女性HDL-C与LDL-C水平对辅助生殖妊娠结局影响的研究进展
Research Progress on the Influence of Female HDL-C and LDL-C Levels on Assisted Reproductive Pregnancy Outcomes
摘要: 本文主要叙述了高密度脂蛋白胆固醇(HDL-C)与低密度脂蛋白胆固醇(LDL-C)水平对辅助生殖技术(Assisted Reproductive Technology, ART)妊娠结局的影响。血脂异常不仅会增加心脑血管疾病风险，还可能通过影响性激素合成、卵泡发育、胚胎质量等导致女性生殖系统受损及生育力下降。HDL-C和LDL-C在调节妊娠结局方面发挥着关键作用，相关临床研究揭示了血脂水平与胚胎质量、子宫内膜容受性及妊娠结局之间的紧密联系。本文的目的在于为辅助生殖技术临床治疗中血脂管理提供理论依据，以期获得更高的妊娠率，改善妊娠结局。
Abstract: This article mainly describes the impact of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels on pregnancy outcomes in assisted reproductive technology (ART). Dyslipidemia not only increases the risk of cardiovascular and cerebrovascular diseases but may also lead to damage to the female reproductive system and decreased fertility by affecting sex hormone synthesis, follicular development, and embryo quality. HDL-C and LDL-C play crucial roles in regulating pregnancy outcomes, and relevant clinical studies have revealed the close relationship between blood lipid levels and embryo quality, endometrial receptivity, and pregnancy outcomes. The purpose of this article is to provide a theoretical basis for blood lipid management in clinical treatment of assisted reproductive technology, with the aim of achieving higher pregnancy rates and improving pregnancy outcomes.
文章引用：侯方玉, 王靖雯, 杨爱军, 朱永萃. 女性HDL-C与LDL-C水平对辅助生殖妊娠结局影响的研究进展[J]. 临床个性化医学, 2025, 4(6): 8-15. https://doi.org/10.12677/jcpm.2025.46472

参考文献

[1] Cai, W.Y., Luo, X., Chen, E., Lv, H., Fu, K., Wu, X., et al. (2021) Serum Lipid Levels and Treatment Outcomes in Women Undergoing Assisted Reproduction: A Retrospective Cohort Study. Frontiers in Endocrinology, 12, Article 633766. [Google Scholar] [CrossRef] [PubMed]
[2] Liu, Y., Ni, T., Zhao, Q., Cui, W., Lan, X., Zhou, T., et al. (2023) Maternal Hypercholesterolemia Would Increase the Incidence of Embryo Aneuploidy in Couples with Recurrent Implantation Failure. European Journal of Medical Research, 28, Article No. 534. [Google Scholar] [CrossRef] [PubMed]
[3] Mikheev, R.K., Andreeva, E.N., Grigoryan, O.R., Sheremetyeva, E.V., Pankratova, M.S. and Loginova, E.V. (2024) Replicative and Biochemical Ageing Mechanisms among Females with Turner Syndromes. Problems of Endocrinology, 69, 113-120. [Google Scholar] [CrossRef] [PubMed]
[4] Jiang, H., Chen, L., Tian, T., Shi, H., Huang, N., Chi, H., et al. (2023) Inflammation Mediates the Effect of Adiposity and Lipid Metabolism Indicators on the Embryogenesis of PCOS Women Undergoing in Vitro Fertilization/Intracytoplasmic Sperm Injection. Frontiers in Endocrinology, 14, Article 1198602. [Google Scholar] [CrossRef] [PubMed]
[5] Jiang, H., Si, M., Tian, T., Shi, H., Huang, N., Chi, H., et al. (2023) Adiposity and Lipid Metabolism Indicators Mediate the Adverse Effect of Glucose Metabolism Indicators on Oogenesis and Embryogenesis in PCOS Women Undergoing IVF/ICSI Cycles. European Journal of Medical Research, 28, Article No. 216. [Google Scholar] [CrossRef] [PubMed]
[6] Wang, S., Wang, J., Jiang, Y. and Jiang, W. (2020) Association between Blood Lipid Level and Embryo Quality during in Vitro Fertilization. Medicine, 99, e19665. [Google Scholar] [CrossRef] [PubMed]
[7] Zhang, Y., Wen, C.H., Xia, X.R., et al. (2022) Effect of Dyslipidemia on Clinical Outcome of Infertility Patients Receiving Donor Eggs. Chinese Journal of Obstetrics and Gynecology, 57, 686-691.
