血管生成素样蛋白与胰岛素抵抗和糖代谢的关系及在多囊卵巢综合征中的作用

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是育龄期女性最常见的内分泌及代谢性疾病之一,PCOS患者发生心血管疾病和2型糖尿病的风险增加。越来越多的研究支持胰岛素抵抗(insulin resistance,IR)是PCOS重要的病理机制之一。血管生成素样蛋白(angiopoietin-like proteins,ANGPTLs)家族是一类与血管生成素结构相似的分泌型糖蛋白,目前已发现8个成员,即ANGPTL1~ANGPTL8。ANGPTLs在PCOS患者血液中表达水平升高,并且与IR程度密切相关,ANGPTLs通过促进脂肪组织炎症、调节胰岛素分泌及磷脂酰肌醇3激酶/蛋白激酶B(PI3K/Akt)信号通路等参与了IR和糖代谢,这很可能与PCOS的发病有关。综述ANGPTLs参与IR和糖代谢的机制及其在PCOS中的作用,以期进一步探讨ANGPTLs参与PCOS发病的机制,为预测和治疗PCOS提供新思路。

Angiopoietin-Like Proteins in Insulin Resistance,and Glucose Metabolism and Its Roles in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic diseases in women of reproductive age. The risk of cardiovascular disease and type 2 diabetes is increased in PCOS patients.More and more studies support that insulin resistance (IR) is one of the important pathological mechanisms of PCOS. The angiopoietin-like proteins (ANGPTLs) family is a group of secreted glycoproteins structurally similar to angiopoietins, and so far, eight members have been found, namely ANGPTL1-ANGPTL8. The expression level of ANGPTLs in the blood of PCOS patients is increased, which is closely related to the degree of IR. ANGPTLs are involved in the regulation of IR and glucose metabolism by promoting adipose tissue inflammation, regulating insulin secretion and PI3K/Akt signaling pathway, which may be related to the pathogenesis of PCOS. We review the mechanism of ANGPTLs involved in IR and glucose metabolism and its role in PCOS, in order to further explore the mechanism of ANGPTLs involved in the pathogenesis of PCOS and provide new ideas for the prediction and treatment of PCOS.