Rojas Joselyn, Chávez Mervin, Olivar Luis, Rojas Milagros, Morillo Jessenia, Mejías José, Calvo María, Bermúdez Valmore
Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela ; Institute of Clinical Immunology, The University of Los Andes, Mérida 5101, Venezuela.
Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela.
Int J Reprod Med. 2014;2014:719050. doi: 10.1155/2014/719050. Epub 2014 Jan 28.
Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. In turn, androgens may lead back to IR by increasing levels of free fatty acids and modifying muscle tissue composition and functionality, perpetuating this IR-hyperinsulinemia-hyperandrogenemia cycle. Nonobese women with PCOS showcase several differential features, with unique biochemical and hormonal profiles. Nevertheless, lean and obese patients have chronic inflammation mediating the long term cardiometabolic complications and comorbidities observed in women with PCOS, including dyslipidemia, metabolic syndrome, type 2 diabetes mellitus, and cardiovascular disease. Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.
多囊卵巢综合征（PCOS）是一种高度常见的内分泌代谢紊乱疾病，对女性健康会产生各种严重后果，包括令人担忧的不孕率。尽管其确切病因仍不明确，但已知其具有多种激素紊乱特征，包括高雄激素血症、胰岛素抵抗（IR）和高胰岛素血症。胰岛素似乎会干扰下丘脑 - 垂体 - 卵巢轴的所有组成部分，卵巢组织胰岛素抵抗会导致代谢信号传导受损，但有丝分裂和类固醇生成活性完好，从而导致高雄激素血症，而高雄激素血症似乎是PCOS临床表现的主要罪魁祸首。反过来，雄激素可能通过增加游离脂肪酸水平以及改变肌肉组织组成和功能导致胰岛素抵抗，使这种胰岛素抵抗 - 高胰岛素血症 - 高雄激素血症循环持续存在。非肥胖型PCOS女性表现出一些不同特征，具有独特的生化和激素谱。然而，瘦型和肥胖型患者都存在慢性炎症，介导了PCOS女性中观察到的长期心脏代谢并发症和合并症，包括血脂异常、代谢综合征、2型糖尿病和心血管疾病。鉴于这些严重影响，深入了解PCOS潜在的病理生理联系非常重要，以便提供更好的治疗策略并确保改善该综合征女性的生活质量。
