Department of Endocrinology, Hospital Universitario Ramón y Cajal and Universidad de Alcalá, Carretera de Colmenar Viejo Km 9.1, E-28034 Madrid, Spain.
J Clin Endocrinol Metab. 2011 Mar;96(3):846-52. doi: 10.1210/jc.2010-2211. Epub 2011 Jan 5.
Hepcidin inhibits the intestinal absorption of iron and its deficiency causes juvenile hemochromatosis.
The objective of the investigation was to study the involvement of hepcidin in the iron overload of patients with polycystic ovary syndrome (PCOS).
This was a case-control study followed by a randomized clinical trial.
The study was conducted at an academic hospital.
Thirty-four patients with PCOS and 30 women without hyperandrogenism, matched for age and body mass index, participated in the study.
Patients with PCOS were randomly allocated to treatment with either an antiandrogenic oral contraceptive or metformin for 24 wk.
Serum hepcidin levels and ferritin to hepcidin molar ratios were measured.
Patients with PCOS showed decreased circulating hepcidin levels and increased ferritin to hepcidin molar ratios compared with controls. Patients with PCOS presenting with chronic oligoamenorrhea (an iron sparing mechanism) showed a paradoxical decrease in serum hepcidin levels and an increase in ferritin to hepcidin molar ratios compared with the patients who had regular anovulatory menstrual cycles and with the controls. The major predictor of circulating hepcidin concentrations was the presence of PCOS, whereas the main determinants of the ferritin to hepcidin molar ratio were the insulin sensitivity index and menstrual dysfunction. Serum hepcidin levels did not change during treatment with either metformin or the antiandrogenic oral contraceptive pill, yet patients treated with the oral contraceptive pill normalized the ferritin to hepcidin molar ratio.
Patients with PCOS had reduced serum hepcidin concentrations that might contribute to their iron overload by favoring the intestinal absorption of iron. The imbalance between increased iron stores and reduced hepcidin levels was related to the insulin resistance and androgen excess characteristic of this syndrome.
铁调素抑制肠道铁吸收，其缺乏导致青少年血色病。
本研究旨在探讨铁调素在多囊卵巢综合征（PCOS）患者铁过载中的作用。
本研究为病例对照研究，随后进行了一项随机临床试验。
本研究在一所学术医院进行。
34 例 PCOS 患者和 30 例无高雄激素血症、年龄和体重指数匹配的女性参与了研究。
PCOS 患者随机分为接受抗雄激素口服避孕药或二甲双胍治疗 24 周。
检测血清铁调素水平和铁蛋白与铁调素摩尔比值。
与对照组相比，PCOS 患者循环铁调素水平降低，铁蛋白与铁调素摩尔比值升高。表现为慢性稀发排卵（一种铁储存机制）的 PCOS 患者与无排卵性月经周期的患者和对照组相比，血清铁调素水平呈反常性降低，铁蛋白与铁调素摩尔比值升高。循环铁调素浓度的主要预测因素是 PCOS 的存在，而铁蛋白与铁调素摩尔比值的主要决定因素是胰岛素敏感性指数和月经功能障碍。无论接受二甲双胍还是抗雄激素口服避孕药治疗，血清铁调素水平均无变化，但口服避孕药治疗可使铁蛋白与铁调素摩尔比值正常化。
PCOS 患者血清铁调素浓度降低，可能通过促进肠道铁吸收导致其铁过载。铁储存增加和铁调素水平降低之间的失衡与该综合征的胰岛素抵抗和雄激素过多有关。
