Wang Yingying, Zeng Zhengyan, Zhao Shuhua, Tang Li, Yan Jin, Li Nianyu, Zou Liping, Fan Xiaorong, Xu Chengcheng, Huang Jin, Xia Wei, Zhu Changhong, Rao Meng
Reproductive Health Institute, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of General Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
Endocrinology. 2021 Aug 1;162(8). doi: 10.1210/endocr/bqab056.
Polycystic ovary syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is characterized by hyperandrogenism and insulin resistance (IR); however, the pathogenesis of local ovarian IR in PCOS remains largely unclear. Humanin, a mitochondria-derived peptide, has been reported to be associated with IR. Our previous study confirmed that humanin is expressed in multiple cell types in the ovary and is present in follicular fluid. However, it remains unknown whether humanin participates in the pathogenesis of local ovarian IR or whether humanin supplementation can improve IR in PCOS patients. In this study, we compared humanin concentrations in follicular fluid from PCOS patients with and without IR. We further investigated the effect of humanin analogue (HNG) supplementation on IR in a rat model of dehydroepiandrosterone-induced PCOS. Humanin concentrations in the follicular fluid were found to be significantly lower in PCOS patients with IR than in those without IR. HNG supplementation attenuated both the increases in the levels of fasting plasma glucose and fasting insulin in rats with PCOS and the decreases in phosphorylation of IRS1, PI3K, AKT, and GLUT4 proteins in the granulosa cells of these rats. Combined supplementation with HNG and insulin significantly improved glucose consumption in normal and humanin-siRNA-transfected COV434 cells. In conclusion, downregulated humanin in the ovaries may be involved in the pathogenesis of IR in PCOS, and exogenous supplementation with HNG improved local ovarian IR through modulation of the IRS1/PI3K/Akt signaling pathway in a rat model. This finding supports the potential future use of HNG as a therapeutic drug for PCOS.
多囊卵巢综合征(PCOS)是育龄女性最常见的内分泌紊乱疾病,其特征为高雄激素血症和胰岛素抵抗(IR);然而,PCOS中卵巢局部IR的发病机制仍不清楚。人胰岛素(Humanin)是一种线粒体衍生肽,据报道与IR有关。我们之前的研究证实,人胰岛素在卵巢的多种细胞类型中表达,并存在于卵泡液中。然而,人胰岛素是否参与卵巢局部IR的发病机制,以及补充人胰岛素是否能改善PCOS患者的IR仍不清楚。在本研究中,我们比较了有IR和无IR的PCOS患者卵泡液中人胰岛素的浓度。我们进一步研究了补充人胰岛素类似物(HNG)对脱氢表雄酮诱导的PCOS大鼠模型IR的影响。发现有IR的PCOS患者卵泡液中的人胰岛素浓度显著低于无IR的患者。补充HNG可减轻PCOS大鼠空腹血糖和空腹胰岛素水平的升高,以及这些大鼠颗粒细胞中IRS1、PI3K、AKT和GLUT4蛋白磷酸化的降低。联合补充HNG和胰岛素可显著改善正常细胞和转染人胰岛素小干扰RNA的COV434细胞的葡萄糖消耗。总之,卵巢中人胰岛素下调可能参与PCOS中IR的发病机制,在大鼠模型中,外源性补充HNG通过调节IRS1/PI3K/Akt信号通路改善卵巢局部IR。这一发现支持了未来HNG作为PCOS治疗药物的潜在用途。