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关于多囊卵巢综合征女性非药物干预以减轻体重和改善代谢紊乱的建议[关于对多囊卵巢综合征女性进行非药物治疗以减轻体重和改善代谢紊乱的建议]

Recomendations on non-pharmacological interventions in women with PCOS to reduce body weight and improve metabolic disorders [Zalecenia dotyczące postępowania niefarmakologicznego u kobiet z PCOS celem zmniejszenia masy ciała i poprawy zaburzeń metabolicznych].

作者信息

Dutkowska Anna, Konieczna Aleksandra, Breska-Kruszewska Justyna, Sendrakowska Magdalena, Kowalska Irina, Rachoń Dominik

机构信息

Department of Clinical and Experimental Endocrinology, Medical University of Gdańsk, Gdańsk, Poland.

Department of Gynaecology and Obstetrics, Medical College, Jagiellonian University, Kraków, Poland.

出版信息

Endokrynol Pol. 2019;70(2):198-212. doi: 10.5603/EP.a2019.0006.

Abstract

Women with PCOS are characterised by ovarian hyperandrogenism, which, apart from fertility problems, hirsutism, acne, and androgenic alopecia, also leads to the development of central (android) obesity and its adverse metabolic consequences. Additionally, women with PCOS have intrinsic insulin resistance (IR) with its consequent hyperinsulinaemia, which leads to the development of atherosclerosis, arterial hypertension, and type 2 diabetes mellitus (T2DM), which give rise to cardiovascular disease (CVD), being the main cause of death among women. Although there are several publications on the topic of life-style changes in women with PCOS to normalise body weight and thus to reduce the adverse metabolic consequences of obesity, such as T2DM and CVD, the number of randomised studies that would enable the formation of strong recommendations is very limited. Nevertheless, taking into consideration the pathophysiology, any intervention implementing healthy dietary habits leading to the reduction of body weigh should be the core of non-pharmacological treatment in women with PCOS. The aim of the given recommendations herein is to point out and systemise the interventions on lifestyle change in women with PCOS as well as to form a practical guideline for the health care specialists, dieticians, and mental-therapists (psychologist) who take care of women with this syndrome.

摘要

多囊卵巢综合征(PCOS)女性的特征是卵巢雄激素过多,除了生育问题、多毛症、痤疮和雄激素性脱发外,还会导致中心性(腹部)肥胖及其不良代谢后果。此外,PCOS女性存在内在的胰岛素抵抗(IR)及其随之而来的高胰岛素血症,这会导致动脉粥样硬化、动脉高血压和2型糖尿病(T2DM)的发生,进而引发心血管疾病(CVD),这是女性死亡的主要原因。尽管有几篇关于PCOS女性通过改变生活方式来使体重正常化从而减少肥胖的不良代谢后果(如T2DM和CVD)的文章,但能够形成有力建议的随机研究数量非常有限。然而,考虑到其病理生理学,任何实施健康饮食习惯以减轻体重的干预措施都应成为PCOS女性非药物治疗的核心。本文给出的建议旨在指出并系统化PCOS女性生活方式改变的干预措施,并为照顾患有该综合征女性的医疗保健专家、营养师和心理治疗师(心理学家)形成一份实用指南。

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