脂联素及其受体在多囊卵巢综合征子宫内膜表达的研究
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摘要
目的:探讨脂联素及其受体在多囊卵巢综合征患者子宫内膜表达及分布的变化与其高发子宫内膜增生症甚至癌变的关系。
     方法:用酶联免疫吸附法(ELISA)测定PCOS患者38例(PCOS组)和正常妇女40例(正常对照组)血清性激素、促性腺激素、血脂血糖和胰岛素水平;应用逆转录-聚合酶链式反应(RT-PCR)和免疫组化(IHC)的方法检测脂联素及其受体在子宫内膜mRNA表达和蛋白分布;比较PCOS患者与正常对照妇女组脂联素及其受体在子宫内膜表达和分布的差异并寻找其相关影响因素。
     结果:(1)血清学检测:PCOS组睾酮72.74±7.64ng/dl明显高于正常对照组36.61±6.20 ng/dl,P<0.05;PCOS组FSH6.81±0.61 IU/E明显低于正常对照组8.49±0.92IU/L,P<0.05;PCOS组LH 9.09±0.89 IU/L明显高于正常对照组4.55±0.72IU/L,P<0.05;PCOS组胆固醇4.99±0.36mmol/L明显高于正常对照组3.63±0.16mmol/L,P<0.05;PCOS组甘油三脂2.06±0.77mmol/L明显高于正常对照组1.13±0.15mmol/L,P<0.05;PCOS组空腹胰岛素9.13±0.59mIU/L明显高于正常对照组6.52±0.73mIU/L,P<0.05;余指标无明显差异。(2)RT-PCR扩增出Adipo,AdipoR1,AdipoR2基因,PCOS组及正常对照组均以AdipoR1为主,AdipoR1与AdipoR2表达量差异有统计学意义(p<0.05);PCOS组AdipoR1 mRNA 0.91±0.1表达明显低于正常对照组1.13±0.19,差异有统计学意义(P<0.05);PCOS组总脂联素受体mRNA 1.22±0.15明显低于正常对照组1.45±0.29(P<0.05);PCOS患者AdipoR2和Adiponectin mRNA表达略低于正常对照组,但差异无统计学意义(P>0.05)。(3)Spearman相关性分析显示,脂联素总受体mRNA表达量与FSH呈正相关(r=0.482,p<0.05),AdipoR1mRNA表达与FINS呈负相关(r=-0.69,p<0.05)。(4)PCOS组和正常对照组子宫内膜免疫组化AdipoR1和AdipoR2呈阳性,主要表达于腺体细胞膜表面。
     结论:(1)PCOS患者子宫内膜存在Adiponectin,AdipoR1和AdipoR2在mRNA水平的表达,且以AdipoR1为主。其中AdipoR1和脂联素总受体较正常对照组表达量下降,可能参与了PCOS患者高发子宫内膜增生症甚至癌变的转化过程。(2)脂联素总受体mRNA水平表达量与FSH呈正相关,而AdipoR1与FINS呈负相关。(3)PCOS和正常子宫内膜存在AdipoR1和AdipoR2蛋白水平表达,主要定位于腺体细胞。
Objectives:To investigate the relationship between expression of adiponectin as well as its receptors in endometrium and high risk of endometrial hyperplasia or even endometrial cancer in patients with polycystic ovary syndrome(PCOS).
     Methods:38 PCOS patients served as study group,while 40 cases of normal endometrium as control group.Serum FSH、LH、PRL、T、E_2、CHO、TG、FPG and FINS were determined by enzyme-linked immunosorbent assay(ELISA),and homeostasis model assessment of insulin resistance(HOMA-IR)were calculated.The expression of adiponectin and its two receptors in endometrium were detected by semiquantitive RT-PCR.In addition,immunohistochemical method was used to detect the expression of adiponectin receptorl and 2 in protein level.
