Department of Gynecology and Obstetrics, Medical School, Federal University of Mato Grosso, Mato Grosso, Brazil.
Tropical Institute of Reproductive Medicine, Cuiabá, MT, Brazil.
Horm Metab Res. 2019 Oct;51(10):639-648. doi: 10.1055/a-0975-9207. Epub 2019 Oct 2.
The aim of the study is to determine the impact of different anthropometric measurements of fat distribution on baseline sex-steroid concentrations and corticosteroidogenic enzyme activity in women with polycystic ovary syndrome compared to those with regular menstrual cycles. The current cross-sectional study included 106 normal cycling controls and 268 polycystic ovary syndrome patients. Patients with polycystic ovary syndrome, diagnosed by Rotterdam criteria, were divided in normoandrogenemic (n=91) and hyperandrogenemic (n=177). Anthropometric, biochemical, and hormone parameters were assessed and correlated with corticosteroidogenic enzyme activities in all three groups. Corticosteroidogenic enzyme activities were calculated using product-to-precursor ratios. Regarding sex-steroids individually, anthropometric parameters correlated with the concentrations of several androgens in polycystic ovary syndrome patients, most of them in patients with biochemical hyperandrogenism. The androgen precursors androstenedione, 17-hydroxyprogesterone, and dehydroepiandrosterone were less correlated with anthropometric parameters. The 17,20 lyase activity, in both Δ4 and Δ5 pathways, correlated with several anthropometric measurements in normo- and hyperandrogenemic polycystic ovary syndrome patients. The 17,20 lyase enzyme activity (Δ4 pathway) also correlated with conicity index, visceral adiposity index, and lipid accumulation product in the control group. 17-Hydroxylase activity positively correlated with waist-height ratio in both polycystic ovary syndrome groups. In contrast, 17-hydroxilase negatively correlated with the conicity index. Anthropometric markers of adiposity are associated with androgen levels and their precursors in blood. Body fat distribution correlates with the activities of some steroidogenic enzyme in both normo-and hyperandrogenemic polycystic ovary syndrome phenotypes. The molecular mechanisms involved in these associations are largely unclear and more investigations are required.
本研究旨在确定不同的脂肪分布人体测量指标对多囊卵巢综合征（PCOS）患者与正常月经周期患者基线性激素浓度和皮质激素生成酶活性的影响。本横断面研究纳入了 106 例正常月经周期对照者和 268 例 PCOS 患者。根据 Rotterdam 标准诊断的 PCOS 患者分为正常雄激素血症（n=91）和高雄激素血症（n=177）。评估所有三组患者的人体测量、生化和激素参数，并与皮质激素生成酶活性相关。使用产物与前体的比值计算皮质激素生成酶的活性。就单个性激素而言，人体测量参数与 PCOS 患者几种雄激素的浓度相关，其中大多数与生化高雄激素血症患者相关。雄激素前体雄烯二酮、17-羟孕酮和脱氢表雄酮与人体测量参数的相关性较低。Δ4 和 Δ5 途径的 17,20 裂解酶活性与正常和高雄激素血症 PCOS 患者的多个人体测量参数相关。Δ4 途径的 17,20 裂解酶活性也与对照组的圆锥度指数、内脏脂肪指数和脂质堆积产物相关。17-羟化酶活性与两组 PCOS 患者的腰臀比呈正相关。相比之下，17-羟化酶与圆锥度指数呈负相关。体脂分布标志物与血液中的雄激素水平及其前体相关。身体脂肪分布与正常和高雄激素血症 PCOS 表型中某些甾体生成酶的活性相关。这些关联涉及的分子机制尚不清楚，需要进一步研究。
