Unit of Endocrinology, Aretaieion University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, Athens, Vasilisis Sofia Avenue 76, 115 28 Athens, Greece.
Reproductive Endocrinology Unit, 3nd University Department of Obs & Gynae, Attikon University Hospital, Medical School of Athens, Ethnikon and Kapodistriakon University of Athens, 12462 Athens, Greece.
Nutrients. 2021 Feb 5;13(2):520. doi: 10.3390/nu13020520.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. It is a heterogeneous condition characterized by reproductive, endocrine, metabolic, and psychiatric abnormalities. More than one pathogenic mechanism is involved in its development. On the other hand, the hypothalamus plays a crucial role in many important functions of the body, including weight balance, food intake, and reproduction. A high-fat diet with a large amount of long-chain saturated fatty acids can induce inflammation in the hypothalamus. Hypothalamic neurons can sense extracellular glucose concentrations and participate, with a feedback mechanism, in the regulation of whole-body glucose homeostasis. When consumed nutrients are rich in fat and sugar, and these regulatory mechanisms can trigger inflammatory pathways resulting in hypothalamic inflammation. The latter has been correlated with metabolic diseases, obesity, and depression. In this review, we explore whether the pattern and the expansion of hypothalamic inflammation, as a result of a high-fat and -sugar diet, may contribute to the heterogeneity of the clinical, hormonal, and metabolic presentation in PCOS via pathophysiologic mechanisms affecting specific areas of the hypothalamus. These mechanisms could be potential targets for the development of effective therapies for the treatment of PCOS.
多囊卵巢综合征（PCOS）是育龄妇女中最常见的内分泌疾病。它是一种异质性疾病，其特征是生殖、内分泌、代谢和精神异常。超过一种发病机制参与其发展。另一方面，下丘脑在许多重要的身体功能中起着至关重要的作用，包括体重平衡、食物摄入和生殖。高脂肪饮食中含有大量长链饱和脂肪酸会导致下丘脑炎症。下丘脑神经元可以感知细胞外葡萄糖浓度，并通过反馈机制参与全身葡萄糖稳态的调节。当消耗的营养物质富含脂肪和糖时，这些调节机制可以触发炎症途径，导致下丘脑炎症。后者与代谢性疾病、肥胖和抑郁症有关。在这篇综述中，我们探讨了高脂肪和高糖饮食引起的下丘脑炎症模式和扩张是否可能通过影响下丘脑特定区域的病理生理机制，导致 PCOS 临床表现、激素和代谢的异质性。这些机制可能是开发治疗 PCOS 的有效疗法的潜在靶点。
