多囊卵巢综合征伴胰岛素抵抗对生育影响的研究进展
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摘要
多囊卵巢综合征(PCOS)是育龄妇女常见的内分泌性疾病,跨越了妇女生命的全过程,以高胰岛素血症、高雄激素血症和(或)无排卵为特征,目前病因尚不明确,然而胰岛素抵抗(IR)是PCOS患者常见的代谢紊乱性疾病。由此产生的高胰岛素血症可导致激素水平改变、卵泡生长受限、子宫内膜容受性改变,增加流产率或导致不孕等,同时可增加妊娠合并症的发病率,甚至让患者产生焦虑、抑郁等心理问题,因此PCOS伴IR越来越受到人们的重视。阐述PCOS伴IR对生育影响的研究进展。
Polycystic ovary syndrome(PCOS), a common endocrine disease in women of pregnancy age, is characterized by hyperinsulinemia, hyperandrogenism and/or anovulation. It spans the whole process of women's life. However, the etiology of PCOS is still unclear. Insulin resistance(IR) is one of the common metabolic disorders in patients with PCOS, in which hyperinsulinemia can lead to the changes in hormone levels, follicular growth restriction, endometrial receptivity, and increased abortion or infertility rates. The increased incidence of pregnancy complications, even anxiety, depression and other psychological problems, could be related with IR.PCOS combined with IR has attracted more and more attention in reproductive medicine.
Polycystic ovary syndrome(PCOS), a common endocrine disease in women of pregnancy age, is characterized by hyperinsulinemia, hyperandrogenism and/or anovulation. It spans the whole process of women's life. However, the etiology of PCOS is still unclear. Insulin resistance(IR) is one of the common metabolic disorders in patients with PCOS, in which hyperinsulinemia can lead to the changes in hormone levels, follicular growth restriction, endometrial receptivity, and increased abortion or infertility rates. The increased incidence of pregnancy complications, even anxiety, depression and other psychological problems, could be related with IR.PCOS combined with IR has attracted more and more attention in reproductive medicine.
引文
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[17]宋学茹,张慧英,张艳芳,等.细胞外信号调节激酶在多囊卵巢综合征患者子宫内膜中的活化及意义[J].中华妇产科杂志,2010,45(10):767-771.
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[19]Campos DB,Palin MF,Bordignon V,The'beneficial'adipokines in reproduction and fertility[J].Int J Obes(Lond),2008,32(2):223-231.
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[21]Wei D,Zhang B,Shi Y,et al.Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome[J].J Clin Endocrinol Metab,2017,102(10):3822-3829.
[22]Yao K,Bian C,Zhao X.Association of polycystic ovary syndrome with metabolic syndrome and gestational diabetes:Aggravated complication of pregnancy[J].Exp Ther Med,2017,14(2):1271-1276.
[23]王婷婷,付翰林,陈立章,等.多囊卵巢综合征患者妊娠并发症发生率的Meta分析[J].中南大学学报(医学版),2017,42(11):1300-1310.
[24]Tian L,Shen H,Lu Q,et al.Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment[J].J Clin Endocrinol Metab,2007,92(4):1430-1433.
[25]Murray AJ.Oxygen delivery and fetal-placental growth:beyond a question of supply and demand?[J].Placenta,2012,33(Suppl 2):e16-e22.
[26]Chakraborty P,Goswami SK,Rajani S,et al.Recurrent pregnancy loss in polycystic ovary syndrome:role of hyperhomocysteinemia and insulin resistance[J].PLoS One,2013,8(5):e64446.
[27]Jakubowicz DJ,Essah PA,Sepp覿l覿M,et al.Reduced serum glycodelin and insulin-like growth factor-binding protein-1 in women with polycystic ovary syndrome during first trimester of pregnancy[J].J Clin Endocrinol Metab,2004,89(2):833-839.
[28]Zhang CM,Zhao Y,Li R,et al.Metabolic heterogeneity of follicular amino acids in polycystic ovary syndrome is affected by obesity and related to pregnancy outcome[J].BMC Pregnancy Childbirth,2014,14:11.
[29]Mu L,Li R,Lai Y,et al.Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome[J].JEndocrinol Invest,2018,[Epub ahead of print].
