Division of Obstetrics and Gynecology; Division of Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm 171 77, 171 76, Sweden.
Nordfertil Research Lab Stockholm, Childhood Cancer Research Unit, Karolinska Institutet, University Hospital, Department of Women's and Children's Health, Karolinska Institutet, Stockholm 171 77, Sweden.
Reprod Biomed Online. 2020 Jul;41(1):128-137. doi: 10.1016/j.rbmo.2020.01.032. Epub 2020 Feb 15.
Is endometrial expression of anti-Müllerian hormone (AMH) and its receptor II (AMH-R) altered in women with polycystic ovary syndrome (PCOS) and affected by lifestyle intervention?
Endometrial immunostaining of AMH and AMH-R was evaluated in obese women with PCOS (OB-PCOS, n = 18) before and after 3 months of lifestyle intervention, as well as in BMI-matched controls (OB-C, n = 10), normal-weight women with PCOS (n = 11) and healthy normal-weight controls (n = 11).
Before lifestyle modification, serum concentrations of AMH were higher in women with PCOS compared with BMI-matched controls, but there were no differences in endometrial immunostaining of AMH or AMH-R between the groups. Following lifestyle modification, a subgroup of OB-PCOS women started to ovulate. Still, there were no differences in endometrial immunostaining of AMH between ovulatory and anovulatory women with PCOS and controls, and no variation within the menstrual cycle. However, immunostaining of stromal AMH-R increased from cycle days 6-8 to 21-23 in all three groups. Furthermore, endometrial immunostaining of AMH-R correlated positively with oestrogen receptor alpha on cycle days 21-23 in the groups of women with PCOS, as well as in the controls (r = 0.66, P = 0.007 and r = 0.85, P < 0.001, respectively).
Although PCOS is associated with increased serum concentrations of AMH, protein expression of AMH and its receptor in the endometrium was no different to controls, and moreover not affected by lifestyle modification. These results imply that circulating AMH is not affecting expression of AMH and its receptor in the endometrium.
多囊卵巢综合征(PCOS)患者的子宫内膜中抗苗勒管激素(AMH)及其受体 II(AMH-R)的表达是否发生改变,以及这种改变是否受生活方式干预的影响?
评估了 18 例肥胖的 PCOS 患者(OB-PCOS)在生活方式干预前和干预后 3 个月的子宫内膜 AMH 和 AMH-R 的免疫染色情况,以及 10 例 BMI 匹配的对照组(OB-C)、11 例正常体重的 PCOS 患者和 11 例健康的正常体重对照组的子宫内膜 AMH 和 AMH-R 的免疫染色情况。
在生活方式改变之前,PCOS 患者的血清 AMH 浓度高于 BMI 匹配的对照组,但两组之间的子宫内膜 AMH 或 AMH-R 的免疫染色没有差异。生活方式改变后,OB-PCOS 患者中的一部分开始排卵。然而,排卵和不排卵的 PCOS 患者与对照组之间的子宫内膜 AMH 免疫染色没有差异,并且在月经周期内没有变化。然而,在所有三组中,基质 AMH-R 的免疫染色从周期第 6-8 天增加到第 21-23 天。此外,在 PCOS 患者和对照组的第 21-23 天的周期中,子宫内膜 AMH-R 的免疫染色与雌激素受体 alpha 呈正相关(r = 0.66,P = 0.007 和 r = 0.85,P < 0.001)。
尽管 PCOS 与血清 AMH 浓度升高有关,但子宫内膜中 AMH 和 AMH-R 的蛋白表达与对照组没有不同,而且不受生活方式干预的影响。这些结果表明,循环 AMH 不会影响子宫内膜中 AMH 和 AMH-R 的表达。