MD, PhD, Division of Human Reproduction, Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 110 Ninth Floor, 30130-100 Belo Horizonte, Brazil.
J Clin Endocrinol Metab. 2013 Dec;98(12):4882-9. doi: 10.1210/jc.2013-2141. Epub 2013 Sep 20.
It is believed that a dysfunction in adipose tissue plays an important role in the pathogenesis of polycystic ovary syndrome (PCOS). Natriuretic peptides are hormones that regulate cardiovascular and body fluid homeostasis and adipose tissue metabolism. Natriuretic peptide levels are reduced in individuals with obesity and diabetes.
This study aimed to investigate whether natriuretic peptide levels are altered in women with PCOS and whether they correlate with adiponectin levels or insulin sensitivity markers.
This was a cross-sectional study at a referral center in a teaching hospital.
We evaluated 40 patients diagnosed with PCOS according to the Rotterdam criteria and 36 control women matched for age and body mass index.
We measured serum adiponectin, plasma atrial natriuretic peptide (ANP), and plasma brain natriuretic peptide using enzyme immunoassays in both groups. We evaluated metabolic markers, such as fasting glucose, insulin, total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides. In addition, we calculated the homeostasis model assessment for insulin resistance index (HOMA-IR) and the lipid accumulation product (LAP) index and tested the linear correlations between these metabolic indices and the plasma ANP and serum adiponectin concentrations.
ANP and adiponectin were reduced in the PCOS group compared with the control group (P = 0.010 and P = 0.014, respectively). The brain natriuretic peptide concentration did not differ between the two groups (P = 0.883). There was no correlation between ANP and any of the metabolic markers. In the control group, the serum adiponectin level was inversely correlated with BMI (P = 0.011), waist circumference (P = 0.021), insulin (P = 0.013), fasting glucose (P = 0.010), homeostasis model assessment for insulin resistance index (P = 0.007), and lipid accumulation product (P = 0.022). Remarkably, none of these correlations were observed in the women with PCOS.
Women with PCOS had lower ANP and adiponectin compared with controls matched for age and BMI. Thus, the mechanisms that affect ANP and adiponectin production and clearance may be altered in PCOS, regardless of adiposity. These hormones may be involved in the metabolic features of PCOS.
人们认为脂肪组织功能障碍在多囊卵巢综合征（PCOS）的发病机制中起着重要作用。利钠肽是调节心血管和体液稳态以及脂肪组织代谢的激素。肥胖和糖尿病患者的利钠肽水平降低。
本研究旨在探讨 PCOS 患者的利钠肽水平是否发生改变，以及它们是否与脂联素水平或胰岛素敏感性标志物相关。
这是一家教学医院转诊中心的横断面研究。
我们评估了 40 名根据鹿特丹标准诊断为 PCOS 的患者和 36 名年龄和体重指数匹配的对照组女性。
我们使用酶免疫分析法测量了两组血清脂联素、血浆心钠肽（ANP）和血浆脑钠肽。我们评估了代谢标志物，如空腹血糖、胰岛素、总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯。此外，我们计算了胰岛素抵抗指数（HOMA-IR）和脂质蓄积产物（LAP）指数，并测试了这些代谢指标与血浆 ANP 和血清脂联素浓度之间的线性相关性。
与对照组相比，PCOS 组的 ANP 和脂联素降低（P=0.010 和 P=0.014）。两组的脑钠肽浓度无差异（P=0.883）。ANP 与任何代谢标志物之间均无相关性。在对照组中，血清脂联素水平与 BMI（P=0.011）、腰围（P=0.021）、胰岛素（P=0.013）、空腹血糖（P=0.010）、HOMA-IR（P=0.007）和脂质蓄积产物（P=0.022）呈负相关。值得注意的是，在 PCOS 患者中没有观察到这些相关性。
与年龄和 BMI 匹配的对照组相比，PCOS 患者的 ANP 和脂联素水平较低。因此，无论肥胖程度如何，影响 ANP 和脂联素产生和清除的机制可能在 PCOS 中发生改变。这些激素可能参与 PCOS 的代谢特征。
