Women's Public Health Research, Monash Applied Research Stream, School of Public Health and Preventive Medicine, Monash University; Diabetes and Vascular Medicine Unit, Southern Health.
Metabolism. 2013 Oct;62(10):1394-400. doi: 10.1016/j.metabol.2013.05.003. Epub 2013 Jun 12.
Polycystic ovary syndrome (PCOS) is common and has reproductive and metabolic manifestations. Activin A and follistatin levels remain controversial and activin B levels are unstudied in PCOS. The aim of this study was to evaluate activin A, activin B and follistatin levels and to examine their associations with metabolic status in overweight and obese women with and without PCOS.
Cross-sectional study assessing overweight and obese, premenopausal women with PCOS (n=51, n=26 National Institutes of Health (NIH) and n=25 non-NIH) and without PCOS (n=25 controls). Outcomes included activin A, activin B, follistatin and activin A/follistatin ratio and the association of the activins and follistatin with metabolic variables.
Activin A, activin B and activin A/follistatin ratio were not significantly different and follistatin was elevated for PCOS versus controls (P=0.01) independent of age or BMI. Follistatin levels were significantly different across the PCOS phenotypes (p=0.05), however this was a non-significant trend (after correction for age and BMI) for women with NIH PCOS or non-NIH PCOS to have elevated levels in comparison to controls. Activin A was most strongly predicted by low density lipoprotein/high density lipoprotein (r(2)=0.192, p<0.001), follistatin by triglycerides and highly sensitive C-reactive protein (r(2)=0.340, p<0.001) and the activin A/follistatin ratio by insulin area under the curve and mean arterial pressure (r(2)=0.289, p<0.001).
Follistatin is elevated and activins A and B are not different between PCOS and controls. Follistatin and activin A are related to metabolic parameters in women with and without PCOS. Follistatin may potentially act as a marker of or be involved in the pathophysiology of both reproductive and metabolic features of PCOS.
多囊卵巢综合征（PCOS）较为常见，具有生殖和代谢表现。激活素 A 和卵泡抑素水平仍存在争议，而激活素 B 在 PCOS 中的水平尚未研究。本研究旨在评估超重和肥胖的绝经前妇女中激活素 A、激活素 B 和卵泡抑素水平，并研究它们与 PCOS 患者和非 PCOS 患者代谢状态的相关性。
本研究为横断面研究，纳入了 51 名患有 PCOS（26 名符合美国国立卫生研究院（NIH）标准，25 名不符合 NIH 标准）和 25 名非 PCOS 对照的超重和肥胖的绝经前妇女。结局包括激活素 A、激活素 B、卵泡抑素和激活素 A/卵泡抑素比值，以及激活素和卵泡抑素与代谢变量的相关性。
激活素 A、激活素 B 和激活素 A/卵泡抑素比值在 PCOS 患者和对照组之间无显著差异，而卵泡抑素水平在 PCOS 患者中显著升高（P=0.01），与年龄或 BMI 无关。卵泡抑素水平在不同的 PCOS 表型中存在显著差异（p=0.05），但在 NIH PCOS 或非 NIH PCOS 女性中，与对照组相比，卵泡抑素水平升高呈非显著趋势（经年龄和 BMI 校正后）。激活素 A 主要由低密度脂蛋白/高密度脂蛋白（r(2)=0.192，p<0.001）预测，卵泡抑素由甘油三酯和高敏 C 反应蛋白（r(2)=0.340，p<0.001）预测，激活素 A/卵泡抑素比值由胰岛素曲线下面积和平均动脉压（r(2)=0.289，p<0.001）预测。
卵泡抑素在 PCOS 患者和对照组之间升高，而激活素 A 和 B 无差异。卵泡抑素和激活素 A 与 PCOS 患者和非 PCOS 患者的代谢参数相关。卵泡抑素可能作为生殖和代谢特征的 PCOS 病理生理学的标志物或参与其中。
