预测 PCOS 的风险。多囊卵巢综合征的汇总统计数据来自欧洲人群的 3 项大型全基因组关联研究,分别涉及 4 138 例病例和 20 129 例对照、3 609 例病例和 229 788 例对照、994 例病例和 165 817 例对照。结果显示IVM分析显示,在荟萃分析中,血浆Hcy水平与多囊卵巢综合征的风险没有因果关系(综合效应=1.032,95%置信区间(CI):0.885-1.203)。结论没有足够的证据支持 Hcy 与多囊卵巢综合症的风险存在因果关系。
{"title":"Causal Relationships between Homocysteine and the Polycystic Ovary Syndrome: A Mendelian Randomization Analysis","authors":"Xianping Lin, Yaojuan Jin, Shihao Hong","doi":"10.1155/2024/3090797","DOIUrl":"https://doi.org/10.1155/2024/3090797","url":null,"abstract":"<i>Background</i>. Polycystic ovary syndrome (PCOS) is an endocrine disease attributed to multiple genetic variants and environmental factors. We aimed to find the causal association of homocysteine (Hcy) with PCOS. <i>Methods</i>. A two-sample Mendelian randomization (MR) analysis was performed. We selected 14 single-nucleotide polymorphisms (SNPs) as instrumental variables to predict the risk of PCOS from genome-wide association studies (GWAS). The summary statistics of PCOS were obtained from 3 large genome-wide association studies in the European population, involving 4,138 cases and 20,129 controls, 3,609 cases and 229,788 controls, 994 cases and 165,817 controls, separately. <i>Results</i>. The IVM analyses revealed that plasma Hcy levels were not causally associated with the risk of PCOS in the meta-analysis (combined effect = 1.032, 95% confidence interval (CI): 0.885–1.203, <span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"-0.0498162 -8.34882 18.973 11.7782\" width=\"18.973pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,0,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,11.342,0)\"></path></g></svg><span></span><span><svg height=\"11.7782pt\" style=\"vertical-align:-3.42938pt\" version=\"1.1\" viewbox=\"22.555183800000002 -8.34882 28.184 11.7782\" width=\"28.184pt\" xmlns=\"http://www.w3.org/2000/svg\" xmlns:xlink=\"http://www.w3.org/1999/xlink\"><g transform=\"matrix(.013,0,0,-0.013,22.605,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,28.845,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,31.809,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,38.049,0)\"></path></g><g transform=\"matrix(.013,0,0,-0.013,44.289,0)\"><use xlink:href=\"#g113-57\"></use></g></svg>).</span></span> <i>Conclusions</i>. There was no sufficient evidence to support the causal association of the Hcy with the risk of PCOS.","PeriodicalId":13966,"journal":{"name":"International Journal of Endocrinology","volume":"112 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140883135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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International Journal of Endocrinology
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