     Results:(1)Endocrine and metabolic characteristics:FSH 6.81±0.61 IU/L in PCOS group were lower than 8.49±0.92IU/L in control group,P<0.05;The amount of testorone、LH、CHO、TG、FINS were72.74±7.64ng/dl、9.09±0.89 IU/L、4.99±0.36mmol/L,2.06±0.77mmol/L,9.13±0.59mIU/L in PCOS,which were higher than that in control group with 36.61±6.20 ng/dl、4.55±0.72 IU/L、3.63±0.16mmol/L、1.13±0.15mmol/Land6.52±0.73mIU/L respectively,P<0.05.(2) Adiponectin and its receptors were all detected in mRNA level in PCOS and control group,and both groups were dominated by AdipoR1,P<0.05;the expression of AdipoR1 and total Adiponectin receptors were lower in PCOS group(0.91±0.1 and1.22±0.15)than in control women(1.13±0.19and1.45±0.29)with statistical significance (P<0.05);there were no significant difference in Adiponectin and AdipoR2 expression between two groups.(3)The relationship between serumal FSH level and expression of total Adiponectin receptors was found(r=0.482,p<0.05),so was FINS and AdipoR1 (r=-0.69,p<0.05).(4)AdipoR1 and AdipoR2 were detected in protein level in endometrial tissue in both groups.
     Conclusion:(1)The expression of total Adiponectin receptors and AdipoR1 in mRNA level in endometrium were declined in PCOS group.So AdipoR1 might play an important role in the conversion of PCOS patients' endometrium from normal to hyperplasia or even cancer.(2)There was a positive correlation between the expression of total Adiponectin receptors in mRNA level and FSH,while negative correlation between AdipoR1 and FINS.(3)Proteins of both AdipoR1 and AdipoR2 were detected in PCOS and normal endometrium,and were mainly located on the membrane of glandular cell.
引文
[1]Cheung AP.Ultrasound and menstrual history in predicting endometrial hyperplasia in polycystic ovary syndrome.Obstet Gynecol.2001,98(2):325-31.
    [2]余凡,靳镭.脂联素与多囊卵巢综合征代谢紊乱.中国优生与遗传杂志.2007,15(7):122-124.
    [3]Deborah K.Oh,Theodore Ciaraldi,and Robert R.Henry.Adiponectin in health and disease.Diabetes,Obesity and Metabolism.2007,9(33):282-289.
    [4]Orio F,Palomba S,Farmakiotis D,et al.Adiponectin levels in women with polycystic ovary syndrome.J Clin Endocrinol Metab.2003,88(6):2619-2623.
    [5]Berg AH,Combs TP,Du X M et al.The adipocyte secreted protein Acrp30enhances hepatic insulin action.Nat Med.2001,7(8):947-53.
    [6]Tsao TS,Tomas E,Murrey HE,et al.Role of disulfide bonds in Acrp30/adiponectin structure and signaling specificity.Different oligomersactivate different signal transduction pathways.J Biol Chem.2003,278(50):50810-7.
    [7]Pajvani UB,Du X,Combs TP,et al.Structure-function studies of the adipocytesecreted hormone Acrp30/adiponectin.Implications for metabolic regulation and bioactivity.J Biol Chem.2003,278(11):9073- 85.
    [8]Yamauchi T,Kamon J,Minokoshi Y,et al.Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP activated protein kinase.Nat Med.2002,8(11):1288-95.
    [9]Pajvani UB,Hawkins M,Combs TP,et al.Complex distribution,not absolute amount of adiponectin,correlates with thiazolidinedione-mediated improvements in insulin sensitivity.J.Biol.Chem.2004,279(13):12152-12162.
    [10]Kadowaki T,Yamauchi T.Adiponectin and adiponectin receptors.Endocr Rev.2005,26(3):439 -51.
    [11]Goldstein BJ,Scalia R.Adiponectin:a novel adipokine linking adipocytes and vascular function.J Clin Endocrinol Metab.2004,89(6):2563- 8.
    [12]Bub JD,Miyazaki T,Iwamoto Y.Adiponectin as a growth inhibitor in prostate cancer cells.Biochem Biophys Res Commun.2006,340(4):1158-66.
    [13] Miyazaki T,Bub JD, Uzuki M, Iwamoto Y. Adiponectin activates c-Jun NH2- terminal kinase and inhibits signal transducer and activator of transcription 3. Biochem Biophys Res Commun .2005, 333(1):79-87.
    [14] Williams CJ, Mitsiades N, Sozopoulos E, et al. Suppressive effects of nobiletin on hyperleptinemia and colitis-related colon carcinogenesis in male ICR mice. Carcinogenesis. 2008, Mar 28; [Epub ahead of print].
    [15] Jung TW, Lee JY, Shim WS,et al.Adiponectin protects human neuroblastoma SH-SY5Y cells against acetaldehyde-induced cytotoxicity. Biochem Pharmacol. 2006,72(5):616-23.
