Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Reprod Sci. 2023 Aug;30(8):2429-2438. doi: 10.1007/s43032-023-01190-3. Epub 2023 Feb 14.
Endometriosis (ENDO) is a chronic estrogen-dependent gynecological condition that affects reproductive-age women, causing pelvic pain, infertility, and increased risk for ovarian cancer. Diabetes mellitus (DM) is a metabolic disease with significant morbidity and mortality and rising incidence worldwide. The occurrence of DM among ENDO patients remains understudied, despite commonalities in these conditions' immune, inflammatory, and metabolic dysfunctions. This pilot study evaluated whether a subset of women with ENDO manifests DM co-morbidity and if so, whether DM promotes ENDO status. Archived ectopic lesions obtained at ENDO surgery from non-diabetic (ENDO-N; n = 11) and diabetic (ENDO-DM; n = 15) patients were identified by a search of an electronic health database. Retrieved samples were analyzed by immunohistochemistry for markers of proliferation (Ki67, PTEN), steroid receptor signaling (ESR, PGR) and macrophage infiltration (CD68). Immunostaining data were expressed as percentages of immune-positive cells in lesion stroma and epithelium. In lesion stroma, the percentages of nuclear immune-positive cells were higher for ESR2 and lower for PGR-T, in ENDO-DM than ENDO-N patients. The percentages of nuclear immune-positive cells for ESR1 and PTEN tended to be higher and lower, respectively, in ENDO-DM than ENDO-N groups. In lesion glandular epithelium, the percentages of nuclear immune-positive cells were higher for ESR1 and ESR2, in ENDO-DM than ENDO-N groups. ENDO-N lesions had lower percentages of stromal CD68 immune-positive cells than ENDO-DM Type 1 lesions. Findings demonstrate DM in a subset of women with ENDO, which was associated with significant changes in lesion stromal and epithelial nuclear steroid hormone receptor levels, suggestive of disease progression.
子宫内膜异位症（ENDO）是一种慢性雌激素依赖性妇科疾病，影响育龄妇女，导致盆腔疼痛、不孕和卵巢癌风险增加。糖尿病（DM）是一种代谢疾病，具有显著的发病率和死亡率，并在全球范围内呈上升趋势。尽管这些疾病在免疫、炎症和代谢功能障碍方面存在共同之处，但 DM 在 ENDO 患者中的发生情况仍研究不足。本研究旨在评估是否有一部分 ENDO 患者表现出 DM 合并症，如果是这样，DM 是否会促进 ENDO 状态。通过电子健康数据库检索，从非糖尿病（ENDO-N；n=11）和糖尿病（ENDO-DM；n=15）患者的 ENDO 手术中获得的异位病变存档标本，通过免疫组化分析增殖标志物（Ki67、PTEN）、类固醇受体信号（ESR、PGR）和巨噬细胞浸润（CD68）。免疫染色数据表示病变基质和上皮中免疫阳性细胞的百分比。在病变基质中，与 ENDO-N 患者相比，ENDO-DM 患者的 ESR2 核免疫阳性细胞百分比更高，PGR-T 百分比更低。ENDO-DM 患者的 ESR1 和 PTEN 核免疫阳性细胞百分比分别倾向于更高和更低。在病变腺上皮中，与 ENDO-N 患者相比，ENDO-DM 患者的 ESR1 和 ESR2 核免疫阳性细胞百分比更高。ENDO-N 病变的基质 CD68 免疫阳性细胞百分比低于 ENDO-DM 1 型病变。这些发现表明，在一部分患有 ENDO 的女性中存在 DM，这与病变基质和上皮核甾体激素受体水平的显著变化相关，提示疾病进展。
