Polycystic ovaries and obesity
Polycystic ovaries and obesity
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DOI：
10.1016/j.bpobgyn.2014.11.001
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发表时间：
2015-05-01
影响因子：
5.5
通讯作者：
Dafopoulos, Konstantinos
中科院分区：
文献类型：
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作者：
Messinis, Ioannis E.;Messini, Christina I.;Dafopoulos, Konstantinos
近50%患有多囊卵巢综合征(PCOS)的女性患有肥胖症。多囊卵巢综合征中的肥胖通过各种机制影响生殖。高雄激素血症、黄体生成素升高和胰岛素抵抗起着关键作用。脂肪组织产生的瘦素、脂联素、抵抗素和内脂素等物质可能参与了PCOS的病理生理过程。多囊卵巢综合征的不孕症与无排卵有关。对于诱导排卵，克罗米芬和人促性腺激素分别是一线和二线治疗。其他治疗方式包括使用胰岛素增敏剂，如二甲双胍、芳香酶抑制剂和腹腔镜卵巢打孔术，而体外受精是最后的手段。肥胖会对多囊卵巢综合征患者的不孕症治疗产生不利影响。建议肥胖女性在尝试受孕前改变饮食和生活方式。在多囊卵巢综合征中使用减肥药物和减肥手术需要进一步的评估。(C)2014爱思唯尔有限公司。保留所有权利。
Almost 50% of the women with polycystic ovary syndrome (PCOS) are obese. Obesity in PCOS affects reproduction via various mechanisms. Hyperandrogenism, increased luteinizing hormone (LH) and insulin resistance play a pivotal role. Several substances produced by the adipose tissue including leptin, adiponectin, resistin and visfatin may play a role in the pathophysiology of PCOS. Infertility in PCOS is related to anovulation. For induction of ovulation, clomiphene citrate and human gonadotrophins are first- and second-line treatments, respectively. Other treatment modalities include the use of insulin sensitizers, such as metformin as well as aromatase inhibitors and laparoscopic ovarian drilling, while in vitro fertilization is the last resort. Obesity can adversely affect infertility treatment in PCOS. Diet and lifestyle changes are recommended for the obese women before they attempt conception. The use of anti-obesity drugs and bariatric surgery in PCOS require further evaluation. (C) 2014 Elsevier Ltd. All rights reserved.