    [16] Korner A, Pazaitou-Panayiotou K, Kelesidis T, et al. Total and highmolecular- weight adiponectin in breast cancer: in vitro and in vivo studies. J Clin Endocrinol Metab.2007,92(3):1041-8.
    [17] Cust AE, Kaaks R, Friedenreich C, et al. Plasma adiponectin levels and endometrial cancer risk in pre- and postmenopausal women. J Clin Endocrinol Metab.2007,92(1):255-63.
    
    [18] Eleni P, Christos M ,Nick D,et al. Plasma Adiponectin Concentrations in Relation to Endometrial Cancer: A Case-Control Study in Greece .The Journal of Clinical Endocrinology & Metabolism. 2003, 88(3):993-997.
    [19] Kubota N,Terauchi Y,Yamauchi T,et al .Disruption of adiponectin causes insulin resistance and neointimal formation.J Biol Chem.2002,227(29):25863-25866.
    [20] Hotta K,Funahashi T,Bodkin NL,et al.Circulating concentrations of the adipocyte protein adiponectin are decreased in parallel with reduced insulin sensitivity during the progression to type 2 diabetes in rhesus monkeys.Diabetes.2001,50 (5): 1126-1133.
    [21] G. Iatrakis a,C. Tsionis b,G. Adonakis c,et al. Polycystic ovarian syndrome, insulin resistanceand thickness of the endometrium. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2006, 127(2):218-221.
    [22] Bermont L, Lamielle F, Lorchel F et al. Insulin up-regulates vascular endothelial growth factor and stabilizes its messengers in endometrial adenocarcinoma cells. The Journal of Clinical Endocrinology and Metabolism.2001,86(1): 363-368.
    [23]Linda C.Endometrium in PCOS:Implantation and predisposition to endocrine CA.Giudice Best Practice & Research Clinical Endocrinology & Metabolism.2006,20(2):235-244.
    [24]Arita Y,Kihara S,Ouchi N,et al.Adipocyte-derived plasma protein adiponectin acts as a platelet-derived growth factor-BB-binding protein and regulate growth factor-induced common post-receptor signal in vascular smooth muscle eell.Circulation.2002,105(24):2893-2898.
    [25]Brakenhielm E,Veitonmaki N,Cao R.Adiponeetin-induced antiangiogenesis and antitumor activity involve caspase-mediated endothelial cell apoptosis.Prec Natl Acad Sci.2004,101(8):2476-2481.
    [26]Quchi N,Kihara S,Arita Y,et al.Novel modulator for endothelial adhesion molecules:adipocyte- derived plasma protein adiponectin.Circulation.1999,100(25):2473-2476.
    [27]雷晓妮.脂联素与胰岛素抵抗的关系.中国临床保健杂志.2007,10(4):442-444.
    [28]Li Cong,Jessica Gasser,Jessica Zhao et al.Human adiponectin inhibits cell growth and induces apoptosis in human endometrial carcinoma cells,HEC-1-A and RL95-2.Endocrine-Related Cancer.2007,14(3):713-720.
    [29]Yokota T,Oritani K,Takahashi I,et al.Adiponectin,a new member of the family of soluble defense collagens,negatively regulates the growth of myelomonocytic progenitors and the functions of macrophages.Blood.2000,96:1723-32.
    [30]Diana Barb,Catherine J Williams,Anke K Neuwirth,et al.Adiponectin in relation to malignancies:a review of existing basic research and clinical evidence.Am J Clin Nutr 2007;86(3):858-866.
    [31]Wang Y,Lam KS,Xu JY et al.Adiponectin inhibits cell proliferation by interacting with several growth factors in an oligomerization-dependent manner.J.Biol.Chem.2005,280(18):18341-18347.
    [32]Barkenhielm E,Veitonmaki N,Cao R,et al.Adiponectin-induced antiangiogenesisi and antitumor activity involve caspase-mediated endothelial cell apoptosis.Proc.Naatl.Acad.Sci.2004,101(8):2476-2481.
    [33]Avcu F,Ural AU,Yilmaz MI,Bingol N,et al.Association of plasma adiponectin concentrations with chronic lymphocytic leukemia and myeloproliferative diseases. Int J Hematol. 2006,83(3):254-8.
    [34] Mantzoros C, Petridou E, Dessypris N, et al. Adiponectin and breast cancer risk. J Clin Endocrinol Metab.2004,89(3):1102-1107.
    [35] Yuri T, Yutaka O, Toshimasa Y,et al. Expression of Adiponectin Receptors and Its Possible Implication in the Human Endometrium. Endocrinology. 2006,147(7):3203-3210.
