Góral Agata, Żywot Klaudia, Zalewski Wojciech, Jagodziński Adam, Murawski Marek
Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland.
Clinical Department of Gynecologic Surgery and Oncology, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
J Clin Med. 2024 Dec 25;14(1):27. doi: 10.3390/jcm14010027.
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects women of reproductive age and is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. PCOS is often associated with hormonal imbalances, metabolic dysfunction and comorbid psychiatric disorders, including eating disorders (EDs). The review identifies key hormonal factors-serotonin, leptin, insulin, ghrelin, kisspeptin and cortisol-and their roles in the pathophysiology of PCOS and associated psychiatric symptoms. Serotonin deficiency, commonly seen in PCOS patients, is associated with mood and eating disorders. Fluctuations in leptin, the satiety hormone, affect hypothalamic-pituitary-ovarian axis function and ovarian follicle maturation, increasing the risk of infertility. Elevated levels of kisspeptin in PCOS patients contribute not only to hormonal dysregulation but also to increased susceptibility to eating disorders such as bulimia and binge eating, likely due to its influence on the limbic system and glucose metabolism. Hyperinsulinemia and insulin resistance further impair reproductive and metabolic health, while promoting eating disorders such as binge eating and bulimia. Ghrelin and cortisol also emerge as significant factors. The review emphasizes the bidirectional relationship between PCOS and eating disorders, in which hormonal imbalances perpetuate psychiatric conditions, creating a vicious cycle. A multidisciplinary approach including gynecologists, endocrinologists, psychiatrists and nutritionists is recommended to ensure complex treatment. Early identification of those at risk through targeted screening and personalized interventions is key. Future research should focus on discovering the underlying hormonal mechanisms to improve treatment strategies and quality of life for women with PCOS.
多囊卵巢综合征（PCOS）是一种复杂的内分泌紊乱疾病，影响育龄女性，其特征为高雄激素血症、排卵功能障碍和多囊卵巢形态。PCOS常与激素失衡、代谢功能障碍及共病精神障碍相关，包括饮食失调（EDs）。该综述确定了关键激素因素——血清素、瘦素、胰岛素、胃饥饿素、亲吻素和皮质醇——及其在PCOS病理生理学和相关精神症状中的作用。血清素缺乏在PCOS患者中常见，与情绪和饮食失调有关。饱腹感激素瘦素的波动会影响下丘脑 - 垂体 - 卵巢轴功能和卵泡成熟，增加不孕风险。PCOS患者中亲吻素水平升高不仅导致激素失调，还可能由于其对边缘系统和葡萄糖代谢的影响，增加贪食症和暴饮暴食等饮食失调的易感性。高胰岛素血症和胰岛素抵抗进一步损害生殖和代谢健康，同时促进暴饮暴食和贪食症等饮食失调。胃饥饿素和皮质醇也成为重要因素。该综述强调了PCOS与饮食失调之间的双向关系，其中激素失衡使精神状况持续存在，形成恶性循环。建议采用包括妇科医生、内分泌学家、精神科医生和营养师在内的多学科方法确保综合治疗。通过有针对性的筛查和个性化干预早期识别高危人群是关键。未来研究应专注于发现潜在的激素机制，以改善PCOS女性的治疗策略和生活质量。
