De Leo Vincenzo, la Marca Antonio, Petraglia Felice
Department of Pediatrics, Obstetrics, and Reproductive Medicine, Institute of Obstetrics and Gynecology, University of Siena, 53100 Siena, Italy.
Endocr Rev. 2003 Oct;24(5):633-67. doi: 10.1210/er.2002-0015.
Polycystic ovary syndrome (PCOS) is a medical condition that has brought multiple specialists together. Gynecologists, endocrinologists, cardiologists, pediatricians, and dermatologists are all concerned with PCOS patients and share research data and design clinical trials to learn more about the syndrome. Insulin resistance is a common feature of PCOS and is more marked in obese women, suggesting that PCOS and obesity have a synergistic effect on the magnitude of the insulin disorder. Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism, and metabolic disturbances. Women with PCOS should be evaluated for cardiovascular risk factors, such as lipid profile and blood pressure. Modification of diet and lifestyle should be suggested to those who are obese. Several insulin-lowering agents have been tested in the management of PCOS. In particular, metformin is the only drug currently in widespread clinical use for treatment of PCOS. In a high percentage of patients, treatment with metformin is followed by regularization of menstrual cycle, reduction in hyperandrogenism and in cardiovascular risk factors, and improvement in response to therapies for induction of ovulation.
多囊卵巢综合征（PCOS）是一种使多个专科医生聚集在一起关注的病症。妇科医生、内分泌学家、心脏病专家、儿科医生和皮肤科医生都关注PCOS患者，并共享研究数据和设计临床试验以更多地了解该综合征。胰岛素抵抗是PCOS的一个常见特征，在肥胖女性中更为明显，这表明PCOS和肥胖对胰岛素紊乱程度具有协同作用。与胰岛素抵抗相关的高胰岛素血症已被因果关联到该综合征的所有特征，如高雄激素血症、生殖障碍、痤疮、多毛症和代谢紊乱。患有PCOS的女性应评估心血管危险因素，如血脂和血压。对于肥胖者，应建议其改变饮食和生活方式。几种降低胰岛素的药物已在PCOS的治疗中进行了测试。特别是，二甲双胍是目前广泛用于治疗PCOS的唯一药物。在高比例的患者中，使用二甲双胍治疗后会出现月经周期规律化、高雄激素血症和心血管危险因素降低，以及对促排卵治疗反应的改善。