[30]Ramezani Tehrani F,Montazeri SA,Hosseinpanah F,et al.Trend of Cardio-Metabolic Risk Factors in Polycystic Ovary Syndrome:APopulation-Based Prospective Cohort Study[J].PLoS One,2015,10(9):e0137609.
[31]Mu L,Zhao Y,Lai Y,et al.Insulin resistance andβ-cell dysfunction and the relationship with cardio-metabolic disorders among women with polycystic ovary syndrome[J].Clin Endocrinol(Oxf),2018,89(6):779-788.
[32]Cooney LG,Lee I,Sammel MD,et al.High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome:a systematic review and meta-analysis[J].Hum Reprod,2017,32(5):1075-1091.
[33]Greenwood EA,Pasch LA,Cedars MI,et al.Insulin resistance is associated with depression risk in polycystic ovary syndrome[J].Fertil Steril,2018,110(1):27-34.
[2]Rice S,Christoforidis N,Gadd C,et al.Impaired insulin-dependent glucose metabolism in granulosa-lutein cells from anovulatory women with polycystic ovaries[J].Hum Reprod,2005,20(2):373-381.
[3]Billig H,Furuta I,Hsueh AJ.Estrogens inhibit and androgens enhance ovarian granulosa cell apoptosis[J].Endocrinology,1993,133(5):2204-2212.
[4]Bicer M,Alan M,Alarslan P,et al.Circulating insulin-like peptide5 levels and its association with metabolic and hormonal parameters in women with polycystic ovary syndrome[J].J Endocrinol Invest,2018,[Epub ahead of print].
[5]Burnicka-Turek O,Mohamed BA,Shirneshan K,et al.INSL5-deficient mice display an alteration in glucose homeostasis and an impaired fertility[J].Endocrinology,2012,153(10):4655-4665.
[6]Alan M,Gurlek B,Yilmaz A,et al.Asprosin:a novel peptide hormone related to insulin resistance in women with polycystic ovary syndrome[J].Gynecol Endocrinol,2018,[Epub ahead of print].
[7]张文娟,孙丽霞,于新艳.脂联素与多囊卵巢综合征胰岛素抵抗的研究现状[J].国际生殖健康/计划生育杂志,2007,26(3):154-157.
[8]Cakiroglu Y,Doger E,Vural F,et al.Impact of insulin resistance and obesity on intracytoplasmic sperm injection outcomes in young women with polycyst覦c ovary syndrome[J].North Clin Istanb,2017,4(3):218-224.
[9]Niu Z,Lin N,Gu R,et al.Associations between insulin resistance,free fatty acids,and oocyte quality in polycystic ovary syndrome during in vitro fertilization[J].J Clin Endocrinol Metab,2014,99(11):E2269-E2276.
[10]Kim E,Seok HH,Lee SY,et al.Correlation between Expression of Glucose Transporters in Granulosa Cells and Oocyte Quality in Women with Polycystic Ovary Syndrome[J].Endocrinol Metab(Seoul),2014,29(1):40-47.
[11]Mumford SL,Legro RS,Diamond MP,et al.Baseline AMH Level Associated With Ovulation Following Ovulation Induction in Women With Polycystic Ovary Syndrome[J].J Clin Endocrinol Metab,2016,101(9):3288-3296.
[12]Xu J,Bishop CV,Lawson MS,et al.Anti-Müllerian hormone promotes pre-antral follicle growth,but inhibits antral follicle maturation and dominant follicle selection in primates[J].Hum Reprod,2016,31(7):1522-1530.
[13]周伟伟,李霞.抗苗勒管激素与非肥胖型多囊卵巢综合征合并胰岛素抵抗的关系[J].国际妇产科学杂志,2017,44(1):118-120.
[14]Qi J,Wang W,Zhu Q,et al.Local Cortisol Elevation Contributes to Endometrial Insulin Resistance in Polycystic Ovary Syndrome[J].JClin Endocrinol Metab,2018,103(7):2457-2467.
[15]Chang EM,Han JE,Seok HH,et al.Insulin resistance does not affect early embryo development but lowers implantation rate in in vitro maturation-in vitro fertilization-embryo transfer cycle[J].Clin Endocrinol(Oxf),2013,79(1):93-99.
