Predictive Value of First-Trimester Serum TREM2 and SIGLEC1 Levels for Adverse Pregnancy Outcomes in Women with PCOS.

OBJECTIVE

To investigate the predictive value of first-trimester serum triggering receptor expressed on myeloid cells 2 (TREM2) and sialic acid-binding immunoglobulin-like lectin 1 (SIGLEC1) levels for adverse pregnancy outcome (APO) in pregnant women with polycystic ovary syndrome (PCOS), and to provide novel biomarkers for risk stratification management during pregnancy.

METHODS

This retrospective cohort study enrolled 380 singleton pregnant women with PCOS diagnosed between August 25, 2022, and January 25, 2025. Serum samples collected at gestational weeks 6-12 were retrieved from the biobank. TREM2 and SIGLEC1 concentrations were measured using ELISA. Participants were stratified into APO (n=117) and non-APO (n=263) groups. Receiver operating characteristic (ROC) curve analysis assessed predictive performance, and multivariable logistic regression identified independent risk factors.

RESULTS

Comparison of clinical data revealed that serum TREM2 and SIGLEC1 levels in the first trimester were significantly higher in the APO group than in the non-APO group (p < 0.05). Additionally, waist circumference, fasting plasma glucose (FPG), fasting insulin (FINS), and homeostatic model assessment for insulin resistance (HOMA-IR) were all significantly elevated in the APO group compared with the non-APO group (all p < 0.001). ROC analysis showed TREM2 achieved an area under the curve (AUC) of 0.828 (sensitivity 80.23%, specificity 75.21%) and SIGLEC1 yielded an AUC of 0.815 (sensitivity 83.65%, specificity 63.25%). The combined model demonstrated superior predictive accuracy (AUC 0.899, sensitivity 84.79%, specificity 82.05%). Multivariable logistic regression analysis demonstrated that elevated waist circumference (OR = 1.035, 95% CI: 1.010-1.060), HOMA-IR (OR = 2.027, 95% CI: 1.053-3.902), TREM2 (OR = 1.007, 95% CI: 1.005-1.009), and SIGLEC1 (OR = 1.006, 95% CI: 1.004-1.008) were all independent risk factors for APO in pregnant women with PCOS (all p < 0.05). TREM2 and SIGLEC1 levels positively correlated with HOMA-IR (r=0.202 and 0.231, respectively; both p < 0.001).

CONCLUSION

Elevated serum TREM2 and SIGLEC1 levels in early pregnancy are associated with overall APO risk in PCOS patients, and their combined detection shows predictive potential; differential predictive values for specific outcome subtypes await further validation.