Galluzzo Aldo, Amato Marco Calogero, Giordano Carla
Section of Endocrinology. Dipartimento di Oncologia Sperimentale e Applicazioni Cliniche, Università degli Studi Palermo, 90127 Palermo, Italy.
Nutr Metab Cardiovasc Dis. 2008 Sep;18(7):511-8. doi: 10.1016/j.numecd.2008.05.004. Epub 2008 Jul 25.
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in humans, affecting approximately 7-8% of women of reproductive age. Despite the criteria adopted, PCOS is considered to be a predominantly hyperandrogenetic syndrome and the evaluation of metabolic parameters and insulin sensitivity is not mandatory. Most women with PCOS also exhibit features of the metabolic syndrome, including insulin resistance, obesity and dyslipidaemia. While the association with type 2 diabetes is well established, whether the incidence of cardiovascular disease is increased in women with PCOS remains unclear. Acknowledging the strong impact of insulin-resistance in the genesis of PCOS could be helpful not only to make the diagnosis more robust, but also for conferring better cardiovascular risk prevention. Several current studies support a strong recommendation that women with PCOS should undergo comprehensive evaluation for the metabolic syndrome 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 of these women do not lose weight easily. Insulin-sensitizing drugs are discussed as a promising and unique therapeutic option for the chronic treatment of PCOS.
多囊卵巢综合征（PCOS）是人类最常见的内分泌疾病之一，影响约7-8%的育龄妇女。尽管采用了相关标准，但PCOS仍被认为主要是一种高雄激素血症综合征，代谢参数和胰岛素敏感性的评估并非必需。大多数PCOS女性还表现出代谢综合征的特征，包括胰岛素抵抗、肥胖和血脂异常。虽然与2型糖尿病的关联已得到充分证实，但PCOS女性心血管疾病的发病率是否增加仍不清楚。认识到胰岛素抵抗在PCOS发病机制中的强烈影响不仅有助于使诊断更可靠，也有助于更好地预防心血管疾病风险。目前的几项研究强烈建议，PCOS女性应接受代谢综合征和公认心血管危险因素的综合评估，并根据需要接受适当治疗。生活方式改变仍然是所有肥胖PCOS女性的一线治疗方法。然而，这些女性中的许多人不容易减肥。胰岛素增敏药物被认为是PCOS慢性治疗的一种有前景且独特的治疗选择。
