Abstract：Objective: To analyze the expression of microRNA (miR)-155 and miR-143 in patients with premature ovarian insufficiency (POF), and to explore their predictive effect on successful pregnancy. Methods: A total of 172 patients with POF in our hospital from June 2020 to December 2021 were selected as the research objects, and 86 healthy people without POF during the same period were selected as the control. The expressions of miR-155 and miR-143 were compared between POF patients and non-POF healthy subjects, and the pregnancy was counted. Logistic regression was used to analyze the influencing factors of successful pregnancy in POF patients. The value of successful pregnancy in patients was analyzed with POF assessed by miR-155 and miR-143 by subject operating characteristic curve (ROC), decision curves were plotted to analyze the benefit of successful pregnancy in patients with POF assessed by miR-155 and miR-143, and the rate of successful pregnancy in patients with POF was compared with different expression of miR-155 and miR-143. Results: Patients with POF had lower miR-155 expression levels and higher miR-143 expression levels than healthy subjects with non-POF (P<0.05). There were 79 successful pregnancies and 93 non-pregnant cases in 172 POF patients; compared with non-pregnant POF patients, those with successful pregnancies had higher basal follicle counts, shorter duration of infertility, younger female age, younger male age, higher expression levels of anti-müllerian hormone and miR-155, and lower expression levels of miR-143 (P<0.05). Basal follicle count of 2-4 and high miR-155 expression were independent protective factors for pregnancy failure in POF patients, and low miR-143 expression was an independent risk factor for pregnancy failure in POF patients (P<0.05). The AUC value of the combined miR-155 and miR-143 assay to assess successful pregnancy in patients with POF was 0.812 (95% CI: 0.746 to 0.867), which was higher than the AUC values of miR-155 (χ2=2.625, P=0.009) and miR-143 (χ2=2.973, P=0.003) alone. Decision curve analysis showed that the net benefit of the combined miR-155 and miR-143 test in assessing successful pregnancy in POF patients was higher than that of the test alone when the risk threshold was 0.10 to 0.63. Decision curve analysis showed that the net benefit of the combined miR-155 and miR-143 test in assessing successful pregnancy in POF patients was higher than that of the test alone when the risk threshold was 0.10 to 0.63. miR-155+/miR-143- had a significantly higher rate of successful pregnancy than miR-155+/miR-143+, miR 155-/miR-143- and miR-155-/miR-143+ (P<0.05). Conclusion: POF patients with low miR-155 expression and high miR-143 expression, both of which have a direct impact on the success of pregnancy in POF patients. miR-155 high expression and miR-143 low expression have a higher success rate of pregnancy in POF patients, and the detection of miR-155 and miR-143 can predict pregnancy, which has certain clinical application value.
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2023, Vol. 29 
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