台灣地區多囊性卵巢症候群內分泌特性與濾泡液蛋白質表現之探討

Study of endocrine and follicular fluid protein expression of PCOS patients in Taiwan

曾柏凱(Po-Kai Tseng)

指導教授 ： 葉錦瑩 ； 謝秀梅

臺北醫學大學/醫學院/醫學科學研究所/碩士(2004年)

摘要

多囊性卵巢症候群(Polycystic ovary syndrome，簡稱PCOS)，為一種女性相當常見的內分泌異常的疾病，也是女性不孕的主要原因之一。多囊性卵巢症候群除了會造成不孕外，也會導致許多其他症狀，並會提高某些慢性疾病的罹病風險。一般而言，PCOS患者會有多囊性卵巢、月經異常、雄性素與胰島素過高等現象，因其症狀複雜，故而診療的困難度也隨之增加。 本研究中，我們與台安醫院生殖醫學中心合作，針對約320例病人之內分泌相關資訊進行資料分析，並利用蛋白質二維電泳分析濾泡液中之蛋白質表現，以試圖瞭解台灣地區PCOS族群與國外之差異性。 資料分析結果可以發現台灣與國外PCOS族群之BMI分布不同，台灣PCOS肥胖之比例較國外的報告低，且BMI值也較國外族群來的小。由分析中也發現台灣PCOS族群之BMI與LH皆高於控制組，且PCOS組顯現出雄性素過高與胰島素過高等現象。本研究中另外也利用Receiver operating characteristic curve(ROC)分析，找出幾個常見指標之建議切點以便提供臨床在診斷上的參考。 在蛋白質二維電泳部分，我們發現在控制組與PCOS組間可以觀察到有差異之訊號存在，但目前仍無法得知其為單純之個體差異或是PCOS所造成之表現差異。在電泳結果中我們觀察到Alpha-1 Antitrypsin、Vitamin D-binding protein與Fibrinogen Gamma-A chain之表現量皆相當穩定，因此之後或許可以將這些蛋白列為內部控制組(internal control)作參考，進一步比較濾泡液中蛋白組成之變化，以便於以卵巢微環境之變化瞭解PCOS可能之致病機制。

關鍵字

多囊性卵巢症候群 ； 不孕症 ； 內分泌

並列摘要

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that is one of the most common causes of anovulatory infertility. PCOS is characterized by hyperandrogenemia, polycystic ovary, hyperinsulinemia, and abnormal menstrual cycle. Long-term effect of PCOS also results the conditions of diabetes, cardiovascular disease, endometrial cancer and breast cancer. In this study, we perform serum endocrine statistics and follicular fluid proteomics analyses to investigate PCOS pattern in Taiwan. Data collection was obtained from 320 PCOS patients enrolled in the Center for Reproductive Medicine and Infertility of Taiwan Adventist Hospital. In proteomics analysis, the proteins in the follicular fluid of both PCOS and control groups were analyzed by 2-Dimensional Electrophoresis (2DE). From the data analysis, we found that the BMI distribution in Taiwan PCOS population is different from the pattern reported from other countries and the ratio of obese PCOS in Taiwan is also less than that in other countries. We also found that higher levels of BMI and LH in patients with PCOS than in the control group. In addition, hyperandrogenemia and hyperinsulinemia are also present in the PCOS population. By Receiver operating characteristic curve (ROC) analysis, we also provide cutting points of several markers that may be useful in the future clinical diagnosis. From the 2DE analysis, we observed some differential expressed proteins between PCOS and control group, but so far we still can’t distinguish these differences are results from individual variation or causes by PCOS. We found the signals of Alpha-1 Antitrypsin, Vitamin D-binding protein and Fibrinogen Gamma-A chain were quite constant with experiments from time to time. It may be a possibility to use these proteins as internal control in our further experiments. The protein expression pattern difference between the follicular microenvironment of PCOS and control groups may reveal some information related to the molecular mechanism of PCOS.

並列關鍵字

polycystic ovary sybdrome ； infertility ； endocrine

參考文獻

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