Impact of Mean Arterial Pressure on Reproductive Endocrine Characteristics in Infertile Patients with Polycystic Ovary Syndrome: A Secondary Analysis of a Randomized Clinical Trial

Baichao Shi^1*Luo Rong²Yang Liu¹Fengjuan Lu¹Muxin Guan¹Jiannan Yu¹Zhuwei Gao¹Yu Wang³Xiaoke Wu³

• ¹Heilongjiang University of Chinese Medicine, Harbin, China
• ²Jiangxi Chest Hospital, Nanchang, Jiangxi Province, China
• ³First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang Province, China

Objective: This study aims to evaluate the association between MAP and anthropometric, metabolic, and endocrine parameters in Chinese infertile women with PCOS. Methods: A total of 1,000 PCOS subjects were enrolled in the clinical trial project of PCOSAct. Of these, 998 patients were selected for this study. Linear trends and regression analyses were conducted to evaluate the association between MAP and anthropometric, metabolic, and endocrine parameters. Logistic regression was employed to estimate the association between MAP and risk of IR, NAFLD and hyperlipidemia. The ROC curve was used to determine the predictive value of the MAP for IR, NAFLD and hyperlipidemia. Results: Linear trends revealed that the MAP was positively associated with age, height, body weight, BMI, WC, HC, WHR, SBP and diastolic blood pressure (DBP), hirsutism score, and acanthosis nigricans score, FBG, FINS, HOMA-IR, LDL, TG, TC, ApoB, ApoB/ApoA1 ratio, TT, and FAI, as well as the prevalence of IR, MetS, NAFLD, and hyperlipidemia. Conversely, MAP was negatively correlated with QUICKI, HDL, SHBG, LH, the LH/FSH ratio, and AMH. After adjusting for age and BMI, a significant linear relationship was observed between MAP and WC, WHR, hirsutism score, FBG, LDL, TG, TC, ApoB, and ApoB/ApoA1 ratio. Logistic regression analysis demonstrated that participants in the highest quartile (Q4) of MAP had no significantly higher odds ratios (OR) for IR, NAFLD and hyperlipidemia after adjusting for confounding factors. The ROC curve analysis indicated that the AUCIR was 0.593 (95%CI: 0.557 ~ 0.629), with 85.9% sensitivity and 28.8% specificity at a cut-off value of 82.83, and the AUCNAFLD was 0.621 (95%CI: 0.554 ~ 0.687), with 69.4% sensitivity and 53.5% specificity at a cut-off value of 87.17, and the AUChyperlipidemia was 0.555 (95% CI: 0.518 ~ 0.592), with 39.5% sensitivity and 70.00% specificity at a cut-off value of 90.83. Conclusion: Elevated MAP is associated with dysregulation of glucose and lipid metabolism and alterations in endocrine hormone levels. It may thus serve as a promising screening approach for IR-related conditions in patients with PCOS.