    [36] Konstantinos Michalakis, Catherine J. Williams, Nicholas Mitsiades, et al. Serum Adiponectin Concentrations and Tissue Expression of Adiponectin Receptors Are Reduced in Patients with Prostate Cancer: A Case Control Study. Cancer Epidemiol Biomarkers Prev.2007,16(2):308-313.
    [37] B. K. Tan, J. Chen,J. E. Digby, et al. Upregulation of adiponectin receptor 1 and 2 mRNA and protein in adipose tissue and adipocytes in insulin-resistant women with polycystic ovary syndrome. Diabetologia. 2006,49(11):2723-2728.
    [38] StaigerH,Kaltenbaeh S, SteigerK,et al.Expression of adiponectin receptor mRNA in human skeletal mscle cells is related to in vivo parameters of glucose and lipid metabolihsm.Diabetes.2004,53(9): 2195-2201.
    [39]Saitoh M, Nagai K, Nakagawa K et al. Adenosine induces apoptosis in the human gastric cancer cells via an intrinsic pathway relevant to activation of AMP-activated protein kinase. Biochem. Pharmacol. 2004,67( 10):2005-2011.
    [40] Chinetti G, Zawadski C,Fruchart JC,et al.Expression of adiponectin receptors in human macrophages and regulation by agonists of the nuclear receptors PPARalpha,PPAR gamma, and LXR.Biochem Biophys Res Commun.2004, 314(1):151—158.
    [41] M.C. Wulster-Radcliffe, K.M. Ajuwon, J. Wang,et al.Adiponectin differentially regulates cytokines in procine macrophages.Biochem. Biophys. Res. Commun. 2004, 316(3): 924- 929.
    [42] Chen H,Montagnani M,Funahashi T, et al. Adiponectin stimulates production of nitric oxide in vascular endothelial cells.J.Biol.Chem. 2003,278(45):45021-45026.
    [43] Dewi DA, Abayasekara DR, Wheeler-Jones CP. Requirement for ERK1/2 activation in the regulation of progesterone production in human granulosa-lutein cells is stimulus specific. Endocrinology. 2002,143(3):877—888.
    [44] Jang C, Inder WJ, Obeyesekere VR, et al.Adiponectin, skeletal muscle adiponectin receptor expression and insulin resistance following dexamet.Clin Endocrinol (Oxf). 2008, Mar 15 [Epub ahead of print]
    [45] Kadowaki T, Yamauchi T, Kubota N, et al.Adiponectin and adiponectin receptors in insulin resistance, diabetes, and the metabolic syndrome.J Clin Invest. 2006,116(7): 1784-92.
    [1] Navaratnarajah R, Pillay OC, Hardiman P. Polycystic ovary syndrome and endometrial cancer. Semin Reprod Med.2008,26(1):62-71.
    [2] Leon L, Bacallao K, Gabler F, et al. Activities of steroid metabolic enzymes in secretory endometria from untreated women with Polycystic Ovary Syndrome. Steroids.2008 ,73(1):88-95.
    [3] Hess AP, Nayak NR, Giudice LC. Oviduct and endometrium: cyclic changes in the primate oviduct and endometrium. In The Physiology of Reproduction. 3rd edition. St. Louis: Neill JD, 2006:359-403.
    [4] Villavicencio A, Bacallao K, Avellaira C, et al. Androgen and estrogen receptors and co-regulators levels in endometria from patients with poycystic ovarian syndrome with and without endometrial hyperplasia.Gynecol. Oncol. 2006,103(1):307-14.
    
    [5] Quezada S, Avellaira C, Johnson MC, et al. Evaluation of steroid receptors, coregulators and molecules associated with uterine receptivity in secretory endometria from untreated women with polycystic vary syndrome. Fertil Steril. 2006,85(4):1017-26.
    [6] Manuel A Maliqueo, Susana Quezada, Marisa Clementi, et al. Potential action of androstenedione on the proliferation and apoptosis of stromal endometrial cells. Reprod Biol Endocrinol. 2004,2(1): 81-91.
    [7] Linda C. Giudice. Endometrium in PCOS: Implantation and predisposition to endocrine CA. Clinical Endocrinology and Metabolism.2006, 20(2):235-244 .
    [8] Slayden OD, Keator CS. Role of progesterone in nonhuman primate implantation. Semin Reprod Med.2007,25(6):418-30.
