Kelley Carly E, Brown Ann J, Setji Tracy L
a Department of Medicine, Division of Endocrinology, Duke University Medical Center, DUMC 3924, 201 Trent Drive, Durham, NC 27710, USA.
b Department of Medicine, Division of Endocrinology, Duke University Medical Center, DUMC 3611, 201 Trent Drive, Durham, NC 27710, USA.
Expert Rev Endocrinol Metab. 2014 Nov;9(6):671-683. doi: 10.1586/17446651.2014.941814. Epub 2014 Jul 25.
Polycystic ovary syndrome (PCOS) is a chronic condition with many reproductive, metabolic and psychological manifestations. Insulin resistance puts women with PCOS at an increased risk for developing impaired glucose tolerance (IGT) and diabetes (T2D). An oral glucose tolerance test is the preferred IGT/T2D screening test, since it is most sensitive for detecting early glucose abnormalities. The goals in detecting IGT in these women are to avoid progression to T2D, modify cardiovascular risk and prevent gestational diabetes. Periodic IGT/T2D rescreening is necessary, given their propensity for more rapid deterioration in glucose tolerance. Lifestyle intervention is first-line therapy for PCOS women with IGT. Metformin is an option if lifestyle intervention fails to have an impact, while bariatric surgery is reserved for a select set of morbidly obese patients.
多囊卵巢综合征（PCOS）是一种具有多种生殖、代谢和心理表现的慢性疾病。胰岛素抵抗使PCOS女性患糖耐量受损（IGT）和糖尿病（T2D）的风险增加。口服葡萄糖耐量试验是首选的IGT/T2D筛查试验，因为它对检测早期血糖异常最为敏感。在这些女性中检测IGT的目标是避免进展为T2D、改善心血管风险并预防妊娠期糖尿病。鉴于她们的糖耐量更容易快速恶化，因此需要定期进行IGT/T2D重新筛查。生活方式干预是患有IGT的PCOS女性的一线治疗方法。如果生活方式干预没有效果，二甲双胍是一种选择，而减肥手术则仅适用于一组特定的病态肥胖患者。
