Glintborg Dorte, Andersen Marianne
Department of Endocrinology, Odense University Hospital, Odense C, Denmark.
Curr Opin Obstet Gynecol. 2017 Dec;29(6):390-396. doi: 10.1097/GCO.0000000000000410.
Polycystic ovary syndrome (PCOS) is defined by hyperandrogenism, irregular menses and polycystic ovaries when other causes are excluded. The possible implication of increased morbidity in PCOS for screening and follow-up is uncertain and is reviewed in this article.
The increased risk of type 2 diabetes and cardiovascular disease in PCOS is closely associated with BMI. Women with PCOS should be screened for the elements of the metabolic syndrome upon diagnosis. Measurement of HbA1c and the lipid accumulation product could be important tools to differentiate women with high metabolic risk. The immune function in PCOS is impaired with increased secretion of autoantibodies and increased risk of type 1 diabetes, asthma and thyroid disease. The occurrence of thyroid disease could be modified by BMI and D-vitamin status. Screening for diabetes and thyroid disease is part of routine evaluation for endocrine diseases at baseline in PCOS, whereas the necessity of prospective screening for thyroid disease awaits future studies. Especially obese women with PCOS are at an increased risk of nonalcoholic fatty liver disease, gall bladder disease and endometrial cancer.
Recent data support that screening and follow-up in patients with PCOS should be stratified according to BMI.
多囊卵巢综合征（PCOS）的定义为排除其他病因后出现高雄激素血症、月经不规律和多囊卵巢。PCOS发病率增加对筛查和随访的潜在影响尚不确定，本文对此进行综述。
PCOS患者2型糖尿病和心血管疾病风险增加与体重指数（BMI）密切相关。PCOS女性确诊时应筛查代谢综合征的各项指标。糖化血红蛋白（HbA1c）和脂质蓄积产物的检测可能是区分高代谢风险女性的重要工具。PCOS患者的免疫功能受损，自身抗体分泌增加，1型糖尿病、哮喘和甲状腺疾病风险升高。甲状腺疾病的发生可能受BMI和维生素D状态影响。糖尿病和甲状腺疾病筛查是PCOS患者基线内分泌疾病常规评估的一部分，而甲状腺疾病前瞻性筛查的必要性有待未来研究确定。尤其是肥胖的PCOS女性患非酒精性脂肪性肝病、胆囊疾病和子宫内膜癌的风险增加。
近期数据支持，PCOS患者的筛查和随访应根据BMI进行分层。
