ABO血型与卵巢储备功能相关性的meta分析

发布时间：2018-07-23 08:27

【摘要】：背景:卵巢储备功能是指卵巢中卵子的质量以及可以用于生殖的卵母细胞的数量。近年来,社会环境的变化及女性自身条件的改变导致女性不孕趋势逐年增长。据统计大约10%的不孕女性卵巢储备功能下降。卵巢储备功能的预测指标研究较多的包括卵泡刺激素及抗苗勒管激素。ABO血型系统是一种非常稳定的遗传标记,研究表明ABO血型与心血管疾病、胃癌、胰腺癌等疾病有关联。近些年有研究探讨ABO血型与卵巢储备功能之间的关系,但并未达成共识。血型是否与卵巢储备功能有关,哪种抗原是保护或危险因素,尚存在争议。目的:本文首次进行Meta分析以阐明ABO血型与卵巢储备功能之间的相关性。方法:检索中英文电子数据库,以“ABO blood group”、“ovarian reserve”、“血型”、“卵巢储备”为主题词加自由词进行检索,并手工搜索相关研究的参考文献,没有语言和国家的限制。主要分析研究结果是卵巢储备功能下降的发生率,研究的效应量懫用比值比(OR)及95%可信区间(CI)评价。统计分析使用Review Manager 5.3版本,采用Q检验和I2分析研究间的异质性。当P≥0.1和I2≤50%被认为是没有异质性的研究;P0.1和I250%的研究被认为有异质性。由于随机效应模型相对较保守,使结果更倾向于安全,故采用随机效应模型。通过敏感性分析评估每一项研究对整体分析的影响来寻找异质性来源。结果:最终Meta分析纳入七篇横断面研究,来自四个国家涉及55113人,采用卵泡刺激素及抗苗勒管激素两种检测指标判定卵巢储备功能。以卵泡刺激素测定卵巢储备功能的五篇研究进行分析,结果显示A型血OR=1.03(95%CI:0.96~1.11),I2=17%;B型血OR=0.98(95%CI:0.75~1.29),I2=88%;AB型血OR=0.96(95%CI:0.71~1.30),I2=75%;O型血OR=1.03(95%CI:0.74~1.43),I2=94%。以抗苗勒管激素测定卵巢储备功能的两篇研究进行分析,结果显示A型血OR=0.89(95%CI:0.76~1.03),I2=0%;B型血OR=1.02(95%CI:0.80~1.30),I2=24%;AB型血OR=1.14(95%CI:0.80~1.64),I2=0%;O型血OR=1.07(95%CI:0.86~1.34),I2=46%。结论:以现有的研究未发现ABO血型与卵巢储备功能之间的关联。然而,需要更多、更严谨、高质量、大样本和多指标的研究进行进一步的验证。
[Abstract]:Background: ovarian reserve function refers to the quality of eggs in the ovary and the number of oocytes that can be used to reproduce. In recent years, the change of social environment and women's own conditions lead to the increasing trend of female infertility. According to statistics, about 10% of infertile women ovarian reserve function decline. The predictors of ovarian reserve function include follicle stimulating hormone (FSH) and anti-Mullerian hormone. ABO blood group system is a very stable genetic marker. It is shown that ABO blood group is associated with cardiovascular disease, gastric cancer, pancreatic cancer and other diseases. Recent studies have explored the relationship between ABO blood group and ovarian reserve function, but there is no consensus. Whether blood type is related to ovarian reserve function, which antigens are protective or risk factors remains controversial. Objective: to investigate the correlation between ABO blood group and ovarian reserve function by meta-analysis for the first time. Methods: Chinese and English electronic databases were searched with "ABO blood group", "ovarian reserve", "blood group" and "ovary reserve" as subject words plus free words. The main result of the study was the incidence of ovarian reserve function decline. The effect of the study was evaluated by ratio (OR) and 95% confidence interval (CI). Statistical analysis used Review Manager 5.3 version, Q test and I 2 analysis of heterogeneity. When P 鈮，

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