多囊卵巢综合征（Polycystic Ovary Syndrome，PCOS）是一种复杂的妇科内分泌代谢性疾病，流行病学 显示全球约14%~19%的女性受其影响，且从生殖健康延伸至代谢与心理健康。 多囊卵巢综合征是什么 超声检查显示"卵巢多囊样改变"，并不等于"多囊卵巢综合征（PCOS）"，卵巢的多囊样改变只是一种 影像学上的表现，并不一定导致疾病。而多囊卵巢综合征（PCOS）则是一种妇科内分泌代谢性疾病， 临床表现主要包括以下几点：月经不规则；高雄激素；代谢异常、肥胖；不孕，且怀孕后早期流产率也 明显升高；黑棘皮症；情感障碍（少部分患者）。 药物治疗可选择，口服避孕药、孕激素后半周期疗法等调整月经周期相关药物（注意药物禁忌及长期使 用相关风险）；胰岛素增敏剂二甲双胍等改善胰岛素抵抗相关药物；糖皮质类固醇、螺内酯、环丙孕酮 等降低雄激素水平药物；对于有生育要求的女性，在上述治疗基础上，可使用诱发排卵药物如来曲唑、 氯米芬等药物来促进排卵，但需注意卵巢过度刺激。治疗期间建议多参加户外活动，感受自然的风光。 专家点评 这是一篇兼具专业深度与科普温度的优秀文章，精准厘清"卵巢多囊样改变"与"多囊卵巢综合征 （PCO ...

Core Viewpoint - The study identifies pyruvate kinase M2 (PKM2) as a transcriptional regulator contributing to polycystic ovary syndrome (PCOS), highlighting its potential as a therapeutic target [4][7]. Group 1: Research Findings - The research team discovered that elevated lactylation levels of histone H3 at lysine 9/18 (H3K9/K18) are associated with PKM2 and genomic binding, altering the three-dimensional structure of the genome [4]. - In mice, ectopic expression of Pkm2 in follicular granulosa cells consistently exhibited PCOS-like characteristics, such as disrupted estrous cycles and hyperandrogenism [5]. - Pharmacological inhibition of PKM2 aggregation in the nucleus alleviated PCOS-like symptoms in mice and restored the transcriptome to wild-type levels [5]. Group 2: Implications - The study emphasizes the significant role of PKM2-mediated histone lactylation in regulating three-dimensional chromatin structure, suggesting its potential as a therapeutic target for PCOS [7].

撰文丨王聪 编辑丨王多鱼 排版丨水成文 多囊卵巢综合征 （PCOS） 是育龄女性中最常见的内分泌紊乱疾病，具有高度遗传性，但我们对其多基因结构仍知之甚少。 2025 年 11 月 4 日，中国科学院脑科学与智能技术卓越创新中心 师咏勇 团队联合山东大学/ 生殖医学与子代健康全国重点实验室 赵涵 教授、 青岛大学/青岛大 学附属医院 李志强 教授、安徽医科大学 曹云霞 教授等，在 Nature Genetics 期刊发表了题为： Multi-ancestry genome-wide association analyses of polycystic ovary syndrome 的研究论文。 在这项最新研究中，研究团队对 12419 名中国 多囊卵巢综合征 （PCOS） 患者和 34235 名对照者进行了全基因组关联研究 （GWAS） ，随后与多达 13773 名欧洲病例和 411088 名对照者进行了多祖先荟萃分析，进而确定了 94 个独立遗传位点，其中 73 个此前未被报道。 该研究发现，尽管进化压力不同，但中国和欧洲血统显示出大量的遗传重叠。功能注释发现， AMH 基因上的错义突变 rs10407022 ...

Core Viewpoint - The article discusses a groundbreaking study on Polycystic Ovary Syndrome (PCOS), identifying four distinct subtypes through AI-driven analysis, which can significantly enhance clinical diagnosis and treatment options for affected women [2][3][6]. Summary by Sections Study Overview - A research team led by Chen Zijiang from Shandong University published a study in Nature Medicine, collaborating with 11 international teams, focusing on the clinical outcomes associated with different PCOS subtypes [2][3]. Identification of Subtypes - The study identified four PCOS subtypes: 1. High Androgen PCOS (HA-PCOS) 2. Obesity PCOS (OB-PCOS) 3. High SHBG PCOS (SHBG-PCOS) 4. High LH/AMH PCOS (LH-PCOS) - This classification was based on nine clinical indicators derived from a large dataset of 11,908 PCOS patients [3][7][9]. Clinical Implications - The research revealed significant differences in reproductive and metabolic outcomes among the identified subtypes, providing evidence for more personalized treatment approaches [3][10]. - The study highlighted that women with PCOS are three times more likely to be obese and have a fourfold increased risk of developing type 2 diabetes before age 40 [5]. Tools for Clinical Application - The research team developed two practical tools, PcosX and a WeChat mini-program for subtype prediction, aimed at facilitating the application of their findings in clinical settings [12]. Longitudinal Findings - A 6.5-year follow-up showed varying reproductive and metabolic trajectories among the subtypes, with HA-PCOS patients experiencing the highest mid-pregnancy loss risk and OB-PCOS patients facing the most severe metabolic complications [10][11]. Validation of Findings - The subtypes demonstrated strong validation across diverse populations, indicating the robustness and applicability of the new classification system [9].

Core Viewpoint - GLP-1 receptor agonists show promise in alleviating symptoms related to Polycystic Ovary Syndrome (PCOS), such as irregular menstruation and weight gain, despite not being FDA-approved for this indication yet [2][5]. Group 1: GLP-1 Receptor Agonists and PCOS - Clinical data indicates that patients with PCOS treated with semaglutide experience significant weight loss and symptom improvement, with fewer adverse reactions [2][6]. - Women with PCOS report benefits from GLP-1 drugs like semaglutide (Wegovy) and tirzepatide (Zepbound), including restored menstrual cycles, reduced pain, and improvements in weight, anxiety, depression, and even hair loss [2][5]. - A study published in 2023 evaluated semaglutide's effects on 27 obese women with PCOS, showing an average weight loss of 7.6 kg and a 3.1 decrease in BMI after three months [5][6]. Group 2: PCOS Overview and Treatment - PCOS is a hormonal disorder affecting ovarian function, characterized by irregular menstruation, elevated androgen levels, and polycystic ovaries, potentially leading to fertility issues, hair loss, weight gain, and acne [4]. - There is a significant unmet need for effective PCOS treatments, as the primary treatment methods have remained unchanged for nearly 50 years [5]. - Early diagnosis and intervention are crucial due to the risk of insulin resistance and related complications, including cardiovascular disease and type 2 diabetes [5]. Group 3: Research and Future Directions - Further large-scale and long-term studies are needed to understand the comprehensive effects of GLP-1 drugs on PCOS symptoms, including potential differences in efficacy across age groups and drug types [7]. - Accessibility to these medications remains a challenge, as insurance may not cover their use for non-approved indications, particularly during drug shortages or policy changes [7].