高浓度雄激素诱导KNDy神经内分泌紊乱在多囊卵巢综合征发病机制中的研究进展  

Research Progress of High-Concentration Androgen-Induecd KNDy Neuroendocrine Disorder in the Pathogenesis of PCOS

作　　者：王莹莹 郑洲 张秀明(审校) WANG Ying-ying;ZHENG Zhou;ZHANG Xiu-ming(The Third Affiliated Hospital of Shenzhen University,Shenzhen 518001,Guangdong Province,China)

机构地区：[1]深圳大学第三附属医院,518001

出　　处：《国际妇产科学杂志》2022年第5期497-501,共5页Journal of International Obstetrics and Gynecology

基　　金：深圳市医学重点学科(SZXK054);深圳市医疗卫生三名工程(SZSM201601062)。

摘　　要：多囊卵巢综合征(polycystic ovary syndrome,PCOS)是全世界女性最常见的生殖障碍性疾病之一,其症状主要表现为排卵、内分泌和代谢异常。尽管PCOS发病机制尚未明确,但是目前越来越多的研究证明高浓度雄激素诱导的神经内分泌紊乱在PCOS的发病中发挥作用,而下丘脑区域的KNDy神经元对女性的生殖功能有着重要的调控作用。近年研究发现,高浓度雄激素可能改变下丘脑区域KNDy神经元网络对促性腺激素释放激素的调节,从而干扰下丘脑-垂体-卵巢/肾上腺/脂肪细胞轴,使下游靶器官生成更多的雄激素即雄激素的恶性循环,加重PCOS的症状。因此,或许可通过在关键发育窗口期降低雄激素对神经内分泌的影响、恢复类固醇反馈的敏感性以及调整促性腺激素释放激素的分泌,进而使黄体生成素/卵泡刺激素(luteinizing hormone/follicle-stimulating hormone,LH/FSH)脉冲正常化来治疗PCOS。Polycystic ovary syndrome(PCOS)is one of the most common reproductive disorders in women worldwide,and its symptoms are mainly manifested as ovulation,endocrine and metabolic abnormalities.Although the pathogenesis of PCOS is not yet clear,more and more studies have demonstrated that high-concentration androgen-induced neuroendocrine disorders play a role in the pathogenesis of PCOS.The KNDy neurons in the hypothalamus play an important role in regulating female reproductive function.Recent studies have found that excessive concentrations of androgens may alter the regulation of GnRH by the KNDy neuronal network in the hypothalamus region,interfering with the hypothalamic-pituitary-ovarian/adrenal/adipocyte axis,which may increase the production of downstream target organs.The vicious cycle of excess androgens,aggravates the symptoms of PCOS.Therefore,it may be possible to treat PCOS patients by reducing androgen effects on neuroendocrine,restoring sensitivity to steroid feedback,and normalizing LH/FSH pulses by modulating GnRH secretion during critical developmental windows.

关 键 词：多囊卵巢综合征 雄激素类 神经分泌系统 神经分泌 神经内分泌紊乱 KNDy神经元 

分 类 号：R711.75[医药卫生—妇产科学]