多囊卵巢综合征(polycystic ovary syndrome, PCOS)是一种生殖内分泌失调和代谢异常的疾病,目前关于其发病机制暂不清楚,可能是因遗传、代谢和环境因素之间相互作用导致的。近年来,许多研究表明PCOS的发病与肠道菌群失衡有关,其中的肠道菌群代谢产物,如胆汁酸和短链脂肪酸等参与了PCOS发病过程。此外,肠道菌群还在高雄激素血症(Hyperandrogenism, HA)、胰岛素抵抗(Insulin Resistance, IR)、慢性炎症及肥胖等多种并发症的女性患者中来影响PCOS的发生发展。此外,本文还归纳了基于肠道微生物改善PCOS患者肠道菌群的研究进展,如粪菌移植、补充益生菌、益生元策略及中药等,为PCOS的研究和将来的临床应用提供参考依据和治疗选择。Polycystic ovary syndrome (PCOS) is a reproductive endocrine disorder and metabolic disorder, and its pathogenesis still remains elusive. The occurrence of PCOS may be attributed to the interplaying among the genetic and/or metabolic matters of females, as well as the inner and outside environmental factors. Recently, evidence indicates that PCOS occurrence is positively related to a homeostasis abnormity in the gut microbiota, by which metabolites of the gut microbiota, including bile acids and short-chain fatty acids, are involved in the pathogenesis of PCOS. In addition, gut microbiota can affect the occurrence and development of PCOS in female patients with various complications, accompanied by hyperandrogenism (HA), insulin resistance (IR), chronic inflammation, and obesity. In addition, in this review, we also summarize the research progress on rebalancing the gut microbiota of PCOS patients with gut microbiota, such as fecal microbiota transplantation, supplementation of probiotics, prebiotic strategies, and traditional Chinese medicine. Taken together, our summarized information here on PCOS advances would provide a helpful reference for PCOS research and clinical applications.
背景:慢性病的发病率高、危险性大,是全球性公共健康首要问题。糖尿病宛如“慢性癌症”,是由饮食、环境、药物、遗传等因素导致的,体内胰岛素分泌相对或者绝对不足而出现的血糖代谢紊乱。常见以II型糖尿病为主,并发症可导致患者心肌梗塞、脑溢血、失明、肾功能衰竭和下肢截肢等严重后果,是影响人类健康和寿命的主要危险因素。目的:总结II型糖尿病大血管病变发病生物标志物的研究进展,以期为II型糖尿病大血管病变及其所引起的心脑血管疾病的防治提供新靶点。方法:以“macrovascular disease in type 2 diabetes mellitus,pathogenesis”为英文检索词,以“II型糖尿病并发大血管病变,发病机制”为中文检索词,应用计算机检索PubMed、Medline、中国知网和万方数据库发表的相关文献,最终纳入文献59篇进行归纳分析。结果与结论:II型糖尿病大血管病变是由多种因素共同作用导致的复杂疾病。近年来,大量实验室和临床研究表明,其发生发展主要与非编码RNA、外泌体、炎性小体、活化T细胞核因子、骨形态发生蛋白等生物标志物有关,上述生物标志物有望成为II型糖尿病大血管病变新靶点。
