肠道菌群与多囊卵巢综合征并发抑郁症关系的研究进展

抑郁症是多囊卵巢综合征（polycystic ovary syndrome,PCOS）常并发的精神障碍性疾病,不仅严重影响PCOS患者的生活质量,还会进一步加重内分泌代谢的紊乱,形成恶性循环,增加治疗疾病的难度。目前临床上对PCOS并发抑郁症主要采用分开诊治的方案,并未根据两者之间内在的联系找到针对性的治疗药物。近年的研究表明,PCOS患者的肠道菌群存在明显失衡,而失衡的肠道菌群可通过“肠-脑轴”导致抑郁症的发生。因此肠道菌群与PCOS并发抑郁症的发生密切相关。本文就肠道菌群与PCOS并发抑郁症关系的研究进展进行综述,以期为临床上治疗PCOS并发抑郁症提供参考。     

多囊卵巢综合症与心血管疾病相关性的探讨

多囊卵巢综合症(Polycystic ovary syndfome,PCOS)是一种育龄期妇女常见病,临床上常伴有月经稀少、不孕、多毛和肥胖等症状,双侧卵巢呈囊性增大,女性内分泌出现紊乱,PCOS中有50%妇女表现为肥胖,尽管多数妇女以不孕和月经异常就诊,但有研究表明PCOS患者的远期并发症如心血管疾病的发生率远远高于正常人群。本文主要探讨了PCOS与心血管疾病的相关性。     

氯胺酮在麻醉和治疗抑郁症中的研究进展

抑郁症是一种精神障碍性疾病,它的主要症状是持续的情绪低落.根据WHO的研究报告:全世界有大约25％的人患有抑郁症,其中约10％的人是重性抑郁症,也即是说难治性抑郁症.抑郁症严重地影响着人们的正常生活、工作和学习,特别值得注意地,患有重性抑郁症的患者是自杀的高危人群.氯胺酮是临床常用的麻醉药,尤其在小儿麻醉手术中被广泛应用,近几年的研究表明氯胺酮能迅速缓解抑郁症患者症状,且治疗效果持续可达一周.本文将就氯胺酮在手术麻醉和治疗抑郁症过程中的研究进行综述.     

抑郁症人群肠道微生物群落结构与功能探讨

目的了解抑郁症人群肠道主要微生物群落情况,探讨在机体精神心理异常状态下肠道内微生态平衡特点,从而为研究抑郁症人群及相关精神心理疾患人群的防治新策略提供数据资料。方法设抑郁症患者研究组和健康对照组,采用日本光冈法定性定量检测肠道乳杆菌属、双歧杆菌属、类杆菌属、消化链球菌属、肠球菌属、产气荚膜梭菌、肠杆菌科及酵母菌的菌群值,计算和比较双歧杆菌属细菌数量与肠杆菌科细菌数量的对数值比值(B/E值)。结果与健康人对照组比较,抑郁症人群研究组肠道乳杆菌和双歧杆菌数量显著降低(P0.01);B/E值显著减少(P0.01);肠杆菌科细菌、肠球菌数量显著增加(P0.01,P0.05)。结论抑郁症人群肠道乳杆菌和双歧杆菌数量显著减少,肠杆菌科及肠球菌细菌数量显著增加,益生菌群与肠杆菌科结构发生改变,推测抑郁症的发生,有可能通过肠-脑轴的联系,使大脑情感中枢功能紊乱与肠道菌群微生态平衡失调的相互作用有关。     

职业倦怠与抑郁症的相关性及其生物学基础研究*

职业倦怠和抑郁症是当今社会人群中普遍存在的影响心理健康的重要因素和疾病,这两者之间有一定的相关性.职业倦怠主要表现在三个方面:情感枯竭,去个性化,个人成就感缺乏.抑郁症主要表现在心境障碍或情感性障碍,缺乏激情.职业倦怠和抑郁症在表现行为方面存在一定关联,患有职业倦怠和抑郁症的人通常态度消极,缺乏对生活和工作的热情,自我评价低,影响工作和生活质量.抑郁情绪易引发职业倦怠,职业倦怠也可以导致抑郁症,二者相互影响.本文就职业倦怠与抑郁症的概念,两者之间的联系及相关的生物学基础进行了综述.     

