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微量元素环境的改变可能在多囊卵巢综合征的发病机制中起病因学作用。

Altered trace mineral milieu might play an aetiological role in the pathogenesis of polycystic ovary syndrome.

机构信息

Department of Infertility, Institute of Reproductive Medicine, Salt Lake City, Kolkata 700106, India.

出版信息

Biol Trace Elem Res. 2013 Apr;152(1):9-15. doi: 10.1007/s12011-012-9592-5. Epub 2013 Jan 16.

Abstract

Insulin resistance is a very common associate of polycystic ovary syndrome (PCOS). Pathophysiology in relation with the essential elements including copper, magnesium, zinc, manganese, chromium, and calcium has been reported in women with insulin resistance. This prospective study was designed to explore whether the women with PCOS do exhibit altered serum element levels in association with/without insulin resistance. One hundred and thirty-two women with PCOS and forty-six control women were studied. Women with PCOS were further divided based on the presence of insulin resistance (insulin resistant: n = 50; non-insulin resistant: n = 82). In all women, basal levels of gonadotropins, prolactin, testosterone, insulin, glucose, and the six different elements were measured. Serum levels of testosterone (p < 0.001), luteinizing hormone (p < 0.05), and fasting insulin (p < 0.004) were significantly higher in the PCOS population compared to controls as well as PCOS women without insulin resistance. Women with PCOS exhibited a significantly high calcium (p < 0.04) and lower manganese levels (p < 0.002) when compared to controls. However, the PCOS women with insulin resistance exhibited significantly lower serum levels of magnesium and chromium (p < 0.04), in addition to higher levels of zinc and copper (p < 0.04). The differences in calcium (p < 0.03) and manganese levels (p < 0.0001) became aggravated with the presence of insulin resistance when compared to control as well as PCOS women without insulin resistance. In PCOS-associated insulin resistance, circulating serum magnesium (r = -0.31; p < 0.03) and chromium (r = -0.38; p < 0.006) status significantly correlated with fasting insulin levels. We conclude that imbalanced element status may be a key foundation for insulin resistance in PCOS. The findings in this study should be investigated with further trials in order to obtain new insights into PCOS.

摘要

胰岛素抵抗是多囊卵巢综合征(PCOS)非常常见的并发症。有研究报道,胰岛素抵抗患者的铜、镁、锌、锰、铬和钙等必需元素的病理生理学发生了变化。本前瞻性研究旨在探讨 PCOS 患者是否存在与胰岛素抵抗相关或不相关的血清元素水平改变。研究纳入了 132 名 PCOS 患者和 46 名对照女性。根据是否存在胰岛素抵抗(胰岛素抵抗组:n = 50;非胰岛素抵抗组:n = 82)将 PCOS 患者进一步分组。所有女性均测量基础促性腺激素、催乳素、睾酮、胰岛素、血糖和六种不同元素水平。与对照组及非胰岛素抵抗的 PCOS 患者相比,PCOS 患者的血清睾酮(p < 0.001)、黄体生成素(p < 0.05)和空腹胰岛素(p < 0.004)水平显著更高。与对照组相比,PCOS 患者的钙(p < 0.04)和锰水平(p < 0.002)显著更高。然而,与对照组及非胰岛素抵抗的 PCOS 患者相比,胰岛素抵抗的 PCOS 患者的血清镁和铬水平显著更低(p < 0.04),锌和铜水平显著更高(p < 0.04)。与对照组及非胰岛素抵抗的 PCOS 患者相比,存在胰岛素抵抗时,钙(p < 0.03)和锰水平(p < 0.0001)的差异更为明显。在 PCOS 相关的胰岛素抵抗中,循环血清镁(r = -0.31;p < 0.03)和铬(r = -0.38;p < 0.006)水平与空腹胰岛素水平显著相关。我们得出结论,元素平衡状态的失衡可能是 PCOS 胰岛素抵抗的关键基础。本研究的结果应通过进一步的试验进行调查,以便为 PCOS 获得新的见解。

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