Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020

Abstract Background Inflammation exerts a critical role in the pathogenesis of infertility. The relationship between inflammatory parameters from peripheral blood and infertility remains unclear. Aim of this study was to investigate the association between inflammatory markers and infertility among...

Full description

Bibliographic Details
Main Authors: Yanfen Chen, Huanying Xu, Jianxing Yan, Qidan Wen, Mingjun Ma, Ningning Xu, Haoxi Zou, Xiaoyan Xing, Yingju Wang, Suzhen Wu
Format: Article
Language:English
Published: BMC 2024-01-01
Series:BMC Public Health
Subjects:
Online Access:https://doi.org/10.1186/s12889-024-17699-4
_version_ 1827377046613917696
author Yanfen Chen
Huanying Xu
Jianxing Yan
Qidan Wen
Mingjun Ma
Ningning Xu
Haoxi Zou
Xiaoyan Xing
Yingju Wang
Suzhen Wu
author_facet Yanfen Chen
Huanying Xu
Jianxing Yan
Qidan Wen
Mingjun Ma
Ningning Xu
Haoxi Zou
Xiaoyan Xing
Yingju Wang
Suzhen Wu
author_sort Yanfen Chen
collection DOAJ
description Abstract Background Inflammation exerts a critical role in the pathogenesis of infertility. The relationship between inflammatory parameters from peripheral blood and infertility remains unclear. Aim of this study was to investigate the association between inflammatory markers and infertility among women of reproductive age in the United States. Methods Women aged 20–45 were included from the National Health and Nutrition Examination Survey (NHANES) 2013–2020 for the present cross-sectional study. Data of reproductive status was collected from the Reproductive Health Questionnaire. Six inflammatory markers, systemic immune inflammation index (SII), lymphocyte count (LC), product of platelet and neutrophil count (PPN), platelet-lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) were calculated from complete blood counts in mobile examination center. Survey-weighted multivariable logistic regression was employed to assess the association between inflammatory markers and infertility in four different models, then restricted cubic spline (RCS) plot was used to explore non-linearity association between inflammatory markers and infertility. Subgroup analyses were performed to further clarify effects of other covariates on association between inflammatory markers and infertility. Results A total of 3,105 women aged 20–45 was included in the final analysis, with 431 (13.88%) self-reported infertility. A negative association was found between log2-SII, log2-PLR and infertility, with an OR of 0.95 (95% CI: 0.78,1.15; p = 0.60), 0.80 (95% CI:0.60,1.05; p = 0.10), respectively. The results were similar in model 1, model 2, and model 3. Compared with the lowest quartile (Q1), the third quartile (Q3) of log2-SII was negatively correlation with infertility, with an OR (95% CI) of 0.56 (95% CI: 0.37,0.85; p = 0.01) in model 3. Similarly, the third quartile (Q3) of log2-PLR was negatively correlation with infertility, with an OR (95% CI) of 0.61 (95% CI: 0.43,0.88; p = 0.01) in model 3. No significant association was observed between log2-LC, log2-PPN, log2-NLR, log2-LMR and infertility in model 3. A similar U-shaped relationship between log2-SII and infertility was found (p for non-linear < 0.05). The results of subgroup analyses revealed that associations between the third quartile (Q3) of log2-SII, log2-PLR and infertility were nearly consistent. Conclusion The findings showed that SII and PLR were negatively associated with infertility. Further studies are needed to explore their association better and the underlying mechanisms.
first_indexed 2024-03-08T12:33:07Z
format Article
id doaj.art-2e2bf2626fb74a6ead1affa50b6590b6
institution Directory Open Access Journal
issn 1471-2458
language English
last_indexed 2024-03-08T12:33:07Z
publishDate 2024-01-01
publisher BMC
record_format Article
series BMC Public Health
spelling doaj.art-2e2bf2626fb74a6ead1affa50b6590b62024-01-21T12:38:22ZengBMCBMC Public Health1471-24582024-01-0124111310.1186/s12889-024-17699-4Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020Yanfen Chen0Huanying Xu1Jianxing Yan2Qidan Wen3Mingjun Ma4Ningning Xu5Haoxi Zou6Xiaoyan Xing7Yingju Wang8Suzhen Wu9Foshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFirst Clinical Medical College of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineFoshan Clinical Medical School of Guangzhou University of Chinese MedicineAbstract Background Inflammation exerts a critical role in the pathogenesis of infertility. The relationship between inflammatory parameters from peripheral