[8] Wang, X., Wu, L., Luo, H., Zhong, W., Zheng, X. and Xu, R. (2024) Association of Lipid Levels at Different Stages of Pregnancy with Gestational Diabetes Mellitus and the Incidence of Neonatal Macrosomia: A Retrospective Study. Journal of Obstetrics and Gynaecology Research, 50, 2066-2075. [Google Scholar] [CrossRef] [PubMed]
[9] Magnus, M.C., Ferreira, D.D.S., Borges, M.C., Tilling, K., Lawlor, D.A. and Fraser, A. (2021) Cardiometabolic Health during Early Adulthood and Risk of Miscarriage: A Prospective Study. Wellcome Open Research, 5, Article 205. [Google Scholar] [CrossRef] [PubMed]
[10] Hong, B.V., Zheng, J. and Zivkovic, A.M. (2023) HDL Function across the Lifespan: From Childhood, to Pregnancy, to Old Age. International Journal of Molecular Sciences, 24, Article 15305. [Google Scholar] [CrossRef] [PubMed]
[11] Zhang, W., Wang, R., Yang, X., Cheng, Z. and Wang, F. (2025) Correlation of Dyslipidemia Characterized by Abnormal Cholesterol in First Trimester with Early Pregnancy Loss: A Retrospective Study. Archives of Gynecology and Obstetrics, 311, 543-553. [Google Scholar] [CrossRef] [PubMed]
[12] Jensen, I.K.B., Roland, C.B., Knudsen, S.d.P., Jessen, A.D., Alomairah, S.A., Mortensen, O.H., et al. (2024) Effects of Physical Activity on Blood Lipids and Hemoglobin A1c in Healthy Pregnant Women: The Fitmum Randomized Controlled Trial. Endocrine Practice, 30, 927-936. [Google Scholar] [CrossRef] [PubMed]
[13] Zhang, J., Chen, H., Dou, X., Huang, W. and Zeng, H. (2023) Association between Gestational Blood Lipids and TSH Levels and Pregnancy Outcome of Patients with Subclinical Hypothyroidism. Pakistan Journal of Medical Sciences, 39, 721-725. [Google Scholar] [CrossRef] [PubMed]
[14] Oishi, T., Mitsuda, N., Watanabe, K., Araki, M., Nagai, R., Eitoku, M., et al. (2024) Association between Maternal LDL Level during Pregnancy and Offspring LDL Level at Age 8. The Tohoku Journal of Experimental Medicine, 264, 81-88. [Google Scholar] [CrossRef] [PubMed]
[15] Liu, T., Liu, D., Song, X., Qu, J., Zheng, X., Li, J., et al. (2021) Lipid Metabolism Was Associated with Oocyte in Vitro Maturation in Women with Polycystic Ovarian Syndrome Undergoing Unstimulated Natural Cycle. Frontiers in Cell and Developmental Biology, 9, Article 719173. [Google Scholar] [CrossRef] [PubMed]
[16] Feng, W., Zhang, D., Fu, L., Hu, J., Gao, S., Song, X., et al. (2022) Temporary Increased LDL-C in Offspring with Extreme Elevation of Maternal Preconception Estradiol: A Retrospective Cohort Study. Clinical Epidemiology, 14, 453-462. [Google Scholar] [CrossRef] [PubMed]
[17] Jiang, Q., Pan, Y., Li, P., Zheng, Y., Bian, Y., Wang, W., et al. (2021) ANGPTL4 Expression in Ovarian Granulosa Cells Is Associated with Polycystic Ovary Syndrome. Frontiers in Endocrinology, 12, Article 799833. [Google Scholar] [CrossRef] [PubMed]
