Polycystic ovary syndrome
Polycystic ovary syndrome
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DOI：
10.1038/nrdp.2016.57
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发表时间：
2016-08-11
影响因子：
81.5
通讯作者：
Yildiz, Bulent O.
中科院分区：
文献类型：
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作者：
Azziz, Ricardo;Carmina, Enrico;Yildiz, Bulent O.
多囊卵巢综合征（PCOS）影响全世界5-20%的育龄妇女。这种情况的特征是高雄激素血症，排卵功能障碍和多囊卵巢形态（PCOM）-卵巢产生过多的雄激素是PCOS的一个关键特征。代谢功能障碍的特点是胰岛素抵抗和代偿性高胰岛素血症是明显的，在绝大多数受影响的个人。多囊卵巢综合征增加了2型糖尿病、妊娠期糖尿病和其他妊娠相关并发症、静脉血栓栓塞、脑血管和心血管事件以及子宫内膜癌的风险。PCOS是一种排除性诊断，主要基于高雄激素血症、排卵功能障碍和PCOS的存在。治疗应根据患者的主诉和需求量身定制，包括通过改变生活方式、药物治疗和可能的手术来预防和管理超重、雄激素抑制和/或阻断、子宫内膜保护、生殖治疗以及心理特征的检测和治疗，从而针对代谢异常。本书总结了目前关于该病的流行病学、发病机制和病理生理学、诊断、筛查和预防、管理和未来研究方向的知识。
Polycystic ovary syndrome (PCOS) affects 5-20% of women of reproductive age worldwide. The condition is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology (PCOM)-with excessive androgen production by the ovaries being a key feature of PCOS. Metabolic dysfunction characterized by insulin resistance and compensatory hyperinsulinaemia is evident in the vast majority of affected individuals. PCOS increases the risk for type 2 diabetes mellitus, gestational diabetes and other pregnancy-related complications, venous thromboembolism, cerebrovascular and cardiovascular events and endometrial cancer. PCOS is a diagnosis of exclusion, based primarily on the presence of hyperandrogenism, ovulatory dysfunction and PCOM. Treatment should be tailored to the complaints and needs of the patient and involves targeting metabolic abnormalities through lifestyle changes, medication and potentially surgery for the prevention and management of excess weight, androgen suppression and/or blockade, endometrial protection, reproductive therapy and the detection and treatment of psychological features. This Primer summarizes the current state of knowledge regarding the epidemiology, mechanisms and pathophysiology, diagnosis, screening and prevention, management and future investigational directions of the disorder.