肥胖相关女性不孕中的膳食脂肪酸谱:机制与生殖意义
Dietary fatty acid profiles in obesity-associated female infertility: mechanisms and reproductive implications
摘要
该文系统检索2017—2026年PubMed等数据库的699条记录,纳入82项人类观察、动物实验和体外机制研究,以叙述性综述梳理饱和、单不饱和及多不饱和脂肪酸对肥胖相关不孕中卵母细胞能力、类固醇生成和早期胚胎发育的影响。结果显示,棕榈酸和硬脂酸经内质网与线粒体应激损伤卵母细胞成熟和囊胚形成;油酸可缓冲脂毒性但过量抑制CYP19A1并激活NLRP3/IL-1β;ω-3与花生四烯酸竞争COX-2,ω-6来源前列腺素支持排卵和着床。结论提示减少棕榈酸、适度油酸、增加EPA/DHA并限制ω-6过量,可作为孕前营养和辅助生殖的干预思路。
原文摘要
BACKGROUND: Dietary fatty acids are membrane components and lipid mediator precursors in the ovarian microenvironment. It is currently unclear how their composition determines the reproductive outcome in obesity-related infertility. AIMS: To map how saturated, monounsaturated and polyunsaturated fatty acids and their proportions affect oocyte competence, steroidogenesis and early embryonic development under obesity and high-fat diets. METHODS: The system retrieved English-language literature published from January 1, 2017 to September 30, 2026 in PubMed, Web of Science, Cochrane Library and Scopus. Predefined keywords for fatty acid types, reproductive outcomes and metabolic background were used, supplemented by manual searches. Two reviewers independently screened the titles, abstracts and full texts according to the pre-defined inclusion and exclusion criteria; eligible evidence included observational studies in humans, animal experiments and in vitro mechanism studies. Results were presented in a narrative summary; due to significant heterogeneity, no meta-analysis was conducted. RESULTS: A total of 699 retrieval records were identified, among which 82 studies met the inclusion criteria and were included in the data extraction. The analysis of these studies showed that the effect direction depended on the type of fatty acid and the context, rather than any single fatty acid: palmitic acid and stearic acid caused damage to oocyte maturation and blastocyst formation through endoplasmic reticulum stress (IRE1-XBP1) and mitochondrial stress (ceramide-AMPK/SIRT3). Oleic acid buffered lipid toxicity through lipid droplets, but excessive amounts inhibited CYP19A1 steroid synthesis and activated NLRP3/IL-1β. Omega-3 competed with arachidonic acid at COX-2 and exerted effects through NF-κB, Nrf2/GPX4 and GPR120, while omega-6-derived prostaglandins supported ovulation and implantation. CONCLUSION: Reducing palmitic acid, moderating oleic acid, increasing EPA and DHA and limiting omega-6 excess opens a non-pharmacological route, informing preconception nutrition in obesity and PCOS, refining assisted reproduction, and guiding ratio-based trials.
推荐理由:系统整合了不同膳食脂肪酸影响卵母细胞与早期胚胎的机制通路,对肥胖/PCOS患者孕前营养和ART策略有参考价值;但属叙述性综述、异质性大未做meta分析,证据等级有限。
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收录来源(3)
- 11-08 11:43PubMed · 辅助生殖临床
- 11-08 11:43PubMed · 配子与性腺
- 11-08 11:44PubMed · 生殖内分泌/遗传/保存