2013-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/645175摘要：肥胖的盛行率在多囊性卵巢症候群的婦女中普遍被認為比正常女性高，而且常會同時合併有高雄性素血症。近年來，不論是我們的研究還是國外的許多研究均發現，多囊性卵巢症候群的婦女其體內的高雄性荷爾蒙，除了與造成其超音波所見之多囊性卵巢的形態及進而導致其卵巢濾泡停止生長的原因有關之外，也會與其肥胖、胰島素抗性、高血壓、脂肪肝等代謝症候群的發生有關。然而，臨床上我們也觀察到並非所有的多囊性卵巢症候群的婦女都會有肥胖及代謝異常等現象，其中若是同時有嚴重青春痘的表現則反而患者會有體重較輕的表現。然而，到底是什麼因素造成這種差異，則直到目前一直沒有答案，所以所知不多。在我們最近的研究中，目前初步發現這樣的差異可能是與不同來源的雄性荷爾蒙有關。為了要進ㄧ歩了解肥胖、胰島素抗性、和高雄性素血症之間在於多囊性卵巢症候群的關係，我們設計ㄧ個三年期的研究計畫，計劃去釐清卵巢及腎上腺來源之雄性荷爾蒙對於多囊性卵巢症候群的差異性表現的原因為何。並希望藉由建立高雄性賀爾蒙之動物模式，了解雄性荷爾蒙在多囊性卵巢症候群所造成不排卵與肥胖、胰島素抗性等差異的致病機轉上所扮演的角色。並也希望藉由基因的研究探討是否是因為影響卵巢及腎上腺來源之雄性荷爾蒙的分泌與代謝之間的酵素基因表現差異，而造成常見多囊性卵巢症候群的臨床表現不同的原因。<br> Abstract: Women with polycystic ovary syndrome (PCOS) were well known to have high prevalence of obesity and androgen levels. Androgen is a well-known anabolic hormone; therefore, according to previous studies, androgen may not only contribute to the polycystic ovary morphology and ovulatory dysfunction, but also lead to the higher risk of metabolic disturbances including aggravated insulin resistance, endothelial dysfunction, dyslipidemia, hypertension, hepatic steatosis and metabolic syndrome in women with PCOS. However, although up to 40-50% women with PCOS were obese, while not all women with PCOS and hyperandrogenism were obese, especially in young adolescent and Asian women with PCOS. In addition, even though the androgen level was comparable, the prevalence of obesity and metabolic disturbance still different among women with PCOS of different study population and ethnicities. The main source of androgen in women with PCOS include both ovary and adrenal gland as testosterone and dehydroepiandrosterone sulfate (DHEAS), respectively. Though the ovarian and adrenal androgens were ever reported to have contradictory effect among the body weight and insulin levels in women with PCOS, it is still controversial. Our preliminary study has showed that the DHEAS as one of the dominant adrenal androgen has opposite relationship with the risk of obesity form the ovarian androgen. Therefore, we might propose that the differential levels of ovarian and adrenal levels may lead to different phenotypes and severity of metabolic disturbances in women with PCOS. Studies regarding to the pathogenesis of the differential role of ovarian and adrenal androgen levels in women with PCOS with the effects on obesity, insulin resistance and ovulatory function are not yet available. Therefore, we design this 3-year study including genetic studies and in-vivo animal studies to elucidate the differential role of ovarian and adrenal androgens play in the pathogenesis of polycystic ovary syndrome.Polycystic ovary syndromeDHEAStotal testosteroneabdominal obesityacnewaist circumferenceinsulin resistance