De Sousa Sunita M C, Norman Robert J
Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia; Hormones and Cancer Group, Garvan Institute of Medical Research, Sydney, Australia; SA Clinical Genetics Service, Women's and Children's Hospital, Adelaide, Australia.
Robinson Research Institute, University of Adelaide, Adelaide, Australia; Fertility SA, Adelaide, Australia; Reproductive Endocrinology and Fertility, Royal Adelaide Hospital, Adelaide, Australia; NHMRC Centre for Research Excellence in Polycystic Ovary Syndrome, Adelaide, Australia.
Best Pract Res Clin Obstet Gynaecol. 2016 Nov;37:140-151. doi: 10.1016/j.bpobgyn.2016.01.006. Epub 2016 Feb 10.
Polycystic ovary syndrome (PCOS) is associated with a range of metabolic complications including insulin resistance (IR), obesity, dyslipidaemia, hypertension, obstructive sleep apnoea (OSA) and non-alcoholic fatty liver disease. These compound risks result in a high prevalence of metabolic syndrome and possibly increased cardiovascular (CV) disease. As the cardiometabolic risk of PCOS is shared amongst the different diagnostic systems, all women with PCOS should undergo metabolic surveillance though the precise approach differs between guidelines. Lifestyle interventions consisting of increased physical activity and caloric restriction have been shown to improve both metabolic and reproductive outcomes. Pharmacotherapy and bariatric surgery may be considered in resistant metabolic disease. Issues requiring further research include the natural history of PCOS-associated metabolic disease, absolute CV risk and comparative efficacy of lifestyle interventions.
多囊卵巢综合征（PCOS）与一系列代谢并发症相关，包括胰岛素抵抗（IR）、肥胖、血脂异常、高血压、阻塞性睡眠呼吸暂停（OSA）和非酒精性脂肪性肝病。这些复合风险导致代谢综合征的高患病率，并可能增加心血管（CV）疾病的发生风险。由于PCOS的心脏代谢风险在不同诊断系统中都存在，所有PCOS女性都应接受代谢监测，尽管不同指南的具体方法有所不同。增加体育活动和热量限制的生活方式干预已被证明可改善代谢和生殖结局。对于耐药性代谢疾病，可考虑药物治疗和减肥手术。需要进一步研究的问题包括PCOS相关代谢疾病的自然史、绝对心血管风险以及生活方式干预的比较疗效。
