Panidis Dimitrios, Rousso David, Koliakos George, Kourtis Anargyros, Katsikis Ilias, Farmakiotis Dimitrios, Votsi Elissavet, Diamanti-Kandarakis Evanthia
Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Fertil Steril. 2006 Jun;85(6):1778-83. doi: 10.1016/j.fertnstert.2005.11.044. Epub 2006 May 2.
This study was designed to: [1] measure, for the first time, metastin (kisspeptin) levels in women with polycystic ovary syndrome (PCOS), a condition associated with hypersecretion of LH and hyperandrogenemia; and [2] investigate the possible correlations between metastin and PCOS-related reproductive and metabolic disturbances.
Clinical study.
University hospital.
PATIENT(S): Twenty-eight obese and overweight (body mass index [BMI] >25 kg/m2) women with PCOS, 28 normal weight (BMI <25 kg/m2) women with the syndrome, and 13 obese and overweight controls (ovulatory women without clinical or biochemical hyperandrogenemia) were selected.
INTERVENTION(S): Blood samples were collected between day 3 and day 6 of a spontaneous bleeding episode in the PCOS groups and a menstrual cycle of the controls, at 9:00 AM, after an overnight fast.
MAIN OUTCOME MEASURE(S): Circulating levels of LH, FSH, PRL, T, Delta4-androstenedione (A), DHEAS, 17alpha-OH-P, sex hormone-binding globulin (SHBG), insulin, glucose, and metastin were measured.
RESULT(S): Both normal weight women with PCOS and obese controls were less insulin resistant and had significantly higher metastin levels, compared to obese and overweight women with the syndrome. Plasma kisspeptin levels were negatively correlated with BMI, free androgen index, and indices of insulin resistance.
CONCLUSION(S): These results indicate that metastin is negatively associated with free androgen levels. The PCOS-associated insulin resistance and consequent hyperinsulinemia probably contribute to this effect by [1] stimulating androgen synthesis by the polycystic ovary (PCO) and [2] suppressing SHBG production in the liver.
本研究旨在：[1]首次测量多囊卵巢综合征（PCOS）女性体内的 metastin（亲吻素）水平，该疾病与促黄体生成素（LH）分泌过多和高雄激素血症相关；[2]研究 metastin 与 PCOS 相关的生殖和代谢紊乱之间的可能相关性。
临床研究。
大学医院。
选取 28 名肥胖和超重（体重指数[BMI]>25 kg/m²）的 PCOS 女性、28 名体重正常（BMI<25 kg/m²）的该综合征女性以及 13 名肥胖和超重对照者（无临床或生化高雄激素血症的排卵女性）。
在 PCOS 组自然出血期的第 3 天至第 6 天以及对照组月经周期的同一时段，于上午 9:00 在空腹过夜后采集血样。
测量 LH、促卵泡生成素（FSH）、催乳素（PRL）、睾酮（T）、雄烯二酮（A）、硫酸脱氢表雄酮（DHEAS）、17α-羟孕酮（17α-OH-P）、性激素结合球蛋白（SHBG）、胰岛素、葡萄糖和 metastin 的循环水平。
与肥胖和超重的 PCOS 女性相比，体重正常的 PCOS 女性和肥胖对照者的胰岛素抵抗均较低，且 metastin 水平显著更高。血浆亲吻素水平与 BMI、游离雄激素指数和胰岛素抵抗指数呈负相关。
这些结果表明，metastin 与游离雄激素水平呈负相关。PCOS 相关的胰岛素抵抗及随之而来的高胰岛素血症可能通过以下方式导致这种效应：[1]刺激多囊卵巢（PCO）合成雄激素；[2]抑制肝脏中 SHBG 的产生。
