Laboratory of Ovarian Physio-pathology, Center of Pharmacological and Botanical Studies, School of Medicine, University of Buenos Aires, Paraguay 2155, CP1121, Buenos Aires, Argentina.
Curr Med Chem. 2021;28(27):5625-5647. doi: 10.2174/0929867328666210106142912.
Lipids are essential components of cells that participate in metabolic and endocrine regulation and reproductive functions. The main organs where lipid regulation takes place are the liver and adipose tissue. Besides, when each tissue- specific action cannot be exerted, it could lead to several endocrine-metabolic disorders closely related to PCOS, such as non-alcoholic fatty liver disease (NAFLD) and obesity.
This work aims to discuss the impact of lipid alterations on metabolic and reproductive health. Therefore, this review focus on the importance of carrying out an integrated study of the molecular pathways affected in PCOS for developing target therapies.
Lipids play a major role in PCOS pathogenesis. In this regard, failures in lipid regulation, synthesis, and/or homeostasis contribute to metabolic and reproductive abnormalities, such as those seen in PCOS. Several lipid pathways and regulators are altered in this pathology, leading to dysfunctions that worsen reproductive functions. Therefore, there are several treatments to manage dyslipidemias. Non-pharmacological therapies are considered a first-line treatment being the pharmacological treatments a second-line option.
The best treatment to improve the lipid profile is lifestyle intervention, a combination of hypocaloric diet and exercise. Regarding pharmacological therapies, a combination of fibrate and statins would be the most recommended drugs. Still, in PCOS women, treatment with metformin or TZDs not only modulates the lipid metabolism, but also improves ovulation. In addition, metformin with lifestyle interventions has positive effects on the metabolic and reproductive features of PCOS patients.
脂质是参与代谢和内分泌调节以及生殖功能的细胞的重要组成部分。脂质调节主要发生在肝脏和脂肪组织等主要器官中。此外，当特定组织的作用无法发挥时，可能会导致几种与 PCOS 密切相关的内分泌代谢紊乱，如非酒精性脂肪肝（NAFLD）和肥胖症。
本研究旨在探讨脂质改变对代谢和生殖健康的影响。因此，本综述重点讨论了对 PCOS 中受影响的分子途径进行综合研究以开发靶向治疗的重要性。
脂质在 PCOS 的发病机制中起主要作用。在这方面，脂质调节、合成和/或动态平衡的失败导致代谢和生殖异常，如 PCOS 中所见。该病理中改变了几种脂质途径和调节剂，导致功能障碍，从而恶化生殖功能。因此，有几种治疗方法可用于控制血脂异常。非药物治疗被认为是一线治疗，药物治疗是二线选择。
改善血脂谱的最佳治疗方法是生活方式干预，即低热量饮食和运动的结合。关于药物治疗，纤维酸和他汀类药物的联合使用将是最推荐的药物。然而，在 PCOS 女性中，二甲双胍或 TZDs 的治疗不仅可以调节脂质代谢，还可以改善排卵。此外，二甲双胍联合生活方式干预对 PCOS 患者的代谢和生殖特征有积极影响。
