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子宫内膜糖原代谢在胚胎着床中的作用研究进展

马永丹, 王翊丞, 岳利民^*

四川大学华西基础医学与法医学院生理学教研室，成都 610041

摘要

糖原的合成与分解可动态调节体内葡萄糖含量以维持细胞内变化的能量需求。胰岛素作为体内唯一降血糖的激素，通过作用于磷脂酰肌醇3-激酶(phosphatidylinositol 3-kinase, PI3K)/蛋白激酶B (Akt)信号通路，促进葡萄糖转运体转位以促进糖原合成，也可抑制糖异生以降低血糖。而子宫内膜糖代谢有其特殊性，不发生糖异生，尚未被利用的葡萄糖均以糖原形式储存。子宫内膜的糖原代谢除受经典糖代谢激素调控外，还受卵巢激素调控。子宫内膜在着床窗口期发生的与着床有关的功能活动都需要葡萄糖供给能量。着床前子宫内膜上皮细胞内大量葡萄糖合成糖原，在着床窗口期分解为葡萄糖，以满足增加的能量需求，保证胚胎着床的顺利进行。糖尿病时子宫内膜糖原代谢受损，糖原合成或分解异常可导致胚胎着床失败、早期流产。本文就子宫内膜的糖原代谢及其在胚胎着床中的作用等方面进行综述，以期为胚胎着床的研究及不孕诊断和治疗提供新思路。

关键词： 糖原; 胰岛素; 子宫内膜; 胚胎着床; 糖尿病

Progress in the role of endometrial glucose metabolism in embryo implantation 

MA Yong-Dan, WANG Yi-Cheng, YUE Li-Min^*

Department of Physiology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, China

Abstract

The synthesis and decomposition of glycogen adjust the blood glucose dynamically to maintain the energy supply required by the cells. As the only hormone that lowers blood sugar in the body, insulin can promote glycogen synthesis by activating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway and increasing glucose transporter translocation, and inhibit gluconeogenesis to lower blood glucose. In the endometrium, glycogen metabolism is active, but gluconeogenesis does not occur. The glycogen metabolism in the endometrium is controlled not only by the classical glucose regulating hormones, but also by the ovarian hormones. The functional activities related to implantation of the endometrium during the implantation window require glucose as energy source. A large amount of glucose is used to synthesize glycogen in the endometrium before implantation, which could meet the increased energy demand for embryo implantation. In diabetes, glycogen metabolism in the endometrium is impaired, which frequently leads to implantation failure and early abortion. This article reviews the glycogen metabolism in the endometrium and discusses its role in embryo implantation, which provide new ideas for embryo implantation research and infertility treatment.

Key words: Glycogen; insulin; endometrium; embryo implantation; diabetes

收稿日期：　　录用日期：

通讯作者：岳利民　　E-mail: yuelimin@scu.edu.cn

DOI: 10.13294/j.aps.2022.0020

引用本文：

马永丹, 王翊丞, 岳利民. 子宫内膜糖原代谢在胚胎着床中的作用研究进展[J]. 生理学报 2022; 74 (2): 255-264.

MA Yong-Dan, WANG Yi-Cheng, YUE Li-Min. Progress in the role of endometrial glucose metabolism in embryo implantation . Acta Physiol Sin 2022; 74 (2): 255-264 (in Chinese with English abstract).