Mahmoud Salma A, Zhang Lizhi, Jia Chenyu, Zang Hong
J Reprod Med. 2016 May-Jun;61(5-6):302-5.
Little prospective data exist on associations between polycystic ovary syndrome (PCOS) and long-term metabolic disorders/endometrial malignancy in women. We report the cases of 2 obese, infertile women with PCOS who experienced long-term adverse metabolic and endometrial consequences.
The first woman developed type 2 diabetes and hypertension after a 10-year history of PCOS and subsequent endometrioid carcinoma after having PCOS for 16 years. The second woman was first diagnosed with endometrial atypical hyperplasia, which failed to respond to high-dose progestin treatment, and then was diagnosed with PCOS after a 10-year history of oligomenorrhea. Laboratory testing revealed dyslipidemia and impaired glucose tolerance. Both women had a family history of diabetes. The second woman was administered oral contraceptives and metformin. Her endometrial atypia regressed and insulin sensitivity improved after 6 months of treatment.
PCOS may be associated with long-term adverse metabolic and endometrial consequences. Timely diagnosis and appropriate monitoring and management should be emphasized in order to prevent these women from adverse long-term complications. Oral contraceptives in combination with metformin reversed endometrial atypical hyperplasia in the obese, progestin-resistant woman with PCOS. Further clinical studies may be needed to confirm the effectiveness of such treatment on endometrial atypia in obese, progestin-resistant women for fertility sparing.
关于多囊卵巢综合征（PCOS）与女性长期代谢紊乱/子宫内膜恶性肿瘤之间关联的前瞻性数据较少。我们报告了2例肥胖、不孕的PCOS女性患者，她们经历了长期不良的代谢和子宫内膜后果。
第一名女性在患PCOS 10年后患上2型糖尿病和高血压，患PCOS 16年后患上子宫内膜样癌。第二名女性最初被诊断为子宫内膜非典型增生，对高剂量孕激素治疗无反应，在有10年月经稀发病史后被诊断为PCOS。实验室检查显示血脂异常和糖耐量受损。两名女性均有糖尿病家族史。第二名女性接受了口服避孕药和二甲双胍治疗。治疗6个月后，她的子宫内膜非典型增生消退，胰岛素敏感性提高。
PCOS可能与长期不良的代谢和子宫内膜后果有关。应强调及时诊断以及适当的监测和管理，以防止这些女性出现长期不良并发症。口服避孕药联合二甲双胍使肥胖、孕激素抵抗的PCOS女性的子宫内膜非典型增生得到逆转。可能需要进一步的临床研究来证实这种治疗对肥胖、孕激素抵抗女性子宫内膜非典型增生的有效性，以保留生育能力。
