多囊卵巢综合征女性的5α-还原酶活性：一项系统评价与荟萃分析。

5α-reductase activity in women with polycystic ovary syndrome: a systematic review and meta-analysis.

作者信息

Wu Chuyan, Wei Ke, Jiang Zhongli

机构信息

Department of Rehabilitation Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Medical Service Section, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Reprod Biol Endocrinol. 2017 Mar 27;15(1):21. doi: 10.1186/s12958-017-0242-9.

BACKGROUND

5α-reductase activity might be important during the development of polycystic ovary syndrome (PCOS). However, the changes of 5α-reductase activity in PCOS subjects and the relationship between 5α-reductase activity and body mass index (BMI), insulin resistance (IR) remain largely unknown.

METHODS

We performed a meta-analysis to examine 5α-reductase activity in women with PCOS; exploratory subgroup analyses were also performed.

RESULTS

Five articles (with 356 cases and 236 controls) reporting 5α-reductase activity in patients with PCOS were selected for the meta-analysis. We observed significantly higher ratios of 5αTHF/THF (5α-reduced tetrahydrocortisol to 5β-reduced tetrahydrocortisol) and An/Et (androsteroneto/etiocholanolone) levels, which were used to assess 5α-reductase activity, among the patients with PCOS, [standardized mean differences (SMD) =0.43, 95%confidence intervals (95%CI) =0.25-0.61, P < 0.00001; SMD = 0.86, 95% CI = 0.29-1.44, P = 0.003]. We observed significant heterogeneity between studies for An/Et (I = 89% and P < 0.00001). According to the group analysis, women with PCOS exhibited increased 5α-reductase activity which was significantly associated with homeostasis model assessment of insulin resistance (HOMA-IR) regardless of obesity.

CONCLUSIONS

5α-reductase activity was enhanced in women with PCOS. Increased 5α-reductase activity in patients with PCOS was related to IR.

背景

5α-还原酶活性在多囊卵巢综合征（PCOS）的发生发展过程中可能具有重要作用。然而，PCOS患者中5α-还原酶活性的变化以及5α-还原酶活性与体重指数（BMI）、胰岛素抵抗（IR）之间的关系仍不清楚。

方法

我们进行了一项荟萃分析，以研究PCOS女性的5α-还原酶活性；同时也进行了探索性亚组分析。

结果

五项报告PCOS患者5α-还原酶活性的文章（共356例病例和236例对照）被纳入荟萃分析。我们观察到，用于评估5α-还原酶活性的5αTHF/THF（5α-还原四氢皮质醇与5β-还原四氢皮质醇的比值）和An/Et（雄酮/表雄酮水平）在PCOS患者中显著升高，[标准化均数差（SMD）=0.43，95%置信区间（95%CI）=0.25 - 0.61，P < 0.00001；SMD = 0.86，95%CI = 0.29 - 1.44，P = 0.003]。我们观察到各研究间An/Et存在显著异质性（I = 89%且P < 0.00001）。根据分组分析，无论是否肥胖，PCOS女性的5α-还原酶活性均升高，且与胰岛素抵抗稳态模型评估（HOMA-IR）显著相关。