抑郁症的成因及其新药治疗研究进展

抑郁症是一种发病率高、危害大的精神疾病,且发病的人群正在急剧增加。抑郁症的成因复杂,其病因机制尚不十分清楚。目前研究的病因主要包括神经递质受体异常、神经退化及内分泌、炎症细胞因子、表观遗传调节和大脑衍生神经营养因子等。随着新病因的揭开,抑郁症治疗的新药及其作用机理研究也取得了较大的进展。研发的新药主要包括:选择性5-羟色胺(5-HT)、去甲肾上腺素(NE)再摄取抑制剂、选择性NE再摄取抑制剂、肾上腺素能和特异性5-HT抗抑郁药、以及新药氯胺酮。本文就抑郁症发病的成因及主要的新药治疗策略进行了综述,为揭示抑郁症致病机制及其新药研发提供了理论依据。     

抑郁症共病胃肠疾病的神经生物学机制研究进展

抑郁症是一种常见的心境障碍性疾病,对人群健康的危害日益加重。胃肠疾病是一类兼具动力学改变和器质性病变的系列疾病,主要包括功能性胃肠病、胃食管反流病、胃炎、胃溃疡。近年来,抑郁症共病胃肠疾病的现象普遍,但是在临床诊疗过程中,患者多被医生诊断为单方面抑郁症或胃肠疾病,造成患者治疗延迟,甚至无效。本文综述了抑郁症共病胃肠疾病的一些临床症状表现,并以两者涉及的可能发病机制为出发点,找寻其共病的神经生物学通路,从而提高人们对抑郁症共病胃肠疾病的重视程度,并为共病的临床与基础研究及兼具治疗作用的药物研发提供依据。     

血清miRNA-93、miRNA-223联合miRNA-324-3p可作为诊断PCOS的生物标记物

本研究拟基于最近的miRNA报道,结合前期关于肌肉生长抑素(myostatin, MSTN)的相关研究,探究多囊卵巢综合症(ploycystic ovary syndrome, PCOS)患者血清miRNA和生长抑素的表达及其相关临床病理特征。本研究选取160例在湘南学院附属医院妇科就诊的女性为研究对象,通过PCR、ELISA等方法比较PCOS患者血清miRNA和生长抑素的表达情况,并且分析其相关临床病理特征。结果显示,通过PCR的方法发现mi RNA-93、mi RNA-223在PCOS患者的血清中显著升高,而mi RNA-4522、mi RNA-6767-5p和mi RNA-324-3p则表达下降。本研究建立了3个miRNA的预测模型,并证实预测模型在筛选组和验证组中有很好的敏感性和特异性,可以有效区分PCOS患者和正常人群,但研究结果也发现,miRNA模型结合MSTN没有更好的诊断价值。     

肥胖对多囊卵巢综合征的影响

多囊卵巢综合征(Polycystic Ovary syndrome,PCOS)是女性最常见的生殖内分泌紊乱性疾病,严重影响女性健康。PCOS患者中有50%-70%存在肥胖,肥胖严重影响女性生殖功能,目前关于肥胖对PCOS影响的临床和实验研究很多,但是关于肥胖对PCOS女性生殖影响方面尚未进行系统的归纳总结,本文就肥胖影响PCOS女性生殖障碍的机制、肥胖对PCOS促排卵和辅助生殖技术的应用效果的影响等进行综述,目的是进一步明确肥胖本身及肥胖的治疗在PCOS生殖方面的影响,为PCOS的临床诊疗提供依据。     

吸烟可导致抑郁症患者免疫系统功能降低

抑郁与吸烟的结合可能会产生特别严重的危害性。一项新的研究发现 ,患有抑郁症的人每天吸一包左右的烟会使免疫功能受损而导致机体癌变。美国ＳａｎＤｉｅｇｏ的ＶｅｔｅｒａｎｓＡｆｆａｉｒｓ医学中心神经病学家ＷａｙｍｏｎｄＪｕｎｇ和ＭｉｃｈａｅｌＩｒｗｉｎ的研究显示 ,抑郁症患者伴有吸烟而发生免疫细胞功能受损的现象 ,在患有抑郁症但不吸烟的人以及无抑郁症但每天吸一包烟的人群中并不曾发现。流行病学研究也表明 ,承受抑郁症折磨的吸烟者其各种癌症的发生率均有明显的升高。Ｊｕｎｇ和Ｉｒｗｉｎ收集了 12 7份不吸烟且没有任何…     

Mood and anxiety disorders in women with PCOS

Women with polycystic ovary syndrome have gynecologic, reproductive and metabolic co-morbidities that span their entire lifespan. More recently a higher risk of mood and anxiety disorders has been reported in women with PCOS. Women with PCOS have higher depression scores and a higher risk of depression independent of BMI. Although clinical features of hyperandrogenism affect health related quality of life, the association between hirsutism, acne, body image and depression is currently unclear. Similarly there is limited data on the association between variables such as biochemical hyperandrogenism or infertility and depression. Women with PCOS are also at risk for symptoms of generalized anxiety disorder. There is insufficient data examining the risk of other anxiety disorders such as social phobia, obsessive compulsive disorders and panic disorder. In a number of patients some of these disorders coexist increasing the health burden. These data underscore the need to screen all women with PCOS for mood and anxiety disorders and adequately treat women who are diagnosed with these conditions.     

