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多囊卵巢综合征(polycyctic ovary syndrome,PCOS)是一种极为复杂的代谢异常病理状态,它与多基因相关。胰岛素对PCOS患者卵泡的影响很复杂,可能主要与糖代谢和卵泡对FSH的敏感性有关。高雄激素血症在PCOS患者中非常常见,高雄激素会抑制优势卵泡形成,造成闭锁。PCOS的卵巢间质血管内皮生长因子(VEGF)呈高表达,VEGF可能增加卵巢血管化,使更多因子渗透,引起多囊卵巢。胰岛素样生长因子(IGF)系统与PCOS患者亦有很密切的关系,IGF-I具有促进有丝分裂、参与新陈代谢等胰岛素样生物学效应。当IGF-I受体下调时,糖吸收障碍,会导致卵泡发育障碍。影响卵泡发育的因素众多,这些因素之间也存在相互影响的关系,高胰岛素和FSH联合作用会促进卵泡膜细胞产生大量雄激素,高胰岛素又增高IGF-I,胰岛素与LH联合还会增加VEGF的表达,这一切都将影响卵泡生长。
Polycystic ovary syndrome (PCOS) is an extremely complex pathological condition of metabolic abnormalities that is associated with multiple genes. The effect of insulin on follicles in PCOS patients is complex and may be mainly related to glucose metabolism and follicular sensitivity to FSH. Hyperandrogenism is very common in patients with PCOS, and hyperandrogenism inhibits the formation of dominant follicles, causing atresia. PCOS ovarian stromal vascular endothelial growth factor (VEGF) was highly expressed, VEGF may increase ovarian vascularization, so that more factors penetrate, causing polycystic ovary. Insulin-like growth factor (IGF) system and PCOS patients are also closely related, IGF-I can promote mitosis, metabolism and other insulin-like biological effects. When the IGF-I receptor is down-regulated, sugar malabsorption can lead to follicular dysgenesis. There are many factors affecting the development of follicles, these factors also exist between the interaction of the relationship between high insulin and FSH joint effect will promote a large number of androgen production of theca cells, high insulin and increased IGF-I, insulin and LH will increase VEGF All of this will affect follicular growth.