Abstract
Polycystic ovarian syndrome (PCOS) is a common, complex, and heterogeneous endocrine and metabolic disorder. There is no standardized treatment, and it therefore requires individualized therapies according to the symptoms and pathogenesis of each patient. The present study aimed to determine the effect of electroacupuncture at the acupoints Zusanli (ST36), Sanyinjiao (SP6), and Neiguan (PC6) on reproductive disorders and insulin resistance in a murine model of PCOS induced by dehydroepiandrosterone (DHEA). Vaginal smear analysis was used to determine mice estrous cycle; intraperitoneal glucose and insulin tolerance tests were adopted to analyze metabolic characteristics; enzyme-linked immunosorbent assay was used to measure hormone levels; gene expression was quantified with real-time PCR; hematoxylin and eosin staining was used to observe ovarian morphology. We observed disordered estrous cycle, polycystic ovarian morphology, and higher levels of homeostasis model assessment-insulin resistance (HOMA-IR) and testosterone (T), indicating successful modeling of PCOS. DHEA increased levels of estrogen (E2), progesterone (P), testosterone (T), luteinizing hormone (LH), and follicle-stimulating hormone (FSH), and EA treatment restored them to levels seen in the control group. EA reduced the days in estrus caused by DHEA, improved the abnormal sex hormone receptor genes, and attenuated the DHEA-induced histomorphological changes in mouse ovaries. The average expressions of the androgen receptor (AR), estrogen receptor (ER), luteinizing hormone receptor (LHR), and follicle-stimulating hormone receptor (FSHR) genes in the ovary greatly increased after DHEA treatment and significantly decreased in the DHEA + EA group. After EA treatment, the cystic follicle (CF) number was reduced and corpora lutea (CL) increased in the DHEA + EA group compared to the DHEA group. EA improved glucose intolerance and insulin intolerance. Statistical analysis of intraperitoneal glucose tolerance test-area under curve (IPGTT-AUC) glucose levels revealed a significant decrease in DHEA group mice compared to the control and DHEA + EA groups. EA was found to restore fasting blood glucose, fasting serum insulin, and HOMA-IR. In summary, our study suggests that EA has a remarkable effect in the DHEA-induced murine PCOS model. Management of EA could improve estrous cycle, hormonal disorders, abnormal sex hormone receptors in ovaries, ovary morphology, and insulin resistance in PCOS mice.
Highlights
Polycystic ovarian syndrome (PCOS) is a common but complex and heterogeneous endocrine and metabolic disorder characterized by anovulation or oligoovulation, hyperandrogenism, and polycystic ovarian morphology [1,2,3,4]
Evidence-Based Complementary and Alternative Medicine level, progesterone is not able to regulate the secretion of gonadotropin-releasing hormone (GnRH) as it does in women without PCOS [7]. e ovarian theca cells secrete higher levels of androgen because of the increased luteinizing hormone (LH)
Research has shown that insulin resistance (IR) and obesity have a close linkage with PCOS; clinical manifestations of PCOS are more apparent in patients with IR and obesity [12,13,14]. e relationship between PCOS and IR is still unknown, and further research is required. ere are currently no effective cures for PCOS. e development of new therapies with increased effectiveness and fewer side effects remains an urgent need
Summary
Polycystic ovarian syndrome (PCOS) is a common but complex and heterogeneous endocrine and metabolic disorder characterized by anovulation or oligoovulation, hyperandrogenism, and polycystic ovarian morphology [1,2,3,4]. Women with PCOS have more frequent pulses of gonadotropin-releasing hormone (GnRH) and luteinizing hormone (LH), as well as an increased LH/follicle-stimulating hormone (FSH) ratio. The ovaries of PCOS patients have numerous antral follicles; the etiology needs further research. Reactive oxygen species (ROS) induced by PCOS could cause ovarian damage, and some reports have shown that antioxidants have a positive effect on ovaries [8, 9]. Reports show that PCOS is closely associated with hypothalamus-pituitary-ovarian axis dysfunction, hyperandrogenism, insulin resistance (IR), hyperinsulinemia, and type II diabetes [10, 11]. Research has shown that IR and obesity have a close linkage with PCOS; clinical manifestations of PCOS are more apparent in patients with IR and obesity [12,13,14]. Research has shown that IR and obesity have a close linkage with PCOS; clinical manifestations of PCOS are more apparent in patients with IR and obesity [12,13,14]. e relationship between PCOS and IR is still unknown, and further research is required. ere are currently no effective cures for PCOS. e development of new therapies with increased effectiveness and fewer side effects remains an urgent need
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