Study of Correlation between Insulin Resistance and Glycolytic Metabolism and Occurrence of Endometrial Polyps
Objective:To explore the relationship between the occurrence of endometrial polyps(EP)and endometrial local insulin resistance and glycolytic metabolism.Methods:From Jun 2023 to Feb 2024,230 patients diagnosed with EP and underwent hysteroscopic surgery were enrolled in the Department of Gynecology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,and 220 patients with non-EP were studied.OGTT and insulin release assays were performed to compare the differences in glucose metabolism and insulin resistance between the two groups.EP tissues and surrounding normal endometrial tissues were extracted from EP patients,and the differences in PI3K/Akt signaling pathway,expression levels of Glut4 protein,glycolytic enzymes and intermediate products were compared.Results:The levels of FPG,OGTT 2h,FINS,1hINS,2hINS and HOMA-IR in the EP group were significantly higher than those in the non-EP group(all P<0.05).In EP patients,compared with the normal endometrium,the expression of insulin-induced kinases p-AKT(Ser473)and p-PI3K(Tyr458)were up-regulated,p-IRS1(Ser307)and glucose transporter Glut4 were down-regulated,and the expression of glycolysis metabolism-regulated proteins Hexo I,Hexo Ⅱ,PKM1/2 and PFKP were decreased.However,the expression of LDHA was increased(all P<0.05).Conclusions:Peripheral blood insulin resistance is present in patients with EP.Glut4 induces local insulin resistance and glycolytic metabolic dysfunction of the endometrium,which may lead to EP formation.
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