Sharma Susmeeta T, Nestler John E
Division of Endocrinology and Metabolism, Medical College of Virginia, Virginia Commonwealth University, P.O. Box 980111, Richmond, VA 23298-0111, USA.
Best Pract Res Clin Endocrinol Metab. 2006 Jun;20(2):245-60. doi: 10.1016/j.beem.2006.02.003.
Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility in United States, affecting 6-10% of females in the reproductive age group. Recent studies have shown that insulin resistance plays an important role in the pathogenesis of PCOS. Traditionally, management of PCOS consisted mainly of ovulation induction, treatment of acne and hirsutism, and prevention of endometrial cancer. However, with mounting evidence showing that PCOS is associated with dysmetabolic syndrome and an increased risk for developing diabetes and heart disease, this can no longer be our sole focus. Current data support a strong recommendation that women with PCOS should undergo comprehensive evaluation for diabetes and recognized cardiovascular risk factors and receive appropriate treatment as needed. Lifestyle modifications remain the first-line therapy for all obese women with PCOS. However, many obese women with PCOS find weight loss difficult to achieve and maintain, and this is not an option for lean women with PCOS. For these reasons, insulin-sensitizing drugs are proving to be a promising and unique therapeutic option for chronic treatment of PCOS.
多囊卵巢综合征（PCOS）是美国无排卵性不孕的最常见原因，影响着6%至10%的育龄女性。最近的研究表明，胰岛素抵抗在PCOS的发病机制中起着重要作用。传统上，PCOS的治疗主要包括促排卵、治疗痤疮和多毛症以及预防子宫内膜癌。然而，越来越多的证据表明，PCOS与代谢综合征相关，患糖尿病和心脏病的风险增加，因此这不再是我们唯一关注的焦点。目前的数据强烈建议，患有PCOS的女性应接受糖尿病和公认的心血管危险因素的全面评估，并根据需要接受适当治疗。生活方式的改变仍然是所有肥胖PCOS女性的一线治疗方法。然而，许多肥胖的PCOS女性发现减肥难以实现和维持，而这对于瘦的PCOS女性来说不是一个选择。由于这些原因，胰岛素增敏药物被证明是慢性治疗PCOS的一种有前景且独特的治疗选择。
