Tasali Esra, Van Cauter Eve, Ehrmann David A
Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, Chicago, IL.
Sleep Med Clin. 2008 Mar;3(1):37-46. doi: 10.1016/j.jsmc.2007.11.001.
Polycystic ovary syndrome (PCOS), the most common endocrine disorder of pre-menopausal women, is characterized by chronic hyperandrogenism, oligoanovulation, obesity and insulin resistance. Importantly, PCOS women are at increased risk for glucose intolerance, type 2 diabetes and cardiovascular disorders. Recent reports indicate an unexpectedly high prevalence of obstructive sleep apnea (OSA) in PCOS. Alterations in sex steroids (i.e. high androgen and low estrogen levels) and increased visceral adiposity in PCOS could potentially contribute to the increased prevalence of OSA in this disorder. There is some evidence to suggest that there may be strong associations between the presence and severity of OSA and the metabolic disturbances that characterize PCOS. Causal mechanisms in the link between PCOS and OSA remain to be elucidated. Clinicians who manage PCOS patients should be aware of the high prevalence of OSA in these patients and systematically evaluate these women for sleep disturbances.
多囊卵巢综合征(PCOS)是绝经前女性最常见的内分泌紊乱疾病,其特征为慢性高雄激素血症、排卵稀少、肥胖和胰岛素抵抗。重要的是,PCOS女性患葡萄糖耐量异常、2型糖尿病和心血管疾病的风险增加。最近的报告表明,PCOS患者中阻塞性睡眠呼吸暂停(OSA)的患病率出人意料地高。PCOS中性类固醇的改变(即高雄激素和低雌激素水平)以及内脏脂肪增多可能是导致该疾病中OSA患病率增加的潜在原因。有证据表明,OSA的存在和严重程度与PCOS所特有的代谢紊乱之间可能存在密切关联。PCOS与OSA之间联系的因果机制仍有待阐明。治疗PCOS患者的临床医生应意识到这些患者中OSA的高患病率,并系统地评估这些女性的睡眠障碍情况。