Institute of Endocrinology, Obesity Management Centre, Prague, Czech Republic.
Obes Facts. 2009;2(1):26-35. doi: 10.1159/000194971. Epub 2009 Feb 10.
Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of fertile age. Obesity is encountered in 30-70% of PCOS-affected women, and its presence significantly modifies both clinical and laboratory expression of the syndrome. Obesity increases the risk of co-morbidities associated with PCOS, such as impaired glucose tolerance and type 2 diabetes mellitus, hyperlipidemia and arterial hypertension. The etiopathogenesis of obesity in PCOS has not yet been exactly clarified. There clearly is a vicious circle of abdominal obesity, insulin resistance, and hyperadrogenemia. Differences in ghrelin and neuropeptide Y levels between PCOS patients and those with simple obesity were also described. Weight loss is the first choice recommendation for the treatment of clinical manifestations of PCOS, such as menstrual cycle irregularities, infertility or hirsutism. However, the best treatment approach in obese PCOS patients remains to be defined. Studies concerning different weight loss regimens, antiobesity drugs, bariatric surgery, insulin sensitizers, and hormonal therapy are reviewed.
多囊卵巢综合征（PCOS）是育龄妇女中最常见的内分泌疾病之一。30%-70%的 PCOS 患者存在肥胖，肥胖显著改变了该综合征的临床和实验室表现。肥胖增加了与 PCOS 相关的合并症的风险，如糖耐量受损和 2 型糖尿病、血脂异常和动脉高血压。PCOS 中肥胖的病因尚未完全阐明。显然存在腹部肥胖、胰岛素抵抗和高雄激素血症的恶性循环。也描述了 PCOS 患者和单纯性肥胖患者之间生长激素释放肽和神经肽 Y 水平的差异。减轻体重是治疗 PCOS 临床表现（如月经周期不规律、不孕或多毛症）的首选建议。然而，肥胖 PCOS 患者的最佳治疗方法仍有待确定。本文回顾了不同的减肥方案、减肥药、减重手术、胰岛素增敏剂和激素治疗的相关研究。