Impact of polycystic ovary syndrome on eating behavior,depression and health related quality of life: A cross-sectional study in Riyadh

Background & objectivesPolycystic ovary syndrome (PCOS) is the most common endocrinal disorder, and the greatest cause of infertility in women. Despite availability of individual data on impact of multiple endocrinal, reproductive and even metabolic factors in PCOS individuals, the data on the co-existence of BED and depression in PCOS patients with its relationship on the quality of life in Saudi Arabian females is not found. Hence this study is aimed to elucidate the implication of PCOS on eating behaviour, induction of depression and general health quality in Saudi Arabian population of Riyadh.Materials and methodsThis is a cross-sectional study carried out in multiple health facilities of Riyadh from January to March 2019. The study samples (494) were recruited by convenience sampling and administered validated questionnaire by trained research participants. The data obtained was analysed by binary logistic regression using SPSS-IBM 25.ResultsOf the total 494 women participated in the study, 23.48% (116) were PCOS individuals. The odds of developing abnormal health related quality of (HRQ) in patients with PCOS was significantly (P = 0.000, OR = 3.472) high when compared to non-PCOS participants. The odds of showing high binge eating disorder (BED, P = 0.007, OR = 2.856) and depression (P = 0.000, OR = 2.497) scores in PCOS participants were significantly more than patients who were not having PCOS. Out of the three parameters studied, abnormal health related quality of life possessed a higher influence of PCOS compared to depression and abnormal eating behavior.Interpretation & conclusionIn conclusion, the present study shows that women with PCOS are at a significant risk for depressive disorders, disorganized eating behavior and impaired quality of life. Therefore, necessary care and screening is required to minimize the impact of PCOS on already burdened individuals.     

The metabolic aspects of polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) is considered to be the main reason of hyperandrogenism in reproductive women. There are often metabolic disorders connected with carbohydrate and adipose metabolism in the patients with PCOS. However, presence of metabolic disorders does not influence the diagnosis of the syndrome. The investigations demonstrated that the changes in lifestyle and use of proper medications could normalize endocrine system and metabolism through insulin-sensitivity increase and in the result it could restore the menses and ovulations. This paper introduces present knowledge concerning metabolic disorders associated with PCOS.     

Current and future aspects of several adjunctive treatment strategies in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age. PCOS is characterized by hyperandrogenism, menstrual disorders, and polycystic ovarian morphology. PCOS patients have an increased risk of type 2 diabetes, cardiovascular disease, and infertility. The mechanism of PCOS is not yet fully understood, but insulin resistance and genetic factors may play distinct roles in the pathomechanism.There is ongoing research on new therapeutic modalities for women with PCOS. In this minireview, we assessed the evidence for the effectiveness and safety of selected adjunctive agents (metformin, statins, resveratrol, melatonin, and inositols) for the treatment of women with PCOS. Metformin is a safe medication used in PCOS for 25 years that is currently recommended in select PCOS subpopulations, such as adolescents, women with metabolic disorders, and infertility infertile women undergoing ovarian hyperstimulation. Statins are also suggested in PCOS therapy, as these compounds decrease testosterone concentrations, improve lipid profiles, and ameliorate inflammatory reactions. Despite promising results, the role of statins in PCOS management needs to be further validated. Dietary supplements have also been tested in PCOS patients. Resveratrol was shown to decrease total testosterone production and improve fasting insulin but, until recently, only in one randomized study. Data on the therapeutic efficacy of melatonin and inositols on endocrine and metabolic abnormalities are limited and inconclusive. The multifactorial etiology of PCOS makes tailoring of its treatment more demanding, and there is a constant need for causative and effective modes of PCOS therapy.     

Polycystic ovary syndrome: brain-derived neurotrophic factor (BDNF) plasma and follicular fluid levels

Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age. Features of PCOS are hyperandrogenism, chronic anovulation and polycystic ovaries on ultrasonography. Follicle development is a complex and carefully orchestrated phenomenon, involving gonadotropins and a rapidly expanding list of other intraovarian regulators, such as brain-derived neurotrophic factor (BDNF). The aim of this study is to evaluate BDNF in plasma and in follicular fluid in women affected by PCOS and in normal menstruating women. In PCOS patients the BDNF levels in plasma and in follicular fluid are higher than values obtained in healthy controls. Therefore we can hypothsize that high levels of luteinizing hormone, probably increase the secretion of BDNF in PCOS patients.     

