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脂质代谢失衡:复发性流产的潜在病理机制与干预新思路

南文慧,秦训思,李蓉   

  1. 北京大学第三医院妇产科生殖医学中心,北京 100191

  • 收稿日期:2025-02-11 修回日期:2025-05-26 出版日期:2025-05-28 发布日期:2025-05-28
  • 基金资助:

    国家重点研发计划项目(编号:2022YFC27025002021YFC2700601)

Lipid metabolism imbalance: potential pathological mechanism and new intervention ideas for recurrent miscarriage

Wenhui Nan,Xunsi Qin,Rong Li   

  1. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China

  • Received:2025-02-11 Revised:2025-05-26 Published:2025-05-28 Online:2025-05-28
  • Supported by:
    [Supported by the National Key R&D Program of China (No. 2022YFC27025002021YFC2700601)]

摘要: 复发性流产指连续3次及以上的自然流产,病因复杂,涉及遗传、免疫及内分泌等因素。近年来,脂质代谢异常作为复发性流产的潜在病因备受关注。脂质代谢异常可损害子宫内膜容受性并导致胚胎着床失败,其具体机制尚未被阐明。本文综述了脂质代谢异常与胚胎发育及子宫内膜容受性建立的病理机制及其研究进展,重点探讨了胆固醇和脂肪酸代谢对复发性流产的潜在影响,阐述了脂质代谢与激素合成和调控,以及脂质异常介导子宫内膜局部炎症反应的病理变化,最后本文展望了血脂监测、饮食调控及脂质代谢相关药物在早期诊断和治疗中的应用,以期为深入揭示脂质代谢异常在复发性流产中的机制,和个体化治疗提供参考和借鉴。

关键词: 复发性流产, 脂质代谢, 胆固醇, 脂肪酸, 子宫内膜容受性, 血脂异常

Abstract: Recurrent miscarriage is defined as three or more consecutive spontaneous abortions. Its etiology is complex, involving genetic, immune, and endocrine factors. In recent years, lipid metabolism disorders have attracted increasing attention for their potential role in recurrent miscarriage. Abnormalities in lipid metabolism can adversely affect endometrial receptivity, contributing to implantation failure. However, the precise underlying mechanisms remain to be fully elucidated. In this review, we provide an overview of the pathological mechanisms and recent advancements in research pertaining to the relationship between lipid metabolic disorders, embryonic development, and the establishment of endometrial receptivity. Special emphasis is placed on the influence of cholesterol and fatty acid metabolism on recurrent miscarriage. Furthermore, we examine the contributions of lipid metabolism to hormone synthesis and regulation, as well as the pathological changes that can arise from lipid-mediated local inflammation within the endometrium. Finally, we discuss the potential roles of lipid profile monitoring, dietary interventions, and lipid metabolism-targeted therapies in the early diagnosis and treatment of recurrent miscarriage. We hope this review can enhance understanding of the mechanisms underlying lipid metabolic dysfunction in this context and inform the development of tailored therapeutic strategies.

Key words: recurrent miscarriage, lipid metabolism, cholesterol, fatty acids, endometrial receptivity, abnormal blood lipids