代谢稳态在早发性卵巢功能不全中的作用及相关干预措施研究进展
The Role of Metabolic Homeostasis in Premature Ovarian Insufficiency and Related Treatment Measures
摘要: 早发性卵巢功能不全(Premature Ovarian Insufficiency, POI)指女性在40岁以前出现卵巢功能减退,严重影响患者的身心健康和生育能力。颗粒细胞及卵母细胞的糖类、脂质及氨基酸的代谢紊乱在POI的发病中具有重要作用。本文综述了糖类、脂质及氨基酸的代谢在维持正常卵巢功能中的作用并讨论了代谢异常对卵巢储备功能的影响以及基于代谢重塑的相关药物或潜在分子对卵巢功能的调控机制。
Abstract: Premature ovarian insufficiency (POI) is defined by loss of normal ovarian function before the age of 40 years, which can severely affect the physical and mental health of women. The metabolism of carbohydrates, amino acids, and lipids in oocytes and granulosa cells plays a significant role in the pathogenesis of POI. This review article provides a summary of glucose metabolism, amino acid and lipid metabolism in maintaining ovarian normal physiological function and homeostasis, the potential impact of metabolic disorder on ovarian reserve and the regulatory mechanisms in repair of ovarian function based on metabolic remodeling.
文章引用:范静雯, 吴瑞瑾. 代谢稳态在早发性卵巢功能不全中的作用及相关干预措施研究进展[J]. 临床医学进展, 2025, 15(9): 1406-1412. https://doi.org/10.12677/acm.2025.1592638

参考文献

[1] Touraine, P., Chabbert-Buffet, N., Plu-Bureau, G., Duranteau, L., Sinclair, A.H. and Tucker, E.J. (2024) Premature Ovarian Insufficiency. Nature Reviews Disease Primers, 10, Article No. 63. [Google Scholar] [CrossRef] [PubMed]
[2] Huhtaniemi, I., Hovatta, O., La Marca, A., Livera, G., Monniaux, D., Persani, L., et al. (2018) Advances in the Molecular Pathophysiology, Genetics, and Treatment of Primary Ovarian Insufficiency. Trends in Endocrinology & Metabolism, 29, 400-419. [Google Scholar] [CrossRef] [PubMed]
[3] Warzych, E. and Lipinska, P. (2020) Energy Metabolism of Follicular Environment during Oocyte Growth and Maturation. Journal of Reproduction and Development, 66, 1-7. [Google Scholar] [CrossRef] [PubMed]
[4] Sugiura, K., Pendola, F.L. and Eppig, J.J. (2005) Oocyte Control of Metabolic Cooperativity between Oocytes and Companion Granulosa Cells: Energy Metabolism. Developmental Biology, 279, 20-30. [Google Scholar] [CrossRef] [PubMed]
[5] Sánchez-Calabuig, M.J., et al. (2021) A High Glucose Concentration during Early Stages of in Vitro Equine Embryo Development Alters Expression of Genes Involved in Glucose Metabolism. Equine Veterinary Journal, 53, 787-795.
https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13342
[6] Malyszka, N., Pawlak, P., Cieslak, A., Szkudelska, K. and Lechniak, D. (2023) Distinct Dynamics of Lipid Accumulation by Porcine Cumulus Cells during in Vitro Maturation with Follicular Fluid of Low and High Fatty Acid Contents. Theriogenology, 195, 93-102. [Google Scholar] [CrossRef] [PubMed]
[7] Fahy, E., Subramaniam, S., Murphy, R.C., Nishijima, M., Raetz, C.R.H., Shimizu, T., et al. (2009) Update of the LIPID MAPS Comprehensive Classification System for Lipids. Journal of Lipid Research, 50, S9-S14. [Google Scholar] [CrossRef] [PubMed]
[8] Sturmey, R. and Leese, H. (2003) Energy Metabolism in Pig Oocytes and Early Embryos. Reproduction, 126, 197-204. [Google Scholar] [CrossRef] [PubMed]
[9] Hou, N., Chen, S., Chen, F., Jiang, M., Zhang, J., Yang, Y., et al. (2016) Association between Premature Ovarian Failure, Polymorphisms in MTHFR and MTRR Genes and Serum Homocysteine Concentration. Reproductive BioMedicine Online, 32, 407-413. [Google Scholar] [CrossRef] [PubMed]
[10] Shi, Q., Liu, R. and Chen, L. (2022) Ferroptosis Inhibitor Ferrostatin-1 Alleviates Homocysteine-Induced Ovarian Granulosa Cell Injury by Regulating TET Activity and DNA Methylation. Molecular Medicine Reports, 25, Article No. 130. [Google Scholar] [CrossRef] [PubMed]