Genetic construction between polycystic ovarian syndrome and type 2 diabetes

Polycystic ovarian syndrome (PCOS) in reproductive-aged women is identified to be one of the endocrine disorders. This heterogeneous disorder is categorized through oligo-anovulation and hyperandrogenemia. National institutes of health and Rotterdam criterions were used to diagnose PCOS women. Type 2 Diabetes (T2D) is one of the complications in PCOS which is connected through insulin resistance (IR), which is a condition in which liver, muscles and fat infrequently respond to the hormones, and this leads to extreme IR and consequently leads to T2D disease. PCOS is inherited by the autosomal dominant mode of inheritance and may also with the different intricate patterns. Till now, many studies have been performed in PCOS with the genes identified by T2D and till now no studies have shown the similar genetic association and pathophysiology between both the diseases. So, the current review aims to investigate the genetic relation between PCOS and T2D and why both the diseases cannot be reverted. In this review, published data were screened with the T2D related genes and single nucleotide polymorphisms in PCOS women. The case-control, hospital-based and meta-analysis molecular studies disclosed both positive and negative connotations. Genetically, no relationship has been established between PCOS and T2D. Maximum studies have shown as PCOS women had developed T2D later in life because as a risk-factor, but none of the studies documented T2D women having developed PCOS as a risk factor. Apart from this, the disease PCOS is developed in women with reproductive age and T2D develops in both the men and women during adulthood. This review concludes as there is a genetic relation only in between PCOS and T2D, but not with T2D to PCOS and further it cannot be explicitly reverted from T2D to PCOS.     

Psychosocial and sociocultural aspects of infertility--a comparison between Austrian women and immigrant women

The polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting female fertility. In this study we examined psychosocial parameters caused by infertility in PCOS women with different socio-cultural background. Symptomatology of PCOS, body composition characteristics as well as psychosocial parameters were examined in 49 PCOS infertility patients of the University Clinic for Gynecology and Obstetrics in Vienna, who originated from two different socio-cultural subgroups--Austrian women and Moslem immigrant women. In the appearance of the symptoms the typical heterogeneity of PCOS could be found in both subgroups with no differences. However, differences in the psychosocial aspects were impressive. Women from Islamic background do have a very high reproductive pressure. The Moslem immigrant PCOS women suffer more from infertility than Austrian women do.     

Mouse models to study polycystic ovary syndrome: A possible link between metabolism and ovarian function?

Polycystic ovary syndrome (PCOS) is the most common cause of female infertility affecting 6–8% of women worldwide. PCOS is characterized by two of the following three criteria: clinical or biochemical hyperandrogenism, oligo- or amenorrhea, and polycystic ovaries (PCO). In addition, women with PCOS are often obese and insulin resistant, and are at risk for type 2 diabetes and cardiovascular disease. The etiology of PCOS remains unknown. Therefore, several animal models for PCOS have been generated to gain insight into the etiology and development of the PCOS-associated phenotypes. Androgens are considered the main culprit of PCOS, and therefore, androgenization of animals is the most frequently used approach to induce symptoms that resemble PCOS. Prenatal or prepubertal androgen treatment results in many characteristics of human PCOS, including anovulation, cyst-like follicles, elevated luteinizing hormone (LH) levels, increased adiposity, and insulin insensitivity. However, PCOS has a heterogeneous presentation, and therefore it is difficult to generate a model that exactly reproduces the reproductive and metabolic phenotypes observed in women with PCOS. In this review, we discuss several mouse models for PCOS, and compare the reproductive and/or metabolic phenotypes observed in several androgen-induced models as well as in several genetic models.     

Association between the prevalence of hyperuricemia and reproductive hormones in polycystic ovary syndrome

Background

The prevalecne of hyperuricemia in polycystic ovary syndrome (PCOS) is still uncertain. We aimed to investigate the prevalence of hyperuricemia in PCOS and to determine the influence of reproductive hormones on uric acid concentration.

Methods

This retrospective cross-sectional study was performed at a large reproductive medicine center. Between March 2007 and October 2016, a total of 1,183 women with PCOS and 10,772 women without PCOS were included. PCOS was diagnosed according to the Rotterdam criteria. Anthropometric parameters, blood pressure, uric acid, reproductive hormones, glucose and lipids were measured in all subjects.

Results

The serum uric acid (SUA) level was higher in women with PCOS than in women without PCOS. The prevalence of hyperuricemia in women with PCOS (25.48%) was significantly higher than that in women without PCOS (8.74%). Analysis stratified for age and body mass index (BMI) showed that both the SUA level and the prevalence of hyperuricemia were higher in women with PCOS of different age and BMI groups than in women without PCOS. After adjusting for age, BMI and estimated glomerular filtration rate (eGFR), logistic regression analysis revealed that the luteinizing/follicle-stimulating hormone (LH/FSH) ratio (odds ratio (OR)?=?1.20, 95% CI?=?1.01–1.43) and testosterone level (OR?=?1.56, 95% CI?=?1.27–1.90) were positively associated with the prevalence of hyperuricemia in females with PCOS.

Conclusions

The serum uric acid (SUA) level and the prevalence of hyperuricemia markedly increased in women with PCOS. The testosterone level was positively associated with the SUA level and the prevalence of hyperuricemia in females with PCOS.