    [9] Susana Quezada,Carla Avellaira,Margarita Vega et al. Evaluation of steroid receptors, coregulators, and molecules associated with uterine receptivity in secretory endometria from untreated women with polycystic ovary syndrome. Fertil Steril.2006,85(4): 1017-26.
    [10] Pavelic J, Matijevic T, Knezevic J.Biological & physiological aspects of action of insulin-like growth factor peptide family. Indian J Med Res.2007, 125(4):511-22.
    [11] Schernhammer ES, Holly JM, Hunter DJ, et al. Insulin-like growth factor-I, its binding proteins (IGFBP-1 and IGFBP-3), and growth hormone and breast cancer risk in The Nurses Health Study II. Endocr Relat Cancer. 2006,13(2): 583-92.
    [12] Zhang S,Li X,Burghardt R, et al. Role of estrogen receptor(ER)alpha in insulin-like growth factor(IGF)-I-induced responses in MCF-7 breast cancer cells. Mol Endocrinol.2005, 35 (3): 433-447.
    [13] Kacalska O, Krzyczkowska-Sendrakowska M, Milewicz T,et al. Molecular action of insulin-sensitizing agents. Endokrynol Pol. 2005, 56(3):308-13.
    [14] Cust AE, Allen NE, Rinaldi S,et al. Serum levels of C-peptide, IGFBP-1 and IGFBP-2 and endometrial cancer risk; results from the European prospective investigation into cancer and nutrition. Int J Cancer.2007, 120(12):2656-64.
    [15] LaZovic G, Radivojevic U, Milicevic S,et al. Influence of adiposity on leptin, LH and androgen levels in lean, overweight and obese PCOS patients. Int J Fertil Womens Med.2007, 52(2):82-8.
    [16] Gonzalez PR, Pueda BR, Ramos MP, et al. Leptine-induced increase in leukemia inhibitory factor and its receptor by human endometrium is partially mediated by interleukin 1 receptor signaling. Endocrinology. 2004,145(8):3850-3857.
    [17] Ramos MP, Rueda BR, Leavis PC, et al. Leptin serves as an upstream activator of an obligatory signaling cascade in the embryo-implantation process]. Endocrinology.2005,146(2):694-701.
    [18] Sharma D, Saxena NK, Vertino PM. Leptin promotes the Proliferative response and invasiveness in human endometrial cancer cells by activating multiple signal-transduction pathways. Endocr Relat Cancer.2006, 13(2):629-40.
    [19] Villavicencio A, Bacallao K, Gabler F,et al. Deregulation of tissue homeostasis in endometria from patients with polycystic ovarian syndrome with and without endometrial hyperplasia. Gynecol Oncol.2007, 104(2):290-5.
    [20] Avellaira C, Villavicencio A, Bacallao K, et al. Expression of molecules associated with tissue homeostasis in secretory endometria from untreated women with polycystic ovary syndrome.Hum Reprod. 2006,21(12):3116-21.
    [21]Tuckerman EM,Okon MA,Li T et al.Do androgens have a direct effect on endometrial function? An in vitro study.Fertility and Sterility.2000,74(4):771-779.
    [22]Gregory CW,Wilson EM,Apparao KBC,et al.Steroid receptor co-activator expression throughout the menstrual cycle in normal and abnormal endometrium.Journal of Clinical Endocrinology and Metabolism.2002,87:2960-2966.
    [23]王颖,陈咏健,李美芝.促排卵治疗对多囊卵巢综合征患者子宫内膜整合素avb3表达的影响.中华妇产科杂志.2000,35(3):163-165.
    [24]Ashkenazi J,Farhi J,Orvieto R et al.Polycystic ovary syndrome patients as oocyte donors:the effect of ovarian stimulation protocol on the implantation rate of the recipient.Fertility and Sterility.1995,64(3):564-567.
    [25]Fedorcsak P,Dale PO,Storeng R et al.The impact of obesity and insulin resistance on the outcome of IVF or ICSI in women with polycystic ovarian syndrome.Human Reproduction(Oxford,England).2001,16(6):1086-1091.
    [26]Fedorcsak P,Storeng R,Dale PO,et al.Obesity is a risk factor for early pregnancy loss after IVF or ICSI.Acta obstetricia et Gynecologica Scandinavica.2000,79(1):43-48.
    [27]Peter G.McGovern,M.D.Utility of screening for other causes of infertility in women with "known" polycystic ovary syndrome.Fertility and Sterility.2007,87(2):13-27.

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