[11] Lu, X., Lv, X., Dong, X., Li, Y., Turathum, B., Liu, S., et al. (2023) Increased Serine Synthesis in Cumulus Cells of Young Infertile Women with Diminished Ovarian Reserve. Human Reproduction (Oxford, England), 38, 1723-1732. [Google Scholar] [CrossRef] [PubMed]
[12] Fernstrom, J.D. (2005) Branched-Chain Amino Acids and Brain Function. The Journal of Nutrition, 135, 1539S-1546S. [Google Scholar] [CrossRef] [PubMed]
[13] Kansaku, K., Itami, N., Kawahara-Miki, R., Shirasuna, K., Kuwayama, T. and Iwata, H. (2017) Differential Effects of Mitochondrial Inhibitors on Porcine Granulosa Cells and Oocytes. Theriogenology, 103, 98-103. [Google Scholar] [CrossRef] [PubMed]
[14] Fontana, J., Martínková, S., Petr, J., Žalmanová, T. and Trnka, J. (2020) Metabolic Cooperation in the Ovarian Follicle. Physiological Research, 69, 33-48. [Google Scholar] [CrossRef] [PubMed]
[15] Munakata, Y., Kawahara-Miki, R., Shiratsuki, S., Tasaki, H., Itami, N., Shirasuna, K., et al. (2016) Gene Expression Patterns in Granulosa Cells and Oocytes at Various Stages of Follicle Development as Well as in in Vitro Grown Oocyte-and-Granulosa Cell Complexes. Journal of Reproduction and Development, 62, 359-366. [Google Scholar] [CrossRef] [PubMed]
[16] Zhang, X., Zhang, W., Wang, Z., Zheng, N., Yuan, F., Li, B., et al. (2022) Enhanced Glycolysis in Granulosa Cells Promotes the Activation of Primordial Follicles through mTOR Signaling. Cell Death & Disease, 13, Article No. 87. [Google Scholar] [CrossRef] [PubMed]
[17] Shiratsuki, S., Hara, T., Munakata, Y., Shirasuna, K., Kuwayama, T. and Iwata, H. (2016) Low Oxygen Level Increases Proliferation and Metabolic Changes in Bovine Granulosa Cells. Molecular and Cellular Endocrinology, 437, 75-85. [Google Scholar] [CrossRef] [PubMed]
[18] Zhang, Z., Ren, S., Yang, W., Xu, X., Zhao, S., Fang, K., et al. (2025) AARS2-Catalyzed Lactylation Induces Follicle Development and Premature Ovarian Insufficiency. Cell Death Discovery, 11, Article No. 209. [Google Scholar] [CrossRef] [PubMed]
[19] Shang, Y., Li, Y., Han, D., Deng, K., Gao, W. and Wu, M. (2025) LRRC4 Deficiency Drives Premature Ovarian Insufficiency by Disrupting Metabolic Homeostasis in Granulosa Cells. Advanced Science, 12, Article ID: 2417717. [Google Scholar] [CrossRef] [PubMed]
[20] Zhao, S., Liu, H., Liu, Y., Wu, J., Wang, C., Hou, X., et al. (2013) miR-143 Inhibits Glycolysis and Depletes Stemness of Glioblastoma Stem-Like Cells. Cancer Letters, 333, 253-260. [Google Scholar] [CrossRef] [PubMed]
[21] Cao, J., Huo, P., Cui, K., Wei, H., Cao, J., Wang, J., et al. (2022) Correction: Follicular Fluid-Derived Exosomal miR-143-3p/miR-155-5p Regulate Follicular Dysplasia by Modulating Glycolysis in Granulosa Cells in Polycystic Ovary Syndrome. Cell Communication and Signaling, 20, Article No. 61. [Google Scholar] [CrossRef] [PubMed]
[22] Li, Z., Zhang, M., Zheng, J., Tian, Y., Zhang, H., Tan, Y., et al. (2021) Human Umbilical Cord Mesenchymal Stem Cell-Derived Exosomes Improve Ovarian Function and Proliferation of Premature Ovarian Insufficiency by Regulating the Hippo Signaling Pathway. Frontiers in Endocrinology, 12, Article ID: 711902. [Google Scholar] [CrossRef] [PubMed]
[23] Zhang, S., Zou, X., Feng, X., Shi, S., Zheng, Y., Li, Q., et al. (2025) Exosomes Derived from Hypoxic Mesenchymal Stem Cell Ameliorate Premature Ovarian Insufficiency by Reducing Mitochondrial Oxidative Stress. Scientific Reports, 15, Article No. 8235. [Google Scholar] [CrossRef] [PubMed]
[24] Li, W., Lu, M., Shang, J., Zhou, J., Lin, L., Liu, Y., et al. (2024) Hypoxic Mesenchymal Stem Cell-Derived Exosomal circDennd2a Regulates Granulosa Cell Glycolysis by Interacting with LDHA. Stem Cell Research & Therapy, 15, Article No. 484. [Google Scholar] [CrossRef] [PubMed]
