Interní Med. 2003; 5(11): 554-557
Syndrom polycystických ovarií
- MUDr. Jana Vrbíková
- Endokrinologický ústav, Praha
Keywords: polycystic ovary syndrome, insulin resistance, ischemic heart disease, insulin sensitizators.
Published: December 31, 2003 Show citation
Vrbíková J. Syndrom polycystických ovarií. Interní Med. 2003;5(11):554-557.
Syndrom polycystických ovarií (PCOS) je jednou z nejčastějších endokrinopatií žen ve fertilním věku (postihuje asi 5-10 % žen v této věkové skupině). Obvykle se definuje per exclusionem jako chronická anovulace s hyperandrogenémií, pokud můžeme vyloučit jinou specifickou příčinu nadbytku androgenů. PCOS je nejčastější příčinou poruch menstruačního cyklu a anovulační sterility. V současné době se do popředí dostává problematika interní, a to tzv. pozdní rizika tohoto syndromu (diabetes mellitus (DM), hyperlipidémie, hyperkoagulační stav, arteriální hypertenze a ischemická choroba srdeční). Terapeuticky kromě hormonální kontracepce jsou v posledních 10 letech zkoušeny také inzulinové senzitizátory.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) belongs to the most common endocrinopathies in women of fertile age (5-10% of women in this age group are affected). It is usually defined per exclusionem as a chronic anovulation with hyperandrogenemia, when other specific causes of high levels of androgens have been excluded. PCOS represents the most frequent cause of menstruation cycle disturbances and anovulation sterility. Recently the attention has been shifted towards other consequences, that means late risks of this syndrome as diabetes mellitus, hyperlipidemias, hypercoagolopathic state, arterial hypertension and ischemic heart disease. In therapy besides hormonal contraceptives insulin sensitizators have been recently tested.
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References
- Adams J, Franks S, Polson DW, Mason HD, Abdulwahid N, Tucker M, Morris DV, Price J, Jacobs HS. Multifollicular ovaries: clinical and endocrine features and response to pulsatile gonadotropin releasing hormone. Lancet 1985; 2: 1375-1379.
Go to original source...
Go to PubMed...
- Arslanian SA, Lewy VD, Danadian K. Glucose intolerance in obese adolescents with polycystic ovary syndrome: roles of insulin resistance and beta-cell dysfunction and risk of cardiovascular disease. J Clin Endocrinol Metab 2001; 86: 66-71.
Go to original source...
- Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ, West C, Jacobs HS. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod 1995; 10: 2107-2111.
Go to original source...
Go to PubMed...
- Bendlová B, Vrbíková J, Šaffková J, Stárka L. Genetické pozadí syndromu polycystických ovarií. Diabetes Metabolismus Endokrinologie a Výživa 2001; 1: 58-62.
- Burghen GA, Givens JR, Kitabchi AE. Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab 1980; 50: 113-116.
Go to