雌二醇对多囊卵巢综合征女性颗粒细胞对促卵泡激素反应的影响。
The effect of estradiol on granulosa cell responses to FSH in women with polycystic ovary syndrome.
作者信息
Homer Michael V, Rosencrantz Marcus A, Shayya Rana F, Chang R Jeffrey
机构信息
Reproductive Medicine, University of California, 200 West Arbor Drive MC: 8710, San Diego, CA, 92103, USA.
Reproductive Endocrinology and Infertility, Southern California Permanente Medical Group, 6650 Alton Parkway, Irvine, CA, 92618, USA.
出版信息
Reprod Biol Endocrinol. 2017 Feb 10;15(1):13. doi: 10.1186/s12958-017-0230-0.
BACKGROUND
The influence of estradiol (E) on granulosa cell (GC) function has not been tested clinically in women with polycystic ovary syndrome (PCOS). The objective of this study is to determine if E influences GC responses to FSH in women with PCOS.
METHODS
This is a two phase, single cohort study conducted over a 2-year period at a single academic center. Nine women with PCOS according to NIH criteria. In Phase 1, FSH stimulation of GC responses as measured by E and Inhibin B (Inh B) were assessed before and at 5 and 6 weeks after GnRH agonist administration. In Phase 2, the same protocol was employed with the addition of an aromatase inhibitor (letrozole, LET) administered daily beginning at week 4 for 2 weeks.
RESULTS
In Phase 1, recovery of FSH, E and Inh B from ovarian suppression occurred at 5 and 6 weeks after GnRH agonist injection and preceded resumption of LH and androgen secretion. In Phase 2, hormone recovery after GnRH agonist was characterized by elevated FSH and suppressed E levels whereas recovery of LH and androgen levels were unchanged. In Phase 1, FSH stimulated E and Inh B responses were unaltered during recovery from ovarian suppression. In Phase 2, E and Inh B fold changes after FSH were significantly reduced at weeks 5 (p < 0.04) and 6 (p < 0.01), respectively.
CONCLUSION
In anovulatory women with PCOS, chronic, unopposed E secretion may contribute, at least in part, to enhanced ovarian responsiveness to FSH.
TRIAL REGISTRATION
NCT02389088.
背景
在多囊卵巢综合征（PCOS）女性中，雌二醇（E）对颗粒细胞（GC）功能的影响尚未进行临床测试。本研究的目的是确定E是否影响PCOS女性GC对促卵泡激素（FSH）的反应。
方法
这是一项在单一学术中心进行的为期2年的两阶段单队列研究。根据美国国立卫生研究院（NIH）标准，选取9名PCOS女性。在第1阶段，在给予促性腺激素释放激素（GnRH）激动剂之前以及给药后5周和6周，评估FSH刺激下以E和抑制素B（Inh B）衡量的GC反应。在第2阶段，采用相同方案，从第4周开始每日添加一种芳香化酶抑制剂（来曲唑，LET），持续2周。
结果
在第1阶段，GnRH激动剂注射后5周和6周，FSH、E和Inh B从卵巢抑制状态恢复，且早于促黄体生成素（LH）和雄激素分泌的恢复。在第2阶段，GnRH激动剂后的激素恢复表现为FSH升高和E水平受抑制，而LH和雄激素水平的恢复未改变。在第1阶段，从卵巢抑制状态恢复期间，FSH刺激的E和Inh B反应未改变。在第2阶段，FSH刺激后E和Inh B的倍数变化在第5周（p<0.04）和第6周（p<0.01）分别显著降低。
结论
在无排卵的PCOS女性中，长期无对抗的E分泌可能至少部分导致卵巢对FSH的反应性增强。
试验注册
NCT0********。 （此处原文编号不全，翻译时保留原文格式）
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