多囊卵巢综合征孕妇胎盘类固醇的研究

Placental steroidogenesis in pregnant women with polycystic ovary syndrome

摘要:

目的  评估多囊卵巢综合征（PCOS）孕妇胎盘类固醇硫酸酯酶（STS）、3β-羟基类固醇脱氢酶1型（3β-HSD-1）和P450芳香化酶（P450arom）活性。方法  研究对象为足月分娩的20例PCOS孕妇和30例健康对照孕妇。分娩后采集胎盘组织和脐带血样本。孕34周时采集母体血液样本。评估胎盘组织中STS、3β-
HSD-1和P450arom活性。测定血液样本内孕酮、硫酸脱氢异雄酮（DHEAS）、脱氢表雄酮（DHEA）、雄烯二酮、睾酮、雌酮、雌二醇和总雌三醇含量。结果  与健康对照组孕妇比较，PCOS孕妇胎盘组织中3β-HSD-1含量较高，而P450arom活性较低。此外，PCOS孕妇雄烯二酮和睾酮浓度比对照组孕妇高（P =0.016和0.025）。相较于对照组女性新生儿，PCOS组女性新生儿脐带血内雄烯二酮较低，而雌三醇浓度较高（P =0.038和0.031）。结论  PCOS孕妇胎盘组织内参与类固醇合成的两个重要酶活性发生改变，3β-HSD-1升高，而P450降低，该变化可引起怀孕期间雄激素分泌增加。

Abstract:

Objective To evaluate the activity of steroid sulfatase (STS), 3β-hydroxysteroid dehydrogenase type 1 (3β-HSD-1) and P450 aromatase (P450arom) in placenta of pregnant women with polycystic ovarian syndrome (PCOS). Methods Twenty pregnant women with PCOS and 30 control pregnant women who delivered at term were studied. Samples of placental tissue and cord blood were obtained after delivery. A maternal blood sample was obtained during the 34th week of gestation. In placental tissue, the activity of STS, 3β-HSD-1 and P450arom was evaluated. The content of progesterone, dehydroepiandrosterone sulfate (DHEAS), dehydroepiandrosterone (DHEA), androstenedione, testosterone, estrone, estradiol and total estriol was determined in the blood samples. Results In placental tissue from women with PCOS, higher 3β-HSD-1 and lower P450 aromatase activity was observed compared to the control women. Moreover, women with PCOS showed higher androstenedione and testosterone concentrations compared to normal pregnant women (P = 0.016 and 0.025, respectively). In cord blood, the female newborns of the women with PCOS exhibited lower androstenedione and higher estriol concentrations compared to the daughters of the control women (P = 0.038 and 0.031). Conclusions Placental tissue from women with PCOS shows changes in the activity of two important enzymes for steroid synthesis, i.e. higher 3β-HSD-1 and lower P450, which could increase androgen production during pregnancy.