Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA.
Nat Rev Endocrinol. 2011 Apr;7(4):219-31. doi: 10.1038/nrendo.2010.217. Epub 2011 Jan 25.
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with a prevalence of up to 10%. Various diagnostic criteria have been proposed, generally centered around the features of hyperandrogenism and/or hyperandrogenemia, oligo-ovulation and polycystic ovarian morphology. Insulin resistance is present in a majority of cases, with compensatory hyperinsulinemia contributing to hyperandrogenism via stimulation of ovarian androgen secretion and inhibition of hepatic sex hormone-binding globulin production. Adipose tissue dysfunction has been implicated as a contributor to the insulin resistance observed in PCOS. Environmental and genetic factors also have a role in the development of PCOS. The syndrome is associated with numerous morbidities, including infertility, obstetrical complications, type 2 diabetes mellitus, cardiovascular disease, and mood and eating disorders. Despite these morbidities, PCOS may be common in our society owing to evolutionary advantages of the syndrome in ancient times, including smaller family sizes, reduced exposure to childbirth-related mortality, increased muscle mass and greater capacity to store energy. The diagnosis of PCOS hinges on establishing key features while ruling out other hyperandrogenic or oligo-ovulatory disorders. Treatment is focused on the goals of ameliorating hyperandrogenic symptoms, inducing ovulation and preventing cardiometabolic complications.
多囊卵巢综合征（PCOS）是育龄妇女中最常见的内分泌疾病，患病率高达 10%。已经提出了各种诊断标准，通常围绕高雄激素血症和/或高雄激素血症、稀发排卵和多囊卵巢形态学的特征。大多数情况下存在胰岛素抵抗，代偿性高胰岛素血症通过刺激卵巢雄激素分泌和抑制肝性激素结合球蛋白生成来导致高雄激素血症。脂肪组织功能障碍被认为是 PCOS 中观察到的胰岛素抵抗的一个促成因素。环境和遗传因素也在 PCOS 的发展中起作用。该综合征与许多疾病相关，包括不孕、产科并发症、2 型糖尿病、心血管疾病以及情绪和饮食障碍。尽管存在这些疾病，但由于该综合征在古代具有较小的家庭规模、降低与分娩相关的死亡率、增加肌肉质量和更大的能量储存能力等优势，PCOS 在我们的社会中可能很常见。PCOS 的诊断取决于确定关键特征，同时排除其他高雄激素血症或稀发排卵障碍。治疗重点是改善高雄激素血症症状、诱导排卵和预防心血管代谢并发症的目标。
