Department of Endocrinology, Faculty of Medicine, Medical University - Sofia, USHATE "Acad. Iv. Penchev", 2, Zdrave Str., 1431, Sofia, Bulgaria.
Endocrine. 2023 Sep;81(3):602-612. doi: 10.1007/s12020-023-03404-9. Epub 2023 May 29.
Polycystic ovarian syndrome (PCOS) is a common heterogeneous condition with probably multifactorial genesis. Animal studies have proven the essential role of the sympathetic nervous system in the syndrome development, while human studies are still contradictory. The present study aims to investigate the possible influence of plasma-free metanephrine (MN), and normetanephrine (NMN), nerve growth factor (NGF), and renalase (RNL) on the hormonal and metabolic parameters in women with PCOS and healthy controls.
Fifty patients with PCOS and 30 healthy women participated in the study. The plasma-free MN and NMN, NGF, RNL, anti-Mullerian hormone (AMH), gonadotropin, androgen levels, and metabolic parameters were investigated.
Plasma-free NMN and NGF concentrations were increased in PCOS individuals, while RNL levels were decreased compared to healthy volunteers. Increased plasma-free NMN (OR = 1.0213 [95%CI 1.0064-1.0364], p = 0.005) and NGF (OR = 1.0078 [95%CI 1.0001-1.0155], p = 0.046) but not MN or RNL levels were associated with a higher risk of PCOS after adjustment for age. Plasma-free NMN levels were positively associated with the LH (r = +0.253; p = 0.039). androstenedione (r = +0.265; p = 0.029), 17-OH progesterone (r = +0.285; p = 0.024), NGF (r = +0.320; p = 0.008), and AMH (r = +0.417; p < 0.001) concentrations of the investigated women. RNL levels were inversely related to the BMI (r = -0.245; p = 0.029), HOMA-IR (r = -0.250; p = 0.030), free testosterone (r = -0.303; p = 0.006) levels. systolic (r = -0.294; p = 0.008) and diastolic (r = -0.342; p = 0.002) blood pressure.
Increased sympathetic noradrenergic activity and NGF synthesis might be related to the increased AMH and delta-4 androgen levels in a subgroup of PCOS patients. RNL levels might influence the metabolic status of PCOS patients. Further studies are needed to explore the significance of adrenal medullar and autonomic dysfunction for developing different PCOS phenotypes and their subsequent cardiovascular complications.
多囊卵巢综合征（PCOS）是一种常见的具有多种病因的异质性疾病。动物研究已经证明，交感神经系统在该综合征的发展中起着重要作用，而人类研究仍然存在矛盾。本研究旨在探讨血浆游离甲肾上腺素（MN）和去甲肾上腺素（NMN）、神经生长因子（NGF）和肾酶（RNL）对 PCOS 患者和健康对照组女性激素和代谢参数的可能影响。
50 名 PCOS 患者和 30 名健康女性参加了这项研究。检测了血浆游离 MN 和 NMN、NGF、RNL、抗苗勒管激素（AMH）、促性腺激素、雄激素水平和代谢参数。
与健康志愿者相比，PCOS 患者的血浆游离 NMN 和 NGF 浓度升高，而 RNL 水平降低。调整年龄后，血浆游离 NMN（OR=1.0213[95%CI 1.0064-1.0364]，p=0.005）和 NGF（OR=1.0078[95%CI 1.0001-1.0155]，p=0.046）水平升高与 PCOS 风险增加相关，但 MN 或 RNL 水平无此关联。血浆游离 NMN 水平与 LH（r=+0.253；p=0.039）、雄烯二酮（r=+0.265；p=0.029）、17-羟孕酮（r=+0.285；p=0.024）、NGF（r=+0.320；p=0.008）和 AMH（r=+0.417；p<0.001）呈正相关。RNL 水平与 BMI（r=-0.245；p=0.029）、HOMA-IR（r=-0.250；p=0.030）、游离睾酮（r=-0.303；p=0.006）水平呈负相关，与收缩压（r=-0.294；p=0.008）和舒张压（r=-0.342；p=0.002）呈负相关。
交感去甲肾上腺素能活性和 NGF 合成的增加可能与 PCOS 患者亚组中 AMH 和 δ-4 雄激素水平的升高有关。RNL 水平可能影响 PCOS 患者的代谢状态。需要进一步研究肾上腺髓质和自主神经功能障碍对不同 PCOS 表型及其随后的心血管并发症的发生的意义。
