Chiofalo Benito, Laganà Antonio Simone, Palmara Vittorio, Granese Roberta, Corrado Giacomo, Mancini Emanuela, Vitale Salvatore Giovanni, Ban Frangež Helena, Vrtačnik-Bokal Eda, Triolo Onofrio
Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy; Department of Surgical Oncology, Gynecologic Oncology Unit, "Regina Elena" National Cancer Institute, Rome, Italy.
Unit of Gynecology and Obstetrics, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
Med Hypotheses. 2017 Aug;105:1-3. doi: 10.1016/j.mehy.2017.06.013. Epub 2017 Jun 23.
Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. In several cases, PCOS women show infertility or subfertility and other metabolic alteration, such as insulin resistance (InsR), dyslipidaemia, hyperinsulinemia and obesity. Despite the aetiology of the syndrome is still far from be elucidated, it could be considered the result of concurrent endocrine modifications, lifestyle factors and genetic background. In particular, accumulating evidence suggests that InsR and compensatory hyperinsulinemia play a pivotal pathogenic role in the hyperandrogenism of many PCOS phenotypes, which in turn have a clear detrimental effect on chronic anovulation. Different forms of fasting, such as intermittent fasting (IF, including alternate day fasting, or twice weekly fasting, for example) and periodic fasting (PF, lasting several days or longer every 2 or more weeks) are currently being tested in several in vitro and in vivo studies. Changes in the circulating levels of Insulin Growth Factor-1 (IGF-1), Insulin-like Growth Factor-Binding Protein 1 (IGFBP1), glucose and insulin are typical effects of fasting which may play a key role on aging and metabolic homeostasis. Considering the paramount importance of InsR and compensatory hyperinsulinemia, different fasting regimens can reduce IGF-1, IGFBP1, glucose and insulin levels and consequently have beneficial effects on ovarian function, androgen excess and infertility in PCOS women.
多囊卵巢综合征（PCOS）是育龄女性中常见的内分泌系统疾病。在一些病例中，患有PCOS的女性表现出不孕或生育能力低下以及其他代谢改变，如胰岛素抵抗（InsR）、血脂异常、高胰岛素血症和肥胖。尽管该综合征的病因仍远未阐明，但它可被认为是内分泌改变、生活方式因素和遗传背景共同作用的结果。特别是，越来越多的证据表明，InsR和代偿性高胰岛素血症在许多PCOS表型的高雄激素血症中起关键致病作用，而高雄激素血症又对慢性无排卵有明显的有害影响。目前，几种不同形式的禁食，如间歇性禁食（IF，包括隔日禁食或每周禁食两次等）和周期性禁食（PF，每2周或更长时间持续数天或更长时间）正在多项体外和体内研究中进行测试。胰岛素生长因子-1（IGF-1）、胰岛素样生长因子结合蛋白1（IGFBP1）、葡萄糖和胰岛素循环水平的变化是禁食的典型效应，可能对衰老和代谢稳态起关键作用。考虑到InsR和代偿性高胰岛素血症的至关重要性，不同的禁食方案可以降低IGF-1、IGFBP1、葡萄糖和胰岛素水平，从而对PCOS女性的卵巢功能、雄激素过多和不孕产生有益影响。
