Establishment And Significance Of Early Warning Model Of Ovarian Aging

Objective:There are many indicators to assess ovarian reserve function,endocrine indicators such as AMH,FSH,ultrasound indicators such as AFC,OV,clomiphene stimulation test and Age,and so on.The most commonly used clinical indicators are Age,FSH,AMH,AFC.However,there is no index can be satisfied with the specificity and sensitivity,many scholars recommend the combination of indicators to improve accuracy.Many studies have shown that different indicators predict ovarian reactivity,pregnancy rate of different ability,and different detection indicators of the ability to predict the existence of inconsistencies.In the international reproductive field,the ovarian reserve function model or score of infertile women,the construction of staging system in recent years as a hot issue,but the healthy female ovarian reserve function model or staging system construction reports are less domestic and foreign,according to healthy female ovarian reserve function The ovarian function model is important for the accurate evaluation of ovarian reserve function.There is a certain influence on the ovarian function,and it is of great significance to develop the ovarian reserve function model according to the characteristics of Chinese women.Because of the metabolic factors on ovarian function,this study is based on the evaluation of ovarian reserve function of endocrine indicators,taking into account the metabolic factors,comprehensive analysis,the establishment of ovarian reserve function early warning model,in order to find ovarian reserve dysfunction,timely intervention,Reproductive potential,perimenopausal women in time MHT treatment,for the prevention of heart and brain disease,cognitive disorders and other chronic diseases have important value and significance.METHODS:A total of 189 healthy women were enrolled in this study from March 2014 to July 2015.19 cases of POI and PCOS were included in the gynecological outpatient department of Shandong Provincial Hospital.The levels of FSH,FSH/LH,E2,AMH,DHEA,IGF-1,25(OH)D,FINS,FPG,LDL,HDL,TG and HbAlc were collected on the 2nd to 4th day of the menstruation.Weight,while calculating BMI,IRI,AMH*FSH,through the statistical method,to build "ovarian age".Assuming that the "ovarian age" of healthy women is consistent with the actual age,the "ovarian age" is used as the dependent variable and the residual index as the independent variable.The independent variables are selected by single factor analysis,and the multiple regression model is established by stepwise regression analysis.Ovarian age ".According to the "ovarian age" formula constructed by healthy women,the relevant indicators of POI and PCOS were obtained into the equation,and the corresponding"ovarian age" was obtained.The "ovarian age" of POI and PCOS patients was independent of the corresponding actual age There was no significant difference between the POI group and the PCOS group "ovarian age" and the actual age.RESULT:The test level was set to 0.2,and the variables selected by the univariate analysis were AMH(p<0.0001)、FSH(p<0.0001)、FSH/LH(p=0.0313)、DHEA-S(p<0.0001)、FPG(p=0.0759)、BMI(p=0.0012)、LDL(p=0.0115)、TG(p=0.108)、HbAlC(<0.0001)、IGF-I(p<0.0001)、25(OH)D(p=0.0483)、AMH*FSH(p<0.0001)and the levels of the samples were determined by univariate analysis.(P =0.0129),The variables of the model were AMH,FSH,DHEA-S,FPG,TG,IGF-I,25(OH)D,the multi variate regression model established by multiple regressive regimens was used for ovarian age =39.71-1.96*AMH + 0.13*FSH-0.52*DHEA_S + 1.72*FPG + 0.64*TG-0.01*1GF-I-0.19*VitD-The fitting degree of the model is R2 = 0.614 and the AIC is 628.3.The model was applied to POI and PCOS patients.The results showed that the "ovarian age" of POI patients was higher than the actual age,and the "ovarian age" of PCOS patients was less than the actual age,and the model was app]ied to the hea]thy subjects Female,the "ovarian age" is consistent with the actual age.Conclusion:The "ovarian age" constructed by this study provides clinicians with an accurate assessment of the "new index" of ovarian reserve,which is simple,easy to operate and high in accuracy.The model will evaluate the ovarian reserve function of endocrine indicators,Clinical indicators of the problem of inconsistent detection,taking into account the metabolic factors,a comprehensive assessment of ovarian function,as one of the innovative points for the evaluation of ovarian reserve function provides a new direction.However,its predictive efficacy requires further clinical validation.