脂肪因子与多囊卵巢综合征的关系

doi:10.12280/gjszjk.20250318

摘要/Abstract

摘要：

脂肪因子的异常表达可促进多囊卵巢综合征（polycystic ovary syndrome，PCOS）发生与发展，其机制涉及Wnt/β-联蛋白（β-catenin）、磷脂酰肌醇3激酶（phosphoinositide 3-kinase，PI3K）/蛋白激酶B（protein kinase B，Akt）、c-Jun氨基末端激酶（c-Jun N-terminal kinase，JNK）/丝裂原激活的蛋白激酶（mitogen-activated protein kinase，MAPK）、Janus激酶（Janus kinase，JAK）/信号转导及转录活化因子（signal transducer and activator of transcription，STAT）、核因子κB（nuclear factor-κB，NF-κB）等多条信号通路及其下游信号分子的调控。研究表明，多种外源性脂肪因子、特异性脂肪因子拮抗剂、传统降糖药物和饮食调节等治疗方案通过纠正脂肪因子及其受体表达，缓解PCOS卵巢病理、调控胰岛素信号转导及激素合成相关基因表达、抑制氧化应激和炎症反应、改善子宫内膜容受性并促进胚胎着床与发育，从而缓解PCOS相关内分泌代谢紊乱、免疫异常及生殖功能障碍。脂肪因子是PCOS治疗的潜在靶点，但由于脂肪因子之间存在复杂的相互作用，且PCOS患者存在显著的异质性，当前研究仍以动物实验为主。在此基础上，未来可能设计临床试验，为开发基于脂肪因子调控的新型PCOS治疗方案提供支持。

关键词: 多囊卵巢综合征, 脂肪因子类, 分子靶向治疗, 分子机制, 外源性脂肪因子, 脂肪因子拮抗剂

Abstract:

The aberrant expression of adipokines may contribute to the onset and progression of polycystic ovary syndrome (PCOS), with its mechanism involving the regulation of multiple signaling pathways including Wnt/β-catenin, phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), c-Jun N-terminal kinase (JNK) /mitogen-activated protein kinase (MAPK), Janus kinase (JAK)/signal transducer and activator of transcription (STAT), nuclear factor-κB (NF-κB) and their downstream signaling molecules. Research indicates that various therapeutic modalities, such as exogenous adipokines, specific adipokine antagonists, conventional hypoglycemic agents and dietary interventions, can ameliorate PCOS-related ovarian pathology, modulate insulin signal transduction and the expression of genes associated with hormone synthesis, suppress oxidative stress and inflammatory reactions, enhance endometrial receptivity, and facilitate embryo implantation and development by rectifying the expression of adipokines and their receptors. In turn, these interventions alleviate PCOS-related endocrine and metabolic disturbances, immune abnormalities, and reproductive dysfunctions. Adipokines may be as a potential target for the PCOS treatment. Nevertheless, owing to the intricate crosstalk between adipokines and the substantial heterogeneity among PCOS patients, current research primarily centers on animal studies. Based on these animal studies, additional clinical trials should be well designed to develope the innovative regimens of PCOS treatment based on adipokine regulation.

Key words: Polycystic ovary syndrome, Adipokines, Molecular targeted therapy, Molecular mechanisms, Exogenous adipokines, Adipokine antagonist

冷亚文, 石百超, 王宇, 吴效科. 脂肪因子与多囊卵巢综合征的关系[J]. 国际生殖健康/计划生育杂志, 2025, 44(6): 518-523.

LENG Ya-wen, SHI Bai-chao, WANG Yu, WU Xiao-ke. The Relationship between Adipokines and Polycystic Ovary Syndrome[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(6): 518-523.

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