[18] Bader, S., Bhatti, R., Mussa, B. and Abusanana, S. (2024) A Systematic Review of GLP-1 on Anthropometrics, Metabolic and Endocrine Parameters in Patients with PCOS. Women’s Health, 20, 1-10. [Google Scholar] [CrossRef] [PubMed]
[19] Alnouri, F. and Raal, F.J. (2025) Familial Hypercholesterolemia in Pregnancy. Current Opinion in Lipidology, 36, 138-144. [Google Scholar] [CrossRef] [PubMed]
[20] Agarwala, A., Dixon, D.L., Gianos, E., Kirkpatrick, C.F., Michos, E.D., Satish, P., et al. (2024) Dyslipidemia Management in Women of Reproductive Potential: An Expert Clinical Consensus from the National Lipid Association. Journal of Clinical Lipidology, 18, e664-e684. [Google Scholar] [CrossRef] [PubMed]
[21] Nava-Salazar, S., Flores-Pliego, A., Pérez-Martínez, G., Parra-Hernández, S., Vanoye-Carlo, A., Ibarguengoitia-Ochoa, F., et al. (2022) Resistin Modulates Low-Density Lipoprotein Cholesterol Uptake in Human Placental Explants via PCSK9. Reproductive Sciences, 29, 3242-3253. [Google Scholar] [CrossRef] [PubMed]
[22] Sinha, S., Das, S., Vinayagamoorthy, V., Malik, A., Tripathy, S.K. and Nishi, (2023) Dyslipidemia among Overweight and Obese Children in Jharkhand: A Hospital-Based Study. Indian Pediatrics, 60, 641-643. [Google Scholar] [CrossRef] 
[23] Maimaitituersun, G., Jureti, S., Yi, Z., Zhou, Y., Li, M., Wei, M., et al. (2025) Trends in Dyslipidemia Prevalence among Uyghur Adults of Different Genders in China: A Retrospective Cohort Study. Peer Journal, 13, e19344. [Google Scholar] [CrossRef] [PubMed]
[24] Zhang, L., Feng, Y., Sun, X., Yi, S., Xiao, X. and Ma, F. (2024) Impact of Body Mass Index on Assisted Reproductive Technology Outcomes in Patients with Polycystic Ovary Syndrome: A Meta-Analysis. Reproductive BioMedicine Online, 48, Article 103849. [Google Scholar] [CrossRef] [PubMed]
[25] Zhang, Y., Sun, X., Zhang, Y., et al. (2025) Immune Dysregulation and Endometrial Receptivity Impairment in Women with Repeated Implantation Failure and Dyslipidemia. The Journal of Clinical Endocrinology & Metabolism, 110, 3230-3242.
[26] Bergman, M. and Dorcely, B. (2023) Remission of Prediabetes via Lifestyle Intervention. The Lancet Diabetes & Endocrinology, 11, 784-785. [Google Scholar] [CrossRef] [PubMed]
[27] Rutters, F., den Braver, N.R., Lakerveld, J., Mackenbach, J.D., van der Ploeg, H.P., Griffin, S., et al. (2024) Lifestyle Interventions for Cardiometabolic Health. Nature Medicine, 30, 3455-3467. [Google Scholar] [CrossRef] [PubMed]
[28] Davis, C.L. and Lorig, K. (2024) Lifestyle Interventions for Obesity. Journal of the American Medical Association, 332, Article 1488. [Google Scholar] [CrossRef] [PubMed]
[29] Salzberg, L. (2022) Risk Factors and Lifestyle Interventions. Primary Care: Clinics in Office Practice, 49, 201-212. [Google Scholar] [CrossRef] [PubMed]
[30] Moholdt, T. and Hawley, J.A. (2020) Maternal Lifestyle Interventions: Targeting Preconception Health. Trends in Endocrinology & Metabolism, 31, 561-569. [Google Scholar] [CrossRef] [PubMed]