多囊卵巢综合征的发育学起源

Developmental Origin of Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)是常见的生殖内分泌及代谢紊乱性疾病。通过对实验诱导的产前雄激素化的恒河猴和绵羊的观察,以及人类相关的数据的支持,得出结论:尽管PCOS是一个复杂的异质的疾病,但是其临床和生物学特征可以用卵巢雄激素产生的发育学起源所解释。胎儿的和(或)青春期的雄激素过剩重排下丘脑-垂体单元对黄体生成激素(LH)的控制,增加内脏脂肪分布,诱发胰岛素抵抗和无排卵,引起成年雄激素过多症的临床表现。其他的遗传和环境因素(尤其是饮食)可以与这个潜在的进程相互作用,修饰最终的表型,引起PCOS异质的特征。综述PCOS的发育学起源。

Polycystic ovary syndrome （PCOS） is a common reproductive endocrine and metabolic disorder. On the basis of experimental observations in the prenatally androgenized sheep and rhesus monkey,and supported by data from human studies. We therefore conclude that although PCOS is a complex, heterogeneous disorder, most if not all of the clinical and bio- chemical features can be explained on the basis of a developmental disorder of ovarian androgen production. This fetal （and/or prepubertal） androgen excess ＂programmes＂ the hypothalamic-pituitary control of LH, enhances visceral fat distribution （thus predisposing to insulin resistance and anovulation） and causes the clinical manifestations of hyperandrogenism in adulthood. Other secondary genetic and environmental （particularly dietary） factors may interact with this underlying linear process to modify the final phenotype and produce the heterogeneous nature of the syndrome.