Follistatin and activin A serum concentrations in obese and non-obese patients with polycystic ovary syndrome
Follistatin and activin A serum concentrations in obese and non-obese patients with polycystic ovary syndrome
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DOI：
10.1093/humrep/16.12.2552
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发表时间：
2001-12-01
影响因子：
6.1
通讯作者：
Homburg, R
中科院分区：
文献类型：
--
作者：
Eldar-Geva, T;Spitz, IM;Homburg, R
背景：激活素促进卵巢卵泡发育，抑制雄激素产生，增加FSH和胰岛素分泌。卵泡抑素是一种激活素结合蛋白，可中和激活素的生物活性。因此，激活素/卵泡抑素比值的降低可能会促进多囊卵巢综合征（PCOS）的特征。我们调查了PCOS妇女是否表现出卵泡抑素和/或激活素血清浓度紊乱。方法：研究组包括24名肥胖和20名非肥胖（体重指数分别为v和< 27 kg/m2）的克罗米芬治疗失败的PCOS患者。对照组包括16例肥胖和46例正常排卵周期的非肥胖患者。在孕酮诱导或自发周期的第3-5天从患者中采集血样，并测定LH、FSH、睾酮、17-羟孕酮、雄烯二酮、卵泡抑素、激活素A、空腹血糖和胰岛素。研究结果：肥胖和非肥胖PCOS患者的卵泡抑素浓度相当（平均值± SE;分别为1171 ± 103和1045 ± 159 pg/ml），显著高于各自的对照组（分别为628 ± 61和592 ± 49 pg/ml，P < 0.0001和P < 0.02）。四组之间的激活素A浓度相当（肥胖和非肥胖PCOS组和对照组分别为590 +/- 35、513 +/- 74、661 +/- 87和595 +/- 43 pg/ml）。逐步回归分析卵泡抑素或激活素A水平与所有其他变量之间的关系表明，卵泡抑素与PCOS（P < 0.0001）、年龄（P < 0.02）、雄烯二酮（P < 0.03）和体重（P < 0.05）有显著和独立的正相关。激活素A与PCOS（P < 0.003）、FSH（P < 0.03）呈负相关，与体重（P < 0.009）、雄烯二酮（P < 0.02）呈正相关。结论：PCOS患者血清卵泡抑素升高，与肥胖无关。PCOS是与高卵泡抑素和低激活素A血清浓度相关的最重要变量。高卵泡抑素/激活素比例可能有助于PCOS的病理生理。
BACKGROUND: Activin promotes ovarian follicular development, inhibits androgen production and increases FSH and insulin secretion. Follistatin, an activin-binding protein, neutralizes activin bioactivity. Therefore, a decrease in the ratio of activin/follistatin might encourage characteristic features of polycystic ovary syndrome (PCOS). We investigated whether women with PCOS showed disordered follistatin and/or activin serum concentrations. METHODS: The study group included 24 obese and 20 non-obese (body mass index box with v and < 27 kg/m(2) respectively) clomiphene-failure PCOS patients. The control group included 16 obese and 46 non-obese patients with normal ovulatory cycles. Blood samples were obtained from the patients on day 3-5 of a progesterone-induced or spontaneous cycle and were assayed for LH, FSH, testosterone, 17-hydroxy-progesterone, androstenedione, follistatin, activin A, fasting glucose and insulin. RESULTS: Follistatin concentrations were comparable between obese and non-obese PCOS patients (mean +/- SE; 1171 +/- 103 and 1045 +/- 159 pg/ml respectively) and significantly higher than their respective controls (628 +/- 61 and 592 +/- 49 pg/ml, P < 0.0001 and P < 0.02 respectively). Activin A concentrations were comparable between the four groups (590 +/- 35, 513 +/- 74, 661 +/- 87 and 595 +/- 43 pg/ml in obese and non-obese PCOS and controls respectively). Stepwise regression analyses for relationships between follistatin or activin A levels and all other variables indicated that follistatin was significantly and independently positively affected by PCOS (P < 0.0001), age (P < 0.02), androstenedione (P < 0.03) and weight (P < 0.05). Activin A was significantly and independently negatively affected by PCOS (P < 0.003) and FSH (P < 0.03), and positively affected by weight (P < 0.009) and androstenedione (P < 0.02). CONCLUSIONS: Serum follistatin is increased in PCOS patients, regardless of obesity. PCOS is the most significant variable that relates to high follistatin and low activin A serum concentration. A high follistatin/activin ratio could well contribute to the pathophysiology of PCOS.