Wang Can, Wen Yang-Xing, Mai Qing-Yun
Reproductive Medicine Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, P.R. China.
Exp Ther Med. 2022 Mar;23(3):221. doi: 10.3892/etm.2022.11145. Epub 2022 Jan 14.
The present study investigated the expression of endometrial receptivity-related molecules in patients with polycystic ovary syndrome (PCOS) and different androgen status, insulin resistance (IR) levels, and body mass indexes (BMI) to identify the mechanism underlying their effects on pregnancy outcomes. The present study recruited 43 participants from November 2020 to January 2021, which were classified into five groups: i) Hyperandrogenemia (HA) combined with impaired glucose tolerance group (n=8); ii) HA combined with diabetes mellitus group (n=8); iii) HA combined with non-IR (NIR) group (n=10); iv) non-HA (NHA) androgen combined with IR group (n=8); and v) NHA combined with NIR group (n=9). In addition, according to their BMIs, patients were sub-grouped into lean/normal (n=27), overweight (n=8) or obese (n=8) groups. The mRNA expression levels of endometrial receptivity-related molecules were detected using reverse transcription-quantitative PCR. In addition, flow cytometry was used to determine the phenotype and percentage of uterine natural killer cells (uNK). According to the results, patients with PCOS and IR status, HA and obesity (BMI ≥24 kg/m) demonstrated significantly decreased mRNA expression levels of adiponectin, adiponectin receptor (AdipoR)1, AdipoR2, adapter protein containing PH domain, PTB domain and leucine zipper motif 1, estrogen receptor (ER) α, ERβ, progesterone receptor (PR), IL-15, integrin β3 avβ3, and insulin-like growth factor binding protein-1, but increased mRNA expression levels of IL-6 and IL-8 compared with NHA + NIR group or lean/normal group, respectively. In addition, obese patients with PCOS demonstrated increased mRNA expression levels of PR compared with overweight patients. This suggested that insulin resistant status, HA, and obesity could alter the endometrial receptivity of patients with PCOS, which may explain poorer embryo implantation and pregnancy outcomes in clinics.
本研究调查了多囊卵巢综合征（PCOS）患者中子宫内膜容受性相关分子的表达情况，以及不同雄激素状态、胰岛素抵抗（IR）水平和体重指数（BMI），以确定它们对妊娠结局产生影响的潜在机制。本研究在2020年11月至2021年1月招募了43名参与者，分为五组：i）高雄激素血症（HA）合并糖耐量受损组（n = 8）；ii）HA合并糖尿病组（n = 8）；iii）HA合并非胰岛素抵抗（NIR）组（n = 10）；iv）非HA（NHA）雄激素合并IR组（n = 8）；v）NHA合并NIR组（n = 9）。此外，根据BMI，患者被进一步分为瘦/正常组（n = 27）、超重组（n = 8）或肥胖组（n = 8）。采用逆转录定量PCR检测子宫内膜容受性相关分子的mRNA表达水平。此外，采用流式细胞术确定子宫自然杀伤细胞（uNK）的表型和百分比。结果显示，与NHA + NIR组或瘦/正常组相比，PCOS合并IR状态、HA和肥胖（BMI≥24 kg/m）的患者脂联素、脂联素受体（AdipoR）1、AdipoR2、含PH结构域、PTB结构域和亮氨酸拉链基序1的衔接蛋白、雌激素受体（ER）α、ERβ、孕激素受体（PR）、IL-15、整合素β3 avβ3和胰岛素样生长因子结合蛋白-1的mRNA表达水平显著降低，但IL-6和IL-8的mRNA表达水平升高。此外，与超重患者相比，PCOS肥胖患者的PR mRNA表达水平升高。这表明胰岛素抵抗状态、HA和肥胖可能会改变PCOS患者的子宫内膜容受性，这可能解释了临床上较差的胚胎着床和妊娠结局。
