Ma Jing, Lin Tzu Chun, Liu Wei
Division of Endocrinology and Metabolism, Department of Internal Medicine, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Endocrine. 2014 Dec;47(3):668-78. doi: 10.1007/s12020-014-0275-1. Epub 2014 May 4.
Polycystic ovary syndrome (PCOS) is an endocrine disease of women in reproductive age. It is characterized by anovulation and hyperandrogenism. Most often patients with PCOS have metabolic abnormalities such as dyslipidemia, insulin resistance, and glucose intolerance. It is not surprising that obesity is high prevalent in PCOS. Over 60 % of PCOS women are obese or overweight. Modulation of appetite and energy intake is essential to maintain energy balance and body weight. The gastrointestinal tract, where nutrients are digested and absorbed, plays a central role in energy homeostasis. The signals from the gastrointestinal tract arise from the stomach (ghrelin release), proximal small intestine (CCK release), and distal small intestine (GLP-1 and PYY) in response to food. These hormones are recognized as "appetite regulatory hormones." Weight loss is the key in the treatments of obese/overweight patients with PCOS. However, current non-pharmacologic management of body weight is hard to achieve. This review highlighted the gastrointestinal hormones, and discussed the potential strategies aimed at modifying hormones for treatment in PCOS.
多囊卵巢综合征(PCOS)是一种育龄期女性的内分泌疾病。其特征为无排卵和高雄激素血症。PCOS患者大多存在代谢异常,如血脂异常、胰岛素抵抗和葡萄糖耐量异常。肥胖在PCOS中高发也就不足为奇了。超过60%的PCOS女性肥胖或超重。调节食欲和能量摄入对于维持能量平衡和体重至关重要。胃肠道是营养物质消化和吸收的场所,在能量稳态中起核心作用。胃肠道发出的信号源于胃(释放胃饥饿素)、近端小肠(释放胆囊收缩素)和远端小肠(释放胰高血糖素样肽-1和酪酪肽)对食物的反应。这些激素被认为是“食欲调节激素”。减肥是肥胖/超重PCOS患者治疗的关键。然而,目前体重的非药物管理很难实现。本综述重点介绍了胃肠道激素,并讨论了针对PCOS通过调节激素进行治疗的潜在策略。