Banaszewska Beata, Ozegowska Katarzyna, Polska Martyna, Pawelczyk Leszek, Chang R Jeffrey, Duleba Antoni J
Division of Infertility and Reproductive Endocrinology, Department of Gynecology, Obstetrics and Gynecological Oncology, Poznan University of Medical Sciences, 60-535 Poznan, Poland.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California 92093-0633, USA.
J Endocr Soc. 2022 Aug 13;6(10):bvac128. doi: 10.1210/jendso/bvac128. eCollection 2022 Oct 1.
Hyperandrogenism is a central feature of polycystic ovary syndrome (PCOS). In vitro studies have demonstrated that inflammatory stimuli promote whereas ibuprofen inhibits androgen production by ovarian theca-interstitial cells.
This work aimed to determine the effects of nonselective inhibitor of cyclooxygenases COX-1 and COX-2 on testosterone levels.
A prospective pilot study took place in an academic hospital of women with PCOS defined according to Rotterdam criteria (N = 20). Evaluations were taken at baseline and after 3 weeks of ibuprofen administration (400 mg twice a day or 400 mg 3 times a day, respectively, in women with weight < and ≥ 70 kg). The main outcome measure was total serum testosterone.
Ibuprofen administration was associated with a decline of total testosterone from 0.75 ± 0.06 ng/mL to 0.59 ± 0.05 ng/mL ( = .008). There was no statistically significant change in the levels of other relevant hormones including dehydroepiandrosterone sulfate, gonadotropins, and insulin. Multiple regression analysis identified the greatest decline of testosterone was independently predicted by baseline testosterone level ( = .004) and by baseline insulin sensitivity index ( = .03).
Nonselective inhibition of COX-1 and COX-2 leads to selective reduction of testosterone consistent with direct inhibitory effect on ovarian steroidogenesis.
高雄激素血症是多囊卵巢综合征(PCOS)的核心特征。体外研究表明,炎症刺激可促进卵巢膜间质细胞产生雄激素,而布洛芬则抑制其产生。
本研究旨在确定环氧化酶COX-1和COX-2的非选择性抑制剂对睾酮水平的影响。
在一家学术医院对符合鹿特丹标准的PCOS女性进行了一项前瞻性初步研究(N = 20)。在基线时以及服用布洛芬3周后(体重<70 kg和≥70 kg的女性分别为每天2次400 mg或每天3次400 mg)进行评估。主要观察指标是血清总睾酮。
服用布洛芬后,总睾酮水平从0.75±0.06 ng/mL降至0.59±0.05 ng/mL(P = .008)。其他相关激素水平,包括硫酸脱氢表雄酮、促性腺激素和胰岛素,均无统计学显著变化。多元回归分析表明,睾酮水平下降幅度最大可由基线睾酮水平(P = .004)和基线胰岛素敏感性指数(P = .03)独立预测。
COX-1和COX-2的非选择性抑制导致睾酮选择性降低,这与对卵巢类固醇生成的直接抑制作用一致。