Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
Monash Centre for Health Research and Implementation, Monash Health and Monash University, Melbourne, Victoria, Australia.
Nat Rev Dis Primers. 2024 Apr 18;10(1):27. doi: 10.1038/s41572-024-00511-3.
Despite affecting ~11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Müllerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.
尽管多囊卵巢综合征（PCOS）在全球范围内影响了约 11-13%的女性，但它仍然是一个研究不足的病症。PCOS 可能会影响到男性健康，在全球范围内造成了相当大的健康和经济负担。成人的诊断遵循国际循证指南，需要满足三个标准中的两个——临床或生化高雄激素血症、排卵功能障碍和/或特定的卵巢形态特征或升高的抗苗勒氏管激素。然而，对青少年的诊断则忽略了卵巢形态和抗苗勒氏管激素的考虑。PCOS 以胰岛素抵抗和高雄激素血症为特征，强烈促进了 2 型糖尿病的早发，增加了心血管疾病的发病几率。与生殖相关的影响包括不规律的月经周期、无排卵性不孕、妊娠并发症和子宫内膜癌的风险增加。除了生理表现，PCOS 还与焦虑、抑郁、饮食失调、性心理功能障碍和负面身体形象有关，这些共同导致了患者健康相关生活质量的下降。尽管 PCOS 的患病率很高，一直持续到绝经后，但诊断 PCOS 通常涉及较长的时间线和多次就诊。由于对潜在机制的了解有限，治疗仍然是临时性的，这突出了研究 PCOS 病因和病理生理学的必要性。确定导致 PCOS 的因素将为个性化医学方法铺平道路。此外，探索新的生物标志物、完善诊断标准和推进治疗方式将是提高干预措施的准确性和疗效的关键，这些干预措施将对患者的生活产生积极影响。
