氧化应激与多囊卵巢综合征雄激素增多症关系的研究现状

Recent advance on relationship between oxidative stress and hyperandrogenism in polycystic ovary syndrome

多囊卵巢综合征(PCOS)是一种病因未明、临床表现呈高度异质性的常见女性内分泌代谢紊乱性疾病,以稀发排卵和(或)无排卵(OA),临床和(或)生化检查存在雄激素增多症(HA)改变,超声检查结果显示卵巢多囊样(PCO)改变为特征。除了月经和生殖功能异常外,PCOS患者常伴有肥胖、胰岛素抵抗(IR)、糖脂代谢异常、氧化应激(OS)增加及亚临床慢性炎症等危险因素,可显著增加代谢综合征、2型糖尿病和远期心血管疾病的发病风险。HA是PCOS的重要特征和关键发病因素之一,在PCOS发病机制中起着重要作用。OS增加不仅是导致动脉粥样硬化与心、脑血管疾病等的重要因素,也与PCOS的发生和进展密切相关。新近研究结果表明,HA与PCOS患者的OS增加密切相关。笔者拟从OS的分子来源与机体抗氧化防御机制,PCOS患者OS水平及其与HA的关系,HA与OS的相互影响及其可能的作用机制,对PCOS患者OS增加的预防、治疗现状及未来展望等方面进行阐述。

Polycystic ovary syndrome （PCOS） is one of common female endocrine metabolic disorders, characterized by oligo-ovulation and/or anovulation （OA）, clinical and/or biochemical hyperandrogenism （HA） and polycystic ovaries （PCO）. The clinical manifestations of PCOS are highly complex and heterogeneous. Aside from menstrual and reproductive dysfunctions, PCOS is often associated with long-term health risks, such as obesity, insulin resistance （IR）, dyslipidaemia, increased oxidative stress （OS）, subclinical chronic inflammation, elevated risks of metabolic syndrome, type 2 diabetes, and future cardiovascular diseases. HA plays an important role in the pathogenesis of PCOS. Increased OS is not only an important factor leading to atherosclerosis and cardiovascular diseases, but also potentially related to the occurrence and progress of PCOS. Recent studies have shown that there was a strong association between HA and increased OS in PCOS. In this article, we focus on the sources of OS molecules and the antioxidant defense mechanisms, the OS status in PCOS and its relationship with HA, the interaction and its impossible mechanisms between HA and OS, and the current status and future prospects of OS prevention and treatment in patients with PCOS.