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多囊卵巢综合征、脂肪组织与代谢综合征

Polycystic ovary syndrome, adipose tissue and metabolic syndrome.

作者信息

Delitala Alessandro P, Capobianco Giampiero, Delitala Giuseppe, Cherchi Pier Luigi, Dessole Salvatore

机构信息

Azienda Ospedaliero-Universitaria di Sassari, Clinica Medica, Viale San Pietro 8, 07100, Sassari, Italy.

Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, 07100, Sassari, Italy.

出版信息

Arch Gynecol Obstet. 2017 Sep;296(3):405-419. doi: 10.1007/s00404-017-4429-2. Epub 2017 Jun 22.

Abstract

PURPOSE

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that affects women of reproductive age and is characterized by ovulatory dysfunction and/or androgen excess or polycystic ovaries. Women with PCOS present a number of systemic symptoms in addition to those related to the reproductive system. It has been associated with functional derangements in adipose tissue, metabolic syndrome, type 2 diabetes, and an increased risk of cardiovascular disease (CVD).

METHODS

A detailed literature search on Pubmed was done for articles about PCOS, adipokines, insulin resistance, and metabolic syndrome. Original articles, reviews, and meta-analysis were included.

RESULTS

PCOS women are prone to visceral fat hypertrophy in the presence of androgen excess and the presence of these conditions is related to insulin resistance and worsens the PCO phenotype. Disturbed secretion of many adipocyte-derived substances (adipokines) is associated with chronic low-grade inflammation and contributes to insulin resistance. Abdominal obesity and insulin resistance stimulate ovarian and adrenal androgen production, and may further increase abdominal obesity and inflammation, thus creating a vicious cycle.

CONCLUSION

The high prevalence of metabolic disorders mainly related to insulin resistance and CVD risk factors in women with PCOS highlight the need for early lifestyle changes for reducing metabolic risks in these patients.

摘要

目的

多囊卵巢综合征(PCOS)是影响育龄女性的最常见内分泌疾病,其特征为排卵功能障碍和/或雄激素过多或多囊卵巢。PCOS女性除了有与生殖系统相关的症状外,还存在一些全身症状。它与脂肪组织功能紊乱、代谢综合征、2型糖尿病以及心血管疾病(CVD)风险增加有关。

方法

在Pubmed上对有关PCOS、脂肪因子、胰岛素抵抗和代谢综合征的文章进行了详细的文献检索。纳入了原创文章、综述和荟萃分析。

结果

PCOS女性在雄激素过多的情况下容易出现内脏脂肪肥大,这些情况的存在与胰岛素抵抗有关,并会使PCO表型恶化。许多脂肪细胞衍生物质(脂肪因子)分泌紊乱与慢性低度炎症相关,并导致胰岛素抵抗。腹部肥胖和胰岛素抵抗会刺激卵巢和肾上腺雄激素的产生,并可能进一步加重腹部肥胖和炎症,从而形成恶性循环。

结论

PCOS女性中主要与胰岛素抵抗和CVD危险因素相关的代谢紊乱的高患病率凸显了早期改变生活方式以降低这些患者代谢风险的必要性。

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