Influence of dehydroepiandrosterone sulphate levels on the slower age-related decline in grey matter in younger women with polycystic ovary syndrome.

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI:10.1093/braincomms/fcaf052
Mei-Jou Chen, Chang-Le Chen, Yu-Yuan Chang, Chu-Chun Huang, Wen-Chau Wu, Hong-Nerng Ho, Wen-Yih Isaac Tseng
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Abstract

Polycystic ovary syndrome (PCOS) is characterized by excess androgens, ovulatory disorders and a higher prevalence of obesity and metabolic disturbances including Type 2 diabetes, hyperlipidaemia and hypertension, some of which are risk factors for neurodegenerative disorders such as Alzheimer's disease and brain atrophy. However, it is unclear whether brain ageing occurs more rapidly in women with PCOS compared with those without PCOS. Except for the hypothalamic-pituitary-gonadal axis involved in the conventional ovulatory process, little is known regarding the role of the grey matter in the pathogenesis of PCOS, and limited existing studies examining brain structures in PCOS have shown inconsistent results. This case-control study aimed to investigate the age-related differences in total and regional brain grey matter volume and average cortical thickness in young women with and without PCOS by using brain magnetic resonance imaging to understand whether women with PCOS exhibit distinctive patterns of brain ageing, and their association with factors including obesity, hyperandrogenism and metabolic disturbances. Seventy-six women diagnosed with PCOS and 68 age-matched women without PCOS (aged 20-35 years) underwent brain magnetic resonance imaging to measure grey matter volume and cortical thickness. Anthropometric, hormonal and metabolic measurements were conducted to assess their associations with the investigated brain structures. In women without PCOS, increasing age was significantly correlated with a decrease in global grey matter volume (r = -0.5598, P < 0.0001), while this association was not significant in women with PCOS (r = -0.1475, P = 0.204). The decline in grey matter volume with age differed significantly between the two groups regardless of obesity (body mass index exceeding 25 kg/m2), especially in the frontal, parietal, occipital and temporal regions. After adjusting for dehydroepiandrosterone sulphate (DHEAS) levels, the negative association between age and global grey matter volume became statistically significant in women with PCOS. Increasing age was also significantly associated with a decrease in global cortical thickness in women without PCOS, but not in women with PCOS. Such negative association between global cortical thickness and age was particularly stronger in women with obesity compared with those without. The negative association between age and global cortical thickness in women with PCOS became pronounced after adjusting for DHEAS levels. Women with PCOS experience a milder grey matter loss with age compared with women without PCOS. The neuroprotective effect of high DHEAS levels in women with PCOS may be implicated in this relationship.

脱氢表雄酮硫酸盐水平对多囊卵巢综合征年轻女性灰质年龄相关性下降的影响
多囊卵巢综合征(PCOS)的特点是雄激素过量、排卵障碍、肥胖和代谢紊乱(包括2型糖尿病、高脂血症和高血压)的较高患病率,其中一些是神经退行性疾病(如阿尔茨海默病和脑萎缩)的危险因素。然而,目前尚不清楚多囊卵巢综合征女性的大脑衰老是否比非多囊卵巢综合征女性更快。除了下丘脑-垂体-性腺轴参与常规的排卵过程外,关于灰质在多囊卵巢综合征发病机制中的作用知之甚少,现有的关于多囊卵巢综合征大脑结构的研究也显示出不一致的结果。本病例对照研究旨在通过脑磁共振成像研究PCOS年轻女性和非PCOS女性脑灰质体积和平均皮质厚度的年龄相关性差异,以了解PCOS女性是否表现出独特的脑衰老模式,以及其与肥胖、高雄激素症和代谢紊乱等因素的关系。76名诊断为多囊卵巢综合征的女性和68名年龄匹配的非多囊卵巢综合征女性(年龄在20-35岁)接受了脑磁共振成像测量灰质体积和皮质厚度。人体测量学、激素和代谢测量被用来评估它们与所研究的大脑结构的关系。在未患PCOS的女性中,年龄的增加与灰质体积的减少显著相关(r = -0.5598, P < 0.0001),而在患有PCOS的女性中,这种关联不显著(r = -0.1475, P = 0.204)。无论肥胖与否(体重指数超过25 kg/m2),两组灰质体积随年龄的下降均有显著差异,尤其是在额、顶叶、枕和颞叶区域。在调整了脱氢表雄酮硫酸盐(DHEAS)水平后,年龄与总体灰质体积之间的负相关在PCOS女性中具有统计学意义。在无PCOS的女性中,年龄的增加也与皮质厚度的减少显著相关,而在有PCOS的女性中则没有。与没有肥胖的女性相比,肥胖女性的大脑皮质厚度与年龄之间的这种负相关关系尤为明显。在调整DHEAS水平后,PCOS女性的年龄和整体皮质厚度之间的负相关变得明显。与未患多囊卵巢综合征的女性相比,患有多囊卵巢综合征的女性随着年龄的增长,灰质的减少程度较轻。高DHEAS水平对多囊卵巢综合征女性的神经保护作用可能与此有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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