[16]Oróstica L,García P,Vera C,et al.Effect of TNF-αon Molecules Related to the Insulin Action in Endometrial Cells Exposed to Hyperandrogenic and Hyperinsulinic Conditions Characteristics of Polycystic Ovary Syndrome[J].Reprod Sci,2018,25(7):1000-1009.
[17]宋学茹,张慧英,张艳芳,等.细胞外信号调节激酶在多囊卵巢综合征患者子宫内膜中的活化及意义[J].中华妇产科杂志,2010,45(10):767-771.
[18]Shafiee MN,Seedhouse C,Mongan N,et al.Up-regulation of genes involved in the insulin signalling pathway(IGF1,PTEN and IGFBP1)in the endometrium may link polycystic ovarian syndrome and endometrial cancer[J].Mol Cell Endocrinol,2016,424:94-101.
[19]Campos DB,Palin MF,Bordignon V,The'beneficial'adipokines in reproduction and fertility[J].Int J Obes(Lond),2008,32(2):223-231.
[20]Morley LC,Tang T,Yasmin E,et al.Insulin-sensitising drugs(metformin,rosiglitazone,pioglitazone,D-chiro-inositol)for women with polycystic ovary syndrome,oligo amenorrhoea and subfertility[J].Cochrane Database Syst Rev,2017,11:CD003053.
[21]Wei D,Zhang B,Shi Y,et al.Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome[J].J Clin Endocrinol Metab,2017,102(10):3822-3829.
[22]Yao K,Bian C,Zhao X.Association of polycystic ovary syndrome with metabolic syndrome and gestational diabetes:Aggravated complication of pregnancy[J].Exp Ther Med,2017,14(2):1271-1276.
[23]王婷婷,付翰林,陈立章,等.多囊卵巢综合征患者妊娠并发症发生率的Meta分析[J].中南大学学报(医学版),2017,42(11):1300-1310.
[24]Tian L,Shen H,Lu Q,et al.Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment[J].J Clin Endocrinol Metab,2007,92(4):1430-1433.
[25]Murray AJ.Oxygen delivery and fetal-placental growth:beyond a question of supply and demand?[J].Placenta,2012,33(Suppl 2):e16-e22.
[26]Chakraborty P,Goswami SK,Rajani S,et al.Recurrent pregnancy loss in polycystic ovary syndrome:role of hyperhomocysteinemia and insulin resistance[J].PLoS One,2013,8(5):e64446.
[27]Jakubowicz DJ,Essah PA,Sepp覿l覿M,et al.Reduced serum glycodelin and insulin-like growth factor-binding protein-1 in women with polycystic ovary syndrome during first trimester of pregnancy[J].J Clin Endocrinol Metab,2004,89(2):833-839.
[28]Zhang CM,Zhao Y,Li R,et al.Metabolic heterogeneity of follicular amino acids in polycystic ovary syndrome is affected by obesity and related to pregnancy outcome[J].BMC Pregnancy Childbirth,2014,14:11.
[29]Mu L,Li R,Lai Y,et al.Adipose insulin resistance is associated with cardiovascular risk factors in polycystic ovary syndrome[J].JEndocrinol Invest,2018,[Epub ahead of print].
[30]Ramezani Tehrani F,Montazeri SA,Hosseinpanah F,et al.Trend of Cardio-Metabolic Risk Factors in Polycystic Ovary Syndrome:APopulation-Based Prospective Cohort Study[J].PLoS One,2015,10(9):e0137609.
[31]Mu L,Zhao Y,Lai Y,et al.Insulin resistance andβ-cell dysfunction and the relationship with cardio-metabolic disorders among women with polycystic ovary syndrome[J].Clin Endocrinol(Oxf),2018,89(6):779-788.
[32]Cooney LG,Lee I,Sammel MD,et al.High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome:a systematic review and meta-analysis[J].Hum Reprod,2017,32(5):1075-1091.
[33]Greenwood EA,Pasch LA,Cedars MI,et al.Insulin resistance is associated with depression risk in polycystic ovary syndrome[J].Fertil Steril,2018,110(1):27-34.