De Leo V, Musacchio M C, Palermo V, Di Sabatino A, Morgante G, Petraglia F
Department of Pediatrics, Obstetrics and Reproductive Medicine, Institute of Obstetrics and Gynecology, University of Siena, Siena, Italy. Italy.
Drugs Today (Barc). 2009 Oct;45(10):763-75.
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women and the most common cause of anovulatory infertility, affecting 5-10% of the population. Approximately 60-70% of PCOS patients are obese. Although it is well known that obesity is associated with insulin resistance, most studies have shown that impaired insulin sensitivity is present without obesity. Hyper-insulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances. PCOS patients often have an atherogenic lipid profile and increased incidence of cardiovascular risk factors and type 2 diabetes. It has been demonstrated that by reducing hyper-insulinemia, insulin-lowering agents might improve endocrine and reproductive abnormalities in PCOS patients, and have numerous beneficial effects on multiple cardiovascular risk factors in PCOS. Metformin is currently the preferred insulin-sensitizing drug for chronic treatment of PCOS and has been shown to improve the metabolic profile, menstrual cyclicity and fertility in women with PCOS, and is associated with weight loss. In this review the metabolic comorbidities of PCOS and their therapeutic options are discussed.
多囊卵巢综合征（PCOS）是女性中最常见的内分泌疾病，也是无排卵性不孕的最常见原因，影响着5%至10%的人群。大约60%至70%的PCOS患者肥胖。尽管众所周知肥胖与胰岛素抵抗有关，但大多数研究表明，即使没有肥胖，胰岛素敏感性也会受损。与胰岛素抵抗相关的高胰岛素血症已被证实与该综合征的所有特征存在因果关系，如高雄激素血症、生殖障碍、痤疮、多毛症和代谢紊乱。PCOS患者通常具有致动脉粥样硬化的血脂谱，心血管危险因素和2型糖尿病的发病率增加。已证明，通过降低高胰岛素血症，胰岛素降低剂可能改善PCOS患者的内分泌和生殖异常，并对PCOS患者的多种心血管危险因素产生诸多有益影响。二甲双胍是目前用于PCOS慢性治疗的首选胰岛素增敏药物，已证明它可改善PCOS女性的代谢状况、月经周期和生育能力，并且与体重减轻有关。在这篇综述中，将讨论PCOS的代谢合并症及其治疗选择。
