Endocrine Section, First Department of Medicine, University of Athens Medical School, Mikras Asias 75, Goudi, 115-27, Athens, Greece.
J Bone Miner Metab. 2011 Mar;29(2):201-6. doi: 10.1007/s00774-010-0211-2. Epub 2010 Aug 7.
Intriguing studies suggest that osteocalcin (OC) and its carboxylated (Gla)/uncarboxylated form are involved in the regulation of insulin secretion and action. Additionally, advanced glycated end products (AGEs) directly regulate the secretion of these osteoblast-derived molecules. In polycystic ovarian syndrome (PCOS), among the pathophysiological aberrations, deregulation of insulin secretion and action as well as elevated AGEs levels have been demonstrated. In this study, we evaluated the serum levels of osteocalcin and Gla osteocalcin and their possible associations with metabolic, hormonal, and ultrasonographic components of PSOS: 97 women were studied, 50 PCOS patients and 47 controls, matched for age and body mass index (BMI). In each subject, the levels of bone metabolism markers have been evaluated, and metabolic and hormonal profiles as well as ovarian ultrasound were carried out. Osteocalcin (4.30 ± 1.74 vs. 6.20 ± 1.78 ng/ml, P < 0.0005) values were significantly lower, whereas Gla osteocalcin (37.93 ± 6.87 vs. 9.64 ± 8.21 ng/ml, P < 0.0005) and receptor activator for nuclear factor-κB ligand (0.54 ± 0.26 vs. 0.16 ± 0.15 pmol/l, P < 0.0005) values were significantly higher in PCOS subjects compared to the control group, independently of obesity. A significant association was disclosed between osteocalcin and Gla osteocalcin with androgens, insulin resistance, AGEs, and ovarian morphology. Receiver operating curve analysis revealed that Gla osteocalcin [AUC, 0.975 (95% CI, 0.93-1.00)] as well as AGEs are significant prognostic factors of PCOS [AUC, 0.986 (95% CI, 0.97-1.00)]. Lower osteocalcin and elevated serum levels of its carboxylated form are displayed in PCOS subjects and are associated with several PCOS components. These findings suggest a potential interaction between bone-derived markers and the metabolic/hormonal abnormalities observed in PCOS. However, the pathophysiological mechanisms and moreover the possible clinical implications require further investigation.
有趣的研究表明，骨钙素（OC）及其羧化（Gla）/未羧化形式参与胰岛素分泌和作用的调节。此外，晚期糖基化终产物（AGEs）直接调节这些成骨细胞衍生分子的分泌。在多囊卵巢综合征（PCOS）中，已经证明存在胰岛素分泌和作用的调节异常以及 AGE 水平升高等病理生理异常。在这项研究中，我们评估了血清骨钙素和 Gla 骨钙素的水平及其与 PCOS 的代谢、激素和超声成分的可能关联：研究了 97 名女性，其中 50 名 PCOS 患者和 47 名对照组，年龄和体重指数（BMI）相匹配。在每个受试者中，都评估了骨代谢标志物的水平，并进行了代谢和激素谱以及卵巢超声检查。骨钙素（4.30±1.74 vs. 6.20±1.78ng/ml，P＜0.0005）值明显降低，而 Gla 骨钙素（37.93±6.87 vs. 9.64±8.21ng/ml，P＜0.0005）和核因子-κB 配体受体激活剂（0.54±0.26 vs. 0.16±0.15pmol/l，P＜0.0005）值在 PCOS 患者中明显高于对照组，而与肥胖无关。骨钙素和 Gla 骨钙素与雄激素、胰岛素抵抗、AGEs 和卵巢形态之间存在显著相关性。接收者操作特征曲线分析显示，Gla 骨钙素[AUC，0.975（95%CI，0.93-1.00）]以及 AGEs 是 PCOS 的重要预后因素[AUC，0.986（95%CI，0.97-1.00）]。PCOS 患者中存在较低的骨钙素和升高的羧化形式血清水平，并与 PCOS 的多个成分相关。这些发现表明，骨源性标志物与 PCOS 中观察到的代谢/激素异常之间可能存在相互作用。然而，病理生理机制，更不用说可能的临床意义，还需要进一步研究。
