Marciniak Aleksandra, Nawrocka Rutkowska Jolanta, Brodowska Agnieszka, Wiśniewska Berenika, Starczewski Andrzej
Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University, Szczecin, Poland.
Ann Agric Environ Med. 2016 Dec 23;23(4):537-541. doi: 10.5604/12321966.1226842.
Polycystic ovary syndrome is a disorder which affects 5-10% of women in reproductive age. PCOS is a cause of hyperandrogenism, menstrual disorders and infertility. The most common clinical symptoms are hirsutism, acne and obesity. Patients often suffer from metabolic disorders: insulin resistance, hyperinsulinemia, dislipidemia, leading to atherosclerosis and others irregularities of the metabolic syndrome. Patients are in the high risk group for cardiovascular diseases (CVD) development because of the metabolic abnormalities. Obesity is observed in 35-60% of women with PCOS. Lean women with PCOS are also exposed to a greater risk of glucose intolerance development and abnormalities in lipid profile than women without PCOS with comparable BMI. Adipocytes are the source of many compounds of the paracrine and endocrine activity. Some of them are also markers and mediators of inflammation. Increased levels of proinflammatory cytokines in blood can promote atherosclerosis and cardiovascular disease. Markers: IL-18, TNF, IL-6 and hs-CRP are often elevated in patients with polycystic ovary syndrome. An increase in inflammatory markers may be an early indicator of the risk of developing insulin resistance and atherosclerosis, and may become a useful prognostic and therapeutic tool for monitoring patients with PCOS: lean and those with overweight and obesity. Assessment of the concentrations of inflammatory markers may become a very useful test in evaluating the risk of developing atherosclerosis and cardiovascular disease, long before their clinical manifestation. It will also allow for the appropriate prophylaxis.
多囊卵巢综合征是一种影响5%-10%育龄女性的疾病。多囊卵巢综合征是高雄激素血症、月经紊乱和不孕的一个病因。最常见的临床症状是多毛、痤疮和肥胖。患者常患有代谢紊乱:胰岛素抵抗、高胰岛素血症、血脂异常,进而导致动脉粥样硬化和其他代谢综合征异常。由于代谢异常,患者属于心血管疾病(CVD)发生的高危人群。35%-60%的多囊卵巢综合征女性存在肥胖。与体重指数相当但无多囊卵巢综合征的女性相比,体重正常的多囊卵巢综合征女性发生葡萄糖耐量异常和血脂异常的风险也更高。脂肪细胞是许多具有旁分泌和内分泌活性化合物的来源。其中一些也是炎症的标志物和介质。血液中促炎细胞因子水平升高可促进动脉粥样硬化和心血管疾病。标志物:白细胞介素-18、肿瘤坏死因子、白细胞介素-6和高敏C反应蛋白在多囊卵巢综合征患者中常升高。炎症标志物升高可能是发生胰岛素抵抗和动脉粥样硬化风险的早期指标,并且可能成为监测多囊卵巢综合征患者(体重正常以及超重和肥胖患者)的有用的预后和治疗工具。在动脉粥样硬化和心血管疾病临床表现出现很久以前,评估炎症标志物浓度可能成为评估其发生风险的非常有用的检测方法。这也将有助于进行适当的预防。