Department of Breast Surgery, Xingtai City People's Hospital, Xingtai, Hebei, China.
Department of General Surgery, Aerospace Center Hospital, Beijing, China.
Front Endocrinol (Lausanne). 2024 Jan 9;14:1326546. doi: 10.3389/fendo.2023.1326546. eCollection 2023.
In the modern era, the escalating global prevalence of obesity has profound implications on female reproductive health. Obesity, transcending mere lifestyle choices, has evolved into a complex disorder affecting physiological and metabolic functions. Concurrently, female infertility is rising as a significant global health issue. Obesity, with its extensive systemic effects, is pinpointed as a major disruptor. The convergence of these health challenges reveals a multifaceted scenario: on one hand, obesity directly impacts female reproductive health, particularly in the context of conditions like polycystic ovary syndrome (PCOS) and menstrual disturbances; on the other, the psychosocial consequences of infertility might intensify weight-gain patterns, forming a challenging cycle. Additionally, the economic implications of treating obesity-related infertility are considerable. This review delves into the myriad ways obesity affects female reproductive health, drawing insights from epidemiological, clinical, and molecular studies. It explores the epidemiological relationship between obesity and PCOS, the influence of obesity on menstrual disturbances, and the broader impact of obesity on female infertility. Weight loss, through pharmacological interventions, surgical methods, or lifestyle adjustments, emerges as a promising strategy. Lastly, the efficacy of assisted reproductive technologies, such as IVF, is influenced by obesity, underscoring the importance of an optimal body mass index. The review also highlights the molecular and physiological mechanisms underlying the impact of obesity on female reproductive health, including the disruption of the hypothalamic-pituitary-ovary axis, altered adipokine secretion, and the role of chronic inflammation and oxidative stress.
在现代,肥胖症在全球的流行率不断上升,对女性生殖健康产生了深远的影响。肥胖已经超越了单纯的生活方式选择,演变成了一种影响生理和代谢功能的复杂疾病。与此同时,女性不孕不育也成为了一个日益严重的全球性健康问题。肥胖作为一个主要的干扰因素,其广泛的系统影响备受关注。这些健康挑战的汇聚揭示了一个多方面的情况:一方面,肥胖直接影响女性生殖健康,特别是在多囊卵巢综合征(PCOS)和月经紊乱等情况下;另一方面,不孕不育的心理社会后果可能会加剧体重增加模式,形成一个具有挑战性的循环。此外,治疗肥胖相关不孕不育的经济影响也相当可观。本综述深入探讨了肥胖影响女性生殖健康的多种方式,从流行病学、临床和分子研究中汲取了见解。它探讨了肥胖与 PCOS 之间的流行病学关系、肥胖对月经紊乱的影响以及肥胖对女性不孕不育的更广泛影响。减肥通过药物干预、手术方法或生活方式调整成为一种有前途的策略。最后,肥胖会影响辅助生殖技术(如试管婴儿)的效果,凸显了保持最佳体重指数的重要性。该综述还强调了肥胖对女性生殖健康影响的分子和生理机制,包括下丘脑-垂体-卵巢轴的紊乱、脂肪因子分泌的改变以及慢性炎症和氧化应激的作用。