[25] Yin, J.Q., Zhu, J. and Ankrum, J.A. (2019) Manufacturing of Primed Mesenchymal Stromal Cells for Therapy. Nature Biomedical Engineering, 3, 90-104. [Google Scholar] [CrossRef] [PubMed]
[26] Chang, Y., Yang, Y., Tien, C., Yang, C. and Hsiao, M. (2018) Roles of Aldolase Family Genes in Human Cancers and Diseases. Trends in Endocrinology & Metabolism, 29, 549-559. [Google Scholar] [CrossRef] [PubMed]
[27] Li, D., Wang, X., Li, G., Dang, Y., Zhao, S. and Qin, Y. (2021) LncRNA ZNF674-AS1 Regulates Granulosa Cell Glycolysis and Proliferation by Interacting with ALDOA. Cell Death Discovery, 7, Article No. 107. [Google Scholar] [CrossRef] [PubMed]
[28] Tao, X., Cai, L., Chen, L., Ge, S. and Deng, X. (2019) Effects of Metformin and Exenatide on Insulin Resistance and AMPKα-SIRT1 Molecular Pathway in PCOS Rats. Journal of Ovarian Research, 12, Article No. 86. [Google Scholar] [CrossRef] [PubMed]
[29] Zhang, S., Tu, H., Yao, J., Le, J., Jiang, Z., Tang, Q., et al. (2020) Combined Use of Diane-35 and Metformin Improves the Ovulation in the PCOS Rat Model Possibly via Regulating Glycolysis Pathway. Reproductive Biology and Endocrinology, 18, Article No. 58. [Google Scholar] [CrossRef] [PubMed]
[30] Jalil, A.T., Zair, M.A., Hanthal, Z.R., Naser, S.J., Aslandook, T., Abosaooda, M., et al. (2023) Role of the AMP-Activated Protein Kinase in the Pathogenesis of Polycystic Ovary Syndrome. Indian Journal of Clinical Biochemistry, 39, 450-458. [Google Scholar] [CrossRef] [PubMed]
[31] Huang, L., Liang, A., Li, T., Lei, X., Chen, X., Liao, B., et al. (2022) Mogroside V Improves Follicular Development and Ovulation in Young-Adult PCOS Rats Induced by Letrozole and High-Fat Diet through Promoting Glycolysis. Frontiers in Endocrinology, 13, Article ID: 838204. [Google Scholar] [CrossRef] [PubMed]
[32] Dunning, K.R., Cashman, K., Russell, D.L., Thompson, J.G., Norman, R.J. and Robker, R.L. (2010) Beta-Oxidation Is Essential for Mouse Oocyte Developmental Competence and Early Embryo Development. Biology of Reproduction, 83, 909-918. [Google Scholar] [CrossRef] [PubMed]
[33] Zhuan, Q., Ma, H., Chen, J., Luo, Y., Luo, Y., Gao, L., et al. (2020) Cytoplasm Lipids Can Be Modulated through Hormone-Sensitive Lipase and Are Related to Mitochondrial Function in Porcine IVM Oocytes. Reproduction, Fertility and Development, 32, Article No. 667. [Google Scholar] [CrossRef] [PubMed]
[34] Foster, D.W. (2012) Malonyl-CoA: The Regulator of Fatty Acid Synthesis and Oxidation. Journal of Clinical Investigation, 122, 1958-1959. [Google Scholar] [CrossRef] [PubMed]
[35] Gilchrist, R.B., Luciano, A.M., Richani, D., Zeng, H.T., Wang, X., Vos, M.D., et al. (2016) Oocyte Maturation and Quality: Role of Cyclic Nucleotides. Reproduction, 152, R143-R157. [Google Scholar] [CrossRef] [PubMed]
[36] Jaffe, L.A. and Egbert, J.R. (2017) Regulation of Mammalian Oocyte Meiosis by Intercellular Communication within the Ovarian Follicle. Annual Review of Physiology, 79, 237-260. [Google Scholar] [CrossRef] [PubMed]
[37] Downs, S.M., Mosey, J.L. and Klinger, J. (2009) Fatty Acid Oxidation and Meiotic Resumption in Mouse Oocytes. Molecular Reproduction and Development, 76, 844-853. [Google Scholar] [CrossRef] [PubMed]
[38] Zhu, H., Wu, Y., Zhuang, Z., Xu, J., Chen, F., Wang, Q., et al. (2024) Ampelopsis Japonica Aqueous Extract Improves Ovulatory Dysfunction in PCOS by Modulating Lipid Metabolism. Biomedicine & Pharmacotherapy, 170, Article ID: 116093. [Google Scholar] [CrossRef] [PubMed]
[39] CN118948837 Application of Artemisinin to Treatment of Polycystic Ovarian Syndrome by Regulating AMPK to Promote White Fat Browning [Internet].
