Hypothalamic - pituitary, ovarian and adrenal contributions to polycystic ovary syndrome
Hypothalamic - pituitary, ovarian and adrenal contributions to polycystic ovary syndrome
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DOI：
10.1016/j.bpobgyn.2016.03.005
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发表时间：
2016-11-01
影响因子：
5.5
通讯作者：
Balen, Adam H.
中科院分区：
文献类型：
--
作者：
Baskind, N. Ellissa;Balen, Adam H.
多囊卵巢综合征（PCOS）是一种常见的异质性疾病，与生殖、内分泌和代谢功能紊乱有关。PCOS的定义和病因学假说正在不断发展，以纳入综合征的不断发展的证据，这似乎是多因素和多基因的。PCOS的病理生理学包括受外部因素（包括下丘脑-垂体轴和高胰岛素血症）强烈影响的固有卵巢功能障碍。神经内分泌异常，包括促性腺激素释放激素（GnRH）脉冲频率增加，导致促黄体生成激素（LH）分泌过多，影响卵巢雄激素合成、卵泡发生和卵母细胞发育。卵巢-垂体和下丘脑反馈紊乱加重促性腺激素异常，并且有新的证据提示Kiss 1系统功能障碍。在卵泡亚单位本身内，有卵巢内旁分泌调节剂、细胞因子和生长因子，它们似乎起作用。肾上腺源性雄激素也可能有助于PCOS的发病机制，但其作用不太明确。(C)2016由Elsevier Ltd.出版
Polycystic ovary syndrome (PCOS) is a prevalent heterogeneous disorder linked with disturbances of reproductive, endocrine and metabolic function. The definition and aetiological hypotheses of PCOS are continually developing to incorporate evolving evidence of the syndrome, which appears to be both multifactorial and polygenic. The pathophysiology of PCOS encompasses inherent ovarian dysfunction that is strongly influenced by external factors including the hypothalamic-pituitary axis and hyperinsulinaemia. Neuroendocrine abnormalities including increased gonadotrophinreleasing hormone (GnRH) pulse frequency with consequent hypersecretion of luteinising hormone (LH) affects ovarian androgen synthesis, folliculogenesis and oocyte development. Disturbed ovarian-pituitary and hypothalamic feedback accentuates the gonadotrophin abnormalities, and there is emerging evidence putatively implicating dysfunction of the Kiss 1 system. Within the follicle subunit itself, there are intra-ovarian paracrine modulators, cytokines and growth factors, which appear to play a role. Adrenally derived androgens may also contribute to the pathogenesis of PCOS, but their role is less defined. (C) 2016 Published by Elsevier Ltd.