Evidence map›Paper›PMID 42760541›Full record

ArticleJournal of ovarian research2026

Hypothalamic Epac2/AKT/GnRH signalling is associated with metformin-responsive neuroendocrine improvement in a PCOS model.

Na Guo, Hongyun Li, Jinhong He, Huanhuan Zhou, Xing Wang, Linlin Yang, Huijuan Ma

Abstract read
In one paragraph

Article in Journal of ovarian research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Na GuoEndocrinology Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Hongyun LiEndocrinology Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Jinhong HeEndocrinology Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Huanhuan ZhouEndocrinology Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Xing WangClinical Medical Research Center, Hebei General Hospital, Shijiazhuang, Hebei, China.
Linlin YangDigital Intelligence Center, The First Hospital of Hebei Medical University, Hebei, Shijiazhuang, China. llyang@hebmu.edu.cn.
Huijuan MaEndocrinology Department, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. huijuan.ma@hebmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPolycystic ovary syndrome (PCOS) is a complex endocrine-metabolic disorder characterised by hypothalamic-pituitary-gonadal (HPG) axis dysfunction and pathological gonadotropin-releasing hormone (GnRH) hypersecretion. While metformin demonstrates therapeutic efficacy in PCOS, its potential neuroendocrine mechanisms remain incompletely understood. This study aimed to investigate the involvement of hypothalamic signalling in metformin-responsive neuroendocrine regulation in PCOS.

methodsLetrozole-induced PCOS rat models were treated with metformin to assess reproductive and metabolic outcomes. Data-independent acquisition (DIA) proteomics of hypothalamic tissue was performed to identify dysregulated pathways, followed by network analysis to explore candidate regulatory nodes. Mechanistic investigations were conducted in glucosamine-induced insulin-resistant GT1-7 GnRH neurons using pharmacological modulation and siRNA knockdown. In vivo functional relevance was examined using AAV-mediated Epac2 knockdown in the mouse arcuate nucleus.

resultsMetformin improved metabolic and reproductive abnormalities in PCOS rats, including insulin resistance, GnRH/LH hypersecretion, estrous cyclicity disruption, and ovarian morphological alterations. Hypothalamic proteomic and network analyses suggested that metformin-responsive changes were associated with insulin and cAMP-related signalling pathways. In GT1-7 neurons, metformin increased Epac2 expression, restored AKT signalling, and reduced GnRH overproduction under insulin-resistant conditions. Hypothalamic Epac2 knockdown reduced AKT signalling and was associated with systemic insulin resistance, increased GnRH/LH secretion, and preliminary supportive ovarian morphological observations, consistent with a functional contribution of Epac2 to reproductive-metabolic regulation.

conclusionsThese findings support the involvement of hypothalamic Epac2/AKT/GnRH signalling in metformin-responsive neuroendocrine regulation in PCOS. Further studies are required to determine the relative contributions of central and peripheral mechanisms.

Indexed as

Gonadotropin-Releasing HormoneGuanine Nucleotide Exchange FactorsHypothalamusMetforminPolycystic Ovary SyndromeProto-Oncogene Proteins c-aktAnimalsDisease Models, AnimalFemaleHypothalamic-Pituitary-Gonadal AxisInsulin ResistanceMiceRatsSignal TransductionGonadotropin-Releasing HormoneGuanine Nucleotide Exchange FactorsMetforminProto-Oncogene Proteins c-aktRapgef4 protein, mouseRapgef4 protein, ratAKT2Epac2GnRHHypothalamic insulin signallingHypothalamusMetforminPolycystic ovary syndrome

Identifiers

PMID42760541
PMCPMC13589382

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.