The Study On The Correlation Between Blood Lipid Levels,Adipocytokines FABP4 And Leptin And The Incidence Of Endometriosis

Part Ⅰ Relationship between blood lipid level and endometriosis:A Meta-analysisObjectiveTo explore the relationship between human blood lipid levels and endometriosis.MethodsThe articles about the correlation between human total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol and endometriosis were screened from Pubmed、Cochrane library、Web of Science、Scopus、China National Knowledge Infrastructure(CNKI)、Wanfang database、the Wiper database,The period is from creating the database to December 2020.After literature screening,quality assessment and data extraction,the software of Rev Man5.3 was used for Meta-analysis.ResultsA total of 7 articles were included,755 patients with endometriosis and 734controls.Meta analysis showed that HDL-c in endometriosis patients was higher than that in the control group after the literatures with higher heterogeneity were excluded,and the difference was statistically significant[SMD=0.36,95%CI(0.24,0.49),P<0.00001,I~2=46%].TC[SMD=0.27,95%CI(-0.10,0.64),P=0.15,I~2=91%],LDL-c[SMD=0.22,95%CI(-0.33,0.77),P=0.44,I~2=94%]and TG[SMD=0.14,95%CI(-0.24,0.53),P=0.46,I~2=92%]had no statistical significance.Due to the large heterogeneity,the subgroup analysis found that the region,age and sample size of the included references might be the source of heterogeneity and affect the results.ConclusionsBlood lipid levels may be related to endometriosis.Higher high density lipoprotein cholesterol levels may be a risk factor for endometriosis.The relationship between total cholesterol、low density lipoprotein cholesterol、triglyceride levels and endometriosis needs further confirmation.Part Ⅱ The expression and clinical significance of FABP4 and leptin in patients with endometriosisObjectiveTo study the expression levels and clinical significance of adipocyte-fatty acid binding protein(FABP4)and leptin in the serum and peritoneal washing fluid of patients with endometriosis.MethodsAccording to the inclusion and exclusion criteria,32 patients with endometriosis(study group)and 36 Patients with non-endometriosis(control group)were recruited.The clinical characteristics of these two groups were compared,The expression levels of FABP4 and leptin in the peritoneal lavage fluid and serum were detected by ELISA,and their correlation was compared.Results1.The triglycerides,cholesterol,CA125,FABP4 in serum,FABP4 and leptin in the abdominal cavity washing fluid,and the degree of dysmenorrhea between the two groups have statistically significant differences(P<0.05).2.The expression level of serum FABP4 has a positive correlation with FABP4 in the peritoneal lavage fluid(r=0.304,P<0.05),while cholesterol level has a positive correlation with FABP4 in the peritoneal lavage fluid(r=0.365,P<0.05);3.A high level of serum FABP4 is a risk factor for endometriosis(OR=1.882,P<0.05).The best cut-off point(7.57ng/ml)for the diagnosis of endometriosis by serum FABP4 were determined by ROC curve.At this time,the sensitivity and specificity are 40.6%and 100%respectively.Combined with CA125,the diagnostic efficiency was improved with a sensitivity of 71.9%and a specificity of 100%;4.The expression level of FABP4 in the mild group with lower r-AFS scores in serum and peritoneal washing fluid was significantly lower than in severe group with higher r-AFS scores(t=-2.312、-2.498,P<0.05),the level of leptin in the peritoneal lavage fluid in the mild group was significantly higher than that in the severe group(t=2.225,P<0.05);5.Serum FABP4and leptin levels in the peritoneal lavage fluid were related to the severity of dysmenorrhea(r=0.471、0.393,P<0.05).ConclusionsFABP4 and leptin are closely related to endometriosis.Serum FABP4 combined with CA125 level can be used as a reference index for the diagnosis of the disease.The therapeutic effect of targeting FABP4 and leptin on endometriosis remains to be further studied.