Endometriosis and polycystic ovary syndrome are diametric disorders.
Endometriosis and polycystic ovary syndrome are diametric disorders.
复制标题
DOI：
10.1111/eva.13244
复制
发表时间：
2021-07
影响因子：
4.1
通讯作者：
Crespi BJ
中科院分区：
文献类型：
--
作者：
Dinsdale NL;Crespi BJ
进化和比较方法可以产生对人类适应和疾病的新见解。子宫内膜异位症和多囊卵巢综合征(PCOS)分别影响多达10%的妇女，并显著降低受影响者的健康、生育能力和生活质量。多囊卵巢综合征和子宫内膜异位症尚未被认为是相互关联的，尽管这两种疾病都涉及产前睾酮水平的改变和下丘脑-垂体-性腺轴(HPG)的非典型功能。在这里，我们提出并评估了一种新的假说，即子宫内膜异位症和多囊卵巢综合征是HPG轴发育和活性变化的极端和直接(相反)结果，子宫内膜异位症在很大程度上是由出生前和出生后低睾酮介导的，而多囊卵巢综合征是由高生前睾酮介导的。这一直径失调假说预测，对于由HPG轴形成的特征，包括激素谱、生殖生理、生活史特征和身体形态，多囊卵巢综合征妇女和子宫内膜异位症妇女将表现出相反的表型。为了评估这些预测，我们回顾和综合了来自发育生物学、内分泌学、生理学、生活史和流行病学的现有证据。子宫内膜异位症和多囊卵巢综合征之间的直径表型假说在这些不同的研究领域中得到了强有力的支持。此外，人类子宫内膜异位症和多囊卵巢综合征之间的对比类似于非人类动物在产前睾酮水平低和高对女性生殖特征的影响方面的差异。这些发现表明，多囊卵巢综合征和子宫内膜异位症代表了女性生活史变异和性别二态女性生殖特征表达的极端不适应。子宫内膜异位症和多囊卵巢综合征的直径失调假说为子宫内膜异位症的风险提供了新的、统一的、接近的和进化的解释，综合了关于两种最常见的女性生殖障碍的不同研究路线，并为改善妇女的生活质量和健康提供了未来的研究途径。
Evolutionary and comparative approaches can yield novel insights into human adaptation and disease. Endometriosis and polycystic ovary syndrome (PCOS) each affect up to 10% of women and significantly reduce the health, fertility, and quality of life of those affected. PCOS and endometriosis have yet to be considered as related to one another, although both conditions involve alterations to prenatal testosterone levels and atypical functioning of the hypothalamic–pituitary–gonadal (HPG) axis. Here, we propose and evaluate the novel hypothesis that endometriosis and PCOS represent extreme and diametric (opposite) outcomes of variation in HPG axis development and activity, with endometriosis mediated in notable part by low prenatal and postnatal testosterone, while PCOS is mediated by high prenatal testosterone. This diametric disorder hypothesis predicts that, for characteristics shaped by the HPG axis, including hormonal profiles, reproductive physiology, life‐history traits, and body morphology, women with PCOS and women with endometriosis will manifest opposite phenotypes. To evaluate these predictions, we review and synthesize existing evidence from developmental biology, endocrinology, physiology, life history, and epidemiology. The hypothesis of diametric phenotypes between endometriosis and PCOS is strongly supported across these diverse fields of research. Furthermore, the contrasts between endometriosis and PCOS in humans parallel differences among nonhuman animals in effects of low versus high prenatal testosterone on female reproductive traits. These findings suggest that PCOS and endometriosis represent maladaptive extremes of both female life‐history variation and expression of sexually dimorphic female reproductive traits. The diametric disorder hypothesis for endometriosis and PCOS provides novel, unifying, proximate, and evolutionary explanations for endometriosis risk, synthesizes diverse lines of research concerning the two most common female reproductive disorders, and generates future avenues of research for improving the quality of life and health of women.
登录
查看更多内容
影响因子：
3.7
作者：
Bourdon M;Raad J;Dahan Y;Marcellin L;Maignien C;Even M;Pocate-Cheriet K;Lamau MC;Santulli P;Chapron C
通讯作者：
Chapron C
影响因子：
2.9
作者：
Abdelkareem, Amr O.;Alotaibi, Fahad T.;Bedaiwy, Mohamed A.
通讯作者：
Bedaiwy, Mohamed A.
影响因子：
5
作者：
Barrett, Emily S.;Parlett, Lauren E.;Swan, Shanna H.
通讯作者：
Swan, Shanna H.
DOI：
10.1017/s2040174417001118
发表时间：
2018-06
影响因子：
1.7
作者：
Barrett ES;Hoeger KM;Sathyanarayana S;Abbott DH;Redmon JB;Nguyen RHN;Swan SH
通讯作者：
Swan SH
影响因子：
3.7
作者：
Abbott AD;Colman RJ;Tiefenthaler R;Dumesic DA;Abbott DH
通讯作者：
Abbott DH