多囊卵巢综合征胰岛素抵抗机制研究进展

多囊卵巢综合征（PCOS）是一种异质性的妇科内分泌性疾病，以高雄激素血症、高胰岛素血症和（或）无排卵为其三大特征。胰岛素抵抗（IR）被认为是PCOS的重要发病机制，多数患者表现出高胰岛素血症。了解IR的机制对于掌握PCOS的病理机制和预后是有帮助的，同时也有助于预防PCOS并发症，特别是心血管疾病。PCOS-IR的分子生物学机制包含多个层面，其中包括胰岛素受体（INSR）基因及其表达调控、胰岛素的信号通路和一些受体后的因素。这些因素中尤其需要指出的是基因的多态性、线粒体转运RNA（mt-tRNA）、微小RNA（miRNA）、INSR和其下游的信号通路，如磷脂酰肌醇3激酶（PI3K）和丝裂原活化蛋白激酶（MAPK）等。

Research Progress in the Mechanism of Insulin Resistance in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS), a gynecological endocrine disease with high heterogeneity, is characterized by hyperandrogenemia, hyperinsulinemia and/or abnormal ovulation. Insulin resistance (IR) is considered as a part of the pathogenesis of PCOS, and PCOS patients often show hyperinsulinemia. It is helpful for understanding the pathogenesis and prognosis of PCOS to explore the mechanism of IR, and for preventing the complications, especially cardiovascular disease. The molecular biological basis of IR in PCOS women is related to the gene of insulin receptor(INSR), the regulation of gene expression and the intracellular insulin signaling pathway. We will mainly discuss the polymorphism of related genes, mitochondrial transport RNA (mt-tRNA), microRNA, INSR and its downstream signals such as PI3K and MAPK, and some post-receptor substances which can regulate the insulin sensibility.