期刊
METABOLISM-CLINICAL AND EXPERIMENTAL
卷 64, 期 1, 页码 79-91出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.metabol.2014.10.013
关键词
Leptin; Reproduction; Puberty; Pregnancy; PCOS
资金
- Ministerio de Economia and Competitividad, Spain [BFU 2008-00984, BFU2011-25021]
- Junta de Andalucia, Spain [P08-CVI-03788, P12-FQM-01943]
- Institut de Salud Carlos III (Red de Centros RCMN) [C03/08, PI042082]
- Ministerio de Sanidad, Spain
- EU [DEER FP7-ENV-2007-1]
As an essential function for perpetuation of species, reproduction, including puberty onset, is sensitive to the size of body energy stores, and the metabolic state of the organism. Accordingly, impaired energy homeostasis; ranging from extreme leanness, such as in anorexia or cachexia, to morbid obesity has an impact on the timing of puberty and is often associated to fertility problems. The neuroendocrine basis for such phenomenon is the close connection between numerous metabolic hormones and nutritional cues with the various elements of the so-called hypothalamic-pituitary-gonadal (HPG) axis. Yet, despite previous fragmentary knowledge, it was only the discovery of the adipose-hormone, leptin, in 1994 what revolutionized our understanding on how metabolic and reproductive systems closely interplay and allowed the definition of the neurohormonal causes of perturbations of puberty and fertility in conditions of impaired body energy homeostasis. In this article, we aim to provide a synoptic view of the mechanisms whereby leptin engages in the regulation of different elements of the HPG axis, with special attention to its effects and mechanisms of action on the different elements of the reproductive brain and its proven direct effects in the gonads. In addition, we will summarize the state-of-the-art regarding the putative roles of leptin during gestation, including its potential function as placental hormone. Finally, comments will be made on the eventual leptin alterations in reproductive disorders, with special attention to the polycystic ovary syndrome (PCOS), a disease in which reproductive, metabolic and neuroendocrine alterations are commonly observed. All in all, we intend to provide an updated account of our knowledge on the physiological roles of leptin in the metabolic regulation of the reproductive axis and its eventual pathophysiological implications in prevalent reproductive disorders, such as PCOS. (C) 2015 Elsevier Inc. All rights reserved.
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