https://patentscope.wipo.int/search/en/detail.jsf?docId=CN443425594
[40] Hashimoto, S. (2009) Application of in Vitro Maturation to Assisted Reproductive Technology. Journal of Reproduction and Development, 55, 1-10. [Google Scholar] [CrossRef] [PubMed]
[41] Wu, L.L., Dunning, K.R., Yang, X., Russell, D.L., Lane, M., Norman, R.J., et al. (2010) High-Fat Diet Causes Lipotoxicity Responses in Cumulus-Oocyte Complexes and Decreased Fertilization Rates. Endocrinology, 151, 5438-5445. [Google Scholar] [CrossRef] [PubMed]
[42] Wu, L.L., Russell, D.L., Norman, R.J. and Robker, R.L. (2012) Endoplasmic Reticulum (ER) Stress in Cumulus-Oocyte Complexes Impairs Pentraxin-3 Secretion, Mitochondrial Membrane Potential (δψm), and Embryo Development. Molecular Endocrinology, 26, 562-573. [Google Scholar] [CrossRef] [PubMed]
[43] Hemmings, K.E., Maruthini, D., Vyjayanthi, S., Hogg, J.E., Balen, A.H., Campbell, B.K., et al. (2013) Amino Acid Turnover by Human Oocytes Is Influenced by Gamete Developmental Competence, Patient Characteristics and Gonadotrophin Treatment. Human Reproduction, 28, 1031-1044. [Google Scholar] [CrossRef] [PubMed]
[44] Alborzi, P., et al. (2020) Incorporation of Arginine, Glutamine or Leucine in Culture Medium Accelerates in Vitro Activation of Primordial Follicles in 1-Day-Old Mouse Ovary. Zygote (Cambridge, England), 1-8.
https://pubmed.ncbi.nlm.nih.gov/32482183/
[45] Moslehi, N., Mirmiran, P., Marzbani, R., Rezadoost, H., Mirzaie, M., Azizi, F., et al. (2020) Serum Metabolomics Study of Women with Different Annual Decline Rates of Anti-Müllerian Hormone: An Untargeted Gas Chromatography-Mass Spectrometry-Based Study. Human Reproduction, 36, 721-733. [Google Scholar] [CrossRef] [PubMed]
[46] Zhenyukh, O., Civantos, E., Ruiz-Ortega, M., Sánchez, M.S., Vázquez, C., Peiró, C., et al. (2017) High Concentration of Branched-Chain Amino Acids Promotes Oxidative Stress, Inflammation and Migration of Human Peripheral Blood Mononuclear Cells via mTORC1 Activation. Free Radical Biology and Medicine, 104, 165-177. [Google Scholar] [CrossRef] [PubMed]
[47] Adhikari, D. and Liu, K. (2010) mTOR Signaling in the Control of Activation of Primordial Follicles. Cell Cycle, 9, 1673-1674. [Google Scholar] [CrossRef] [PubMed]
[48] Guo, X., Zhu, Y., Guo, L., Qi, Y., Liu, X., Wang, J., et al. (2023) BCAA Insufficiency Leads to Premature Ovarian Insufficiency via Ceramide‐Induced Elevation of ROS. EMBO Molecular Medicine, 15, e17450. [Google Scholar] [CrossRef] [PubMed]