PCOS患者子宫内膜基质细胞蜕膜化的糖脂代谢研究进展

doi:10.12280/gjfckx.20250509

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovary syndrome，PCOS）是育龄期女性常见的内分泌代谢性疾病，其糖脂代谢稳态失衡会干扰子宫内膜基质细胞（endometrial stromal cell，ESC）蜕膜化进程，并显著增加不良妊娠结局的发生风险。研究发现，在葡萄糖代谢方面，PCOS患者存在表观遗传调控异常、胰岛素信号通路传导障碍和高雄激素影响内质网应激等异常机制。在脂质代谢方面，高雄激素作用于肾母细胞瘤1-极低密度脂蛋白受体（Wilms tumor 1-very low density lipoprotein receptor，WT1-VLDLR）通路导致脂质存储异常，PCOS相关的脂肪因子紊乱抑制ESC蜕膜化。综述PCOS患者ESC蜕膜化过程中的糖脂代谢异常的机制，为深入研究PCOS生殖障碍的代谢性因素和进一步开发靶向代谢重塑的治疗策略提供理论依据。

关键词: 多囊卵巢综合征, 子宫内膜, 基质细胞, 葡萄糖代谢障碍, 脂代谢障碍, 蜕膜化

Abstract:

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disease among women of reproductive age. The imbalance of glucose and lipid metabolic homeostasis in PCOS can interfere with decidualization process of endometrial stromal cell (ESC) and significantly increase the risk of adverse pregnancy outcomes. Studies have found that in terms of glucose metabolism, there are abnormal mechanisms in patients with PCOS, such as abnormal epigenetic regulation, insulin signaling pathway transduction disorders, and the influence of hyperandrogenism on endoplasmic reticulum stress. In terms of lipid metabolism, hyperandrogenism acts on the Wilms tumor 1-very low density lipoprotein receptor (WT1-VLDLR) pathway, leading to abnormal lipid storage, and the disorder of PCOS-related adipokines inhibits ESC decidualization. This review summarizes the mechanisms of abnormal glucose and lipid metabolism during the decidualization of ESC in patients with PCOS, providing a theoretical basis for in-depth research on the metabolic factors of reproductive disorders in PCOS and the further development of treatment strategies targeting metabolic remodeling.

Key words: Polycystic ovary syndrome, Endometrium, Stromal cells, Glucose metabolism disorders, Lipid metabolism disorders, Decidualization

曾慧芳, 窦真, 李玉欣, 姜欣雨, 夏天. PCOS患者子宫内膜基质细胞蜕膜化的糖脂代谢研究进展[J]. 国际妇产科学杂志, 2025, 52(5): 534-539.

ZENG Hui-fang, DOU Zhen, LI Yu-xin, JIANG Xin-yu, XIA Tian. Research Progress on Glucose and Lipid Metabolism in Decidualization of Endometrial Stromal Cells in Patients with PCOS[J]. Journal of International Obstetrics and Gynecology, 2025, 52(5): 534-539.

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