blood and infertility remains unclear. Aim of this study was to investigate the association between inflammatory markers and infertility among women of reproductive age in the United States. Methods Women aged 20–45 were included from the National Health and Nutrition Examination Survey (NHANES) 2013–2020 for the present cross-sectional study. Data of reproductive status was collected from the Reproductive Health Questionnaire. Six inflammatory markers, systemic immune inflammation index (SII), lymphocyte count (LC), product of platelet and neutrophil count (PPN), platelet-lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) were calculated from complete blood counts in mobile examination center. Survey-weighted multivariable logistic regression was employed to assess the association between inflammatory markers and infertility in four different models, then restricted cubic spline (RCS) plot was used to explore non-linearity association between inflammatory markers and infertility. Subgroup analyses were performed to further clarify effects of other covariates on association between inflammatory markers and infertility. Results A total of 3,105 women aged 20–45 was included in the final analysis, with 431 (13.88%) self-reported infertility. A negative association was found between log2-SII, log2-PLR and infertility, with an OR of 0.95 (95% CI: 0.78,1.15; p = 0.60), 0.80 (95% CI:0.60,1.05; p = 0.10), respectively. The results were similar in model 1, model 2, and model 3. Compared with the lowest quartile (Q1), the third quartile (Q3) of log2-SII was negatively correlation with infertility, with an OR (95% CI) of 0.56 (95% CI: 0.37,0.85; p = 0.01) in model 3. Similarly, the third quartile (Q3) of log2-PLR was negatively correlation with infertility, with an OR (95% CI) of 0.61 (95% CI: 0.43,0.88; p = 0.01) in model 3. No significant association was observed between log2-LC, log2-PPN, log2-NLR, log2-LMR and infertility in model 3. A similar U-shaped relationship between log2-SII and infertility was found (p for non-linear < 0.05). The results of subgroup analyses revealed that associations between the third quartile (Q3) of log2-SII, log2-PLR and infertility were nearly consistent. Conclusion The findings showed that SII and PLR were negatively associated with infertility. Further studies are needed to explore their association better and the underlying mechanisms.https://doi.org/10.1186/s12889-024-17699-4InfertilityNational Health and Nutrition Examination Survey (NHANES)Inflammatory markersSystemic immune inflammation index (SII)Lymphocyte count (LC)Product of platelet and neutrophil count (PPN)
spellingShingle Yanfen Chen
Huanying Xu
Jianxing Yan
Qidan Wen
Mingjun Ma
Ningning Xu
Haoxi Zou
Xiaoyan Xing
Yingju Wang
Suzhen Wu
Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
BMC Public Health
Infertility
National Health and Nutrition Examination Survey (NHANES)
Inflammatory markers
Systemic immune inflammation index (SII)
Lymphocyte count (LC)
Product of platelet and neutrophil count (PPN)
title Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
title_full Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
title_fullStr Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
title_full_unstemmed Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
title_short Inflammatory markers are associated with infertility prevalence: a cross-sectional analysis of the NHANES 2013–2020
title_sort inflammatory markers are associated with infertility prevalence a cross sectional analysis of the nhanes 2013 2020
topic Infertility
National Health and Nutrition Examination Survey (NHANES)
Inflammatory markers
Systemic immune inflammation index (SII)
Lymphocyte count (LC)
Product of platelet and neutrophil count (PPN)
url https://doi.org/10.1186/s12889-024-17699-4
work_keys_str_mv AT yanfenchen inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT huanyingxu inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT jianxingyan inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT qidanwen inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT mingjunma inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT ningningxu inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT haoxizou inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT xiaoyanxing inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT yingjuwang inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020
AT suzhenwu inflammatorymarkersareassociatedwithinfertilityprevalenceacrosssectionalanalysisofthenhanes20132020