Association between circulating neuregulin 4 levels and metabolic, aterogenic, and AMH profile of polycystic ovary syndrome
Association between circulating neuregulin 4 levels and metabolic, aterogenic, and AMH profile of polycystic ovary syndrome
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DOI：
10.1080/01443615.2019.1581754
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发表时间：
2019-04-27
影响因子：
1.3
通讯作者：
Cevik, Ozge
中科院分区：
文献类型：
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作者：
Eken, Meryem Kurek;Ersoy, Gulcin Sahin;Cevik, Ozge
多囊卵巢综合征(PCOS)是一种与肥胖和脂肪组织能量代谢系统紊乱相关的代谢紊乱。神经调节蛋白4(NRG4)由脂肪组织分泌，调节能量代谢。在本研究中，我们旨在评估肥胖和正常体重的PCOS患者血清NRG4水平之间的关系。这项横断面研究于2017年4月至8月在土耳其的一家三级医院进行。我们将148名妇女分为四组：40名正常体重和39名根据鹿特丹标准诊断为肥胖的PCOS妇女，以及38名正常体重和31名肥胖、年龄匹配、有规律月经周期的非高雄激素血症妇女(对照组)。评估血清NRG4、抗苗勒氏激素(AMH)、空腹血糖(FBG)、胰岛素和高敏C反应蛋白(hs-CRP)水平；血脂和激素谱；胰岛素抵抗指数[胰岛素抵抗的稳态模型评估(HOMA-IR)]；以及人体测量参数。正常体重PCOS组血清NRG4水平高于对照组。此外，肥胖PCOS组血清NRG4水平高于正常体重PCOS组和肥胖对照组(p<；.01)。血清NRG4水平与体重指数(BMI)、腰臀比、HOMA-IR、甘油三酯、hs-CRP、空腹血糖、胰岛素、AMH和脱氢表雄酮硫酸盐水平呈正相关。多元回归分析显示血清NRG4水平与BMI独立相关。肥胖似乎是影响多囊卵巢综合征患者NRG4分泌的最大因素。肥胖的管理可能是解决多囊卵巢综合征相关代谢异常和生育问题的关键因素。多囊卵巢综合征是一种在生育期具有不同临床和代谢特征的动态综合征。PCOS与各种代谢异常有关，如胰岛素抵抗(IR)、糖耐量异常、血脂异常、肥胖(特别是内脏肥胖)以及长期并发症，如2型糖尿病和心血管疾病。神经调节蛋白4(NRG4)由脂肪组织分泌，调节能量代谢。这项研究的结果补充了什么？据我们所知，这是第一次研究具有不同BMI的PCOS患者的NRG4水平。肥胖似乎是这些患者分泌NRG4的最大影响因素。控制肥胖可能是解决PCOS相关代谢异常的关键因素。
Polycystic ovary syndrome (PCOS) is a metabolic disorder associated with obesity and energy metabolic system disturbances in adipose tissue. Neuregulin 4 (NRG4), which is secreted by adipose tissue, regulates energy metabolism. In the present study, we aimed to evaluate the association between serum NRG4 levels in obese and normal weight PCOS patients. This cross-sectional study was conducted at a tertiary hospital in Turkey from April to August 2017. We included 148 women who were divided into four groups as follows: 40 normal weight and 39 obese PCOS women diagnosed according to the Rotterdam criteria as well as 38 normal weight and 31 obese, age-matched, non-hyperandrogenemic women with a regular menstrual cycle (controls). Levels of serum NRG4, anti-Mullerian hormone (AMH), fasting blood glucose (FBG), insulin, and high-sensitivity C-reactive protein (hs-CRP); lipid and hormone profiles; insulin resistance indices [homeostasis model assessment of insulin resistance (HOMA-IR)];and anthropometric parameters were evaluated. Serum NRG4 levels were elevated in the normal weight PCOS group than in the control group. Moreover, serum NRG4 levels were higher in the obese PCOS group than in the normal weight PCOS and obese control groups (p < .01). Serum NRG4 levels were positively correlated with body mass index (BMI); waist/hip ratio; HOMA-IR; and levels of triglycerides, hs-CRP, FBG, insulin, AMH, and dehydroepiandrosterone sulphate. Multiple regression analyses revealed that serum NRG4 levels were independently associated with BMI. Obesity appears to be the most influential factor for NRG4 secretion in PCOS patients. Management of obesity may be a key factor for resolving PCOS-related metabolic abnormalities and fertility problems.Impact Sstatement What is already known on this subject? PCOS is a dynamic syndrome with different clinical and metabolic features during the reproductive age. PCOS is associated with various metabolic abnormalities, such as insulin resistance (IR), glucose intolerance, dyslipidemia, and obesity (particularly visceral obesity) as well as long-term complications, such as type 2 diabetes and cardiovascular diseases. Neuregulin 4 (NRG4), which is secreted by adipose tissue, regulates energy metabolism. What do the results of this study add? To the best of our knowledge, this was the first study investigating NRG4 levels in PCOS patients with different BMIs. Obesity appears to be the most influential factor for NRG4 secretion in these patients. Managing obesity may be a key factor for resolving PCOS-related metabolic abnormalities.