Obesity and its effect on reproductive function.
Obesity and its effect on reproductive function.
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肥胖及其对生殖功能的影响。
DOI：
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发表时间：
1985
影响因子：
1.5
通讯作者：
M. H. Kim
中科院分区：
文献类型：
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作者：
C. Friedman;M. H. Kim
本文综述了目前关于肥胖对排卵和生殖潜能影响的知识。虽然只有少数肥胖女性受到影响，但似乎可以肯定的是，肥胖和无排卵之间存在联系。这种相互关系是由减肥在抑制肥胖和恢复排卵所观察到的高雄激素血症方面的明显有效性所提示的。肥胖女性芳香酶活性和高胰岛素血症的增加被认为是导致高雄激素血症的主要原因，可能是通过刺激黄体生成素分泌或直接刺激卵巢。除了卵巢高雄激素血症外，垂体下丘脑功能障碍也被观察到与肥胖有关。中枢5 -羟色胺刺激不足、多巴胺刺激过多、内啡肽不敏感都可能与垂体-下丘脑功能障碍有关，也可能与减肥抵抗有关。关于减肥对肥胖妇女恢复排卵功能的功效的数据很少；尽管如此，减肥应被视为任何尝试诱导排卵的核心组成部分。就生育能力而言，即使是短期的减肥也可能是有益的。回肠空肠旁路手术减轻体重似乎会使胎儿处于危险之中；因此，建议术后至少2年内避免妊娠。
This article reviews current knowledge of the effect of obesity on ovulation and reproductive potential. Although only a minority of obese women are affected, it seems certain that there is a link between obesity and anovulation. This interrelationship is suggested by the apparent effectiveness of weight reduction in suppressing the hyperandrogenemia observed with obesity and restoring ovulation. The increased aromatase activity and hyperinsulinemia observed in obese women is believed to play a major role in causing the hyperandrogenemia, either by stimulating luteinizing hormone secretion or directly stimulating the ovary. In addition to ovarian hyperandrogenemia, pituitary hypothalamic dysfunction has been observed in response to obesity. Inadequate central serotonin stimulation, excessive dopamine stimulation, and insensitivity to endorphins may all be involved in the pituitary hypothalamic dysfunction, as well as resistance to weight reduction. Few data are available on the efficacy of weight loss in restoring ovulatory function in obese women; nonetheless, weight reduction should be regarded as a central component of any attempt to induce ovulation. In terms of fertility, even a short-term weight loss can be beneficial. Ileal jejunal bypass surgery to effect weight reduction appears to place a fetus at risk; thus, avoidance of pregnancy for at least 2 years after such surgery is advised.