氨基酸代谢与多囊卵巢综合征的研究进展

doi:10.12280/gjszjk.20260004

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovary syndrome，PCOS）是一种常见的妇科内分泌疾病，以高雄激素血症、排卵障碍和卵巢多囊样改变为核心特征，常伴随胰岛素抵抗（insulin resistance，IR）、代谢综合征及2型糖尿病风险增加，严重影响育龄期女性的生殖健康和代谢功能。近年代谢组学研究揭示，氨基酸代谢紊乱与PCOS发生发展密切相关。支链氨基酸（branched-chain amino acid，BCAA）通过激活哺乳动物雷帕霉素靶蛋白（mammalian target of rapamycin，mTOR）通路干扰胰岛素信号转导；芳香族氨基酸（aromatic amino acid，AAA）代谢异常影响卵母细胞发育并加剧炎症反应；谷氨酰胺/谷氨酸（glutamine/glutamic acid，Gln/Glu）代谢失衡加重胰岛素抵抗及高雄激素血症；同型半胱氨酸（homocysteine，Hcy）则通过诱导内质网应激和炎症反应加重胰岛素抵抗。针对上述代谢异常，可通过生活方式干预，以及胰岛素增敏剂（如二甲双胍）、肌醇、N-乙酰半胱氨酸等营养补充剂，改善胰岛素抵抗、优化卵泡发育及妊娠结局。综述关键氨基酸代谢异常在PCOS中的作用机制及干预策略，以期为PCOS的精准诊疗提供新的视角。

关键词: 多囊卵巢综合征, 氨基酸类, 代谢, 胰岛素抵抗, 代谢综合征

Abstract:

Polycystic ovary syndrome (PCOS) is a common gynecological endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology as its core features. It is often accompanied by insulin resistance (IR), metabolic syndrome and an increased risk of type 2 diabetes, impairing the reproductive health and metabolic functions of women of childbearing age. In recent years, metabolomic studies have revealed that amino acid metabolic disorders are closely associated with the occurrence and progression of PCOS. Branched-chain amino acid (BCAA) interfere with insulin signaling by activating the mammalian target of rapamycin(mTOR) pathway; abnormal metabolism of aromatic amino acid (AAA) impairs oocyte development and exacerbates inflammation; an imbalance in glutamine/glutamic acid (Gln/Glu) aggravates IR and hyperandrogenism; and homocysteine (Hcy) exacerbates IR through endoplasmic reticulum stress and inflammation. Targeting these metabolic abnormalities, intervention strategies include lifestyle modifications and nutritional supplements such as insulin sensitizers (e.g., metformin), inositol and N-acetylcysteine, which can improve IR, optimize follicular development and pregnancy outcomes. This paper reviews the mechanisms underlying the role of key amino acid metabolic disorders in PCOS and the corresponding intervention strategies, aiming to provide a new perspective for the precise diagnosis and treatment of PCOS.

Key words: Polycystic ovary syndrome, Amino acids, Metabolism, Insulin resistance, Metabolic syndrome

王海韵, 魏嘉豫, 兰甜宁, 张柯欣, 张慧英, 田文艳. 氨基酸代谢与多囊卵巢综合征的研究进展[J]. 国际生殖健康/计划生育杂志, 2026, 45(2): 160-165.

WANG Hai-yun, WEI Jia-yu, LAN Tian-ning, ZHANG Ke-xin, ZHANG Hui-ying, TIAN Wen-yan. Research Progress on Amino Acid Metabolism and Polycystic Ovary Syndrome[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(2): 160-165.

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