miR-34a和Sirt1在多囊卵巢综合征不孕患者血清中的表达研究

目的：探究多囊卵巢综合征（PCOS）不孕患者血清中微小核糖核酸-34a（miR-34a）和沉默信息调节因子1（Sirt1）表达水平及意义。方法：选取2018年4月~2020年2月本院收治的PCOS不孕患者79例作为观察组，另选取同期在本院进行孕前体检的健康妇女79例作为对照组。采用实时荧光定量（qRT-PCR）法检测所有受试者血清miR-34a表达水平，采用酶联免疫吸附（ELISA）法检测所有受试者血清Sirt1表达水平，分析二者相关性及对PCOS不孕诊断价值。结果：观察组血清miR-34a表达水平、身体质量指数（BMI）、空腹血糖（FPG）、空腹胰岛素、胰岛素抵抗指数（HOMA-IR）水平及月经紊乱比例明显高于对照组（P＜0.05），Sirt1表达水平明显低于对照组（P＜0.05）。PCOS不孕患者血清miR-34a与Sirt1表达水平呈负相关（P＜0.05）。高FPG、高空腹胰岛素、高HOMA-IR、高miR-34a、低Sirt1水平为影响PCOS不孕发生的独立危险因素（P＜0.05）。血清miR-34a、Sirt1水平联合预测PCOS不孕诊断的曲线下面积为0.880，敏感度为87.30%，特异度为86.10%。结论：PCOS不孕患者血清miR-34a表达水平明显升高，Sirt1表达水平明显降低，二者可能相互作用，共同参与PCOS不孕症发生发展。

Study on expressions of miR-34a and Sirt1 in serum of patients with polycystic ovary syndrome infertility

Objective: To investigate the expression levels and significance of micro ribonucleic acid-34a (miR-34a) and silent information regulator 1 (Sirt1) in serum of patients with polycystic ovary syndrome (PCOS) infertility. Methods: From April 2018 to February 2020, 79 patients with PCOS infertility were selected as the observation group, and 79 healthy women who had pre pregnancy physical examination in the same period were selected as the control group. The expression level of miR-34a in serum of all subjects was detected by real-time fluorescence quantitative PCR (qRT-PCR), and the expression level of Sirt1 in serum of all subjects was detected by enzyme-linked immunosorbent assay (ELISA). The correlation between them and their values in the diagnosis of PCOS infertility were analyzed. Results: The expression level of miR-34a, body mass index (BMI), fasting blood glucose (FPG), fasting insulin, insulin resistance index (HOMA-IR) and the proportion of menstrual disorder in the observation group were significantly higher than those in the control group (P < 0.05), while the expression level of Sirt1 was significantly lower than that in the control group (P < 0.05). There was a negative correlation between the expression levels of miR-34a and Sirt1 in PCOS infertile patients (P < 0.05). High FPG, high fasting insulin, high HOMA-IR, high miR-34a and low Sirt1 levels were independent risk factors for PCOS infertility (P < 0.05). The area under the curve of serum miR-34a combined with Sirt1 levels was 0.880, the sensitivity was 87.30%, and the specificity was 86.10%. Conclusions: The expression level of miR-34a in PCOS infertile patients is significantly increased, while the expression level of Sirt1 is significantly decreased, and they may interact and participate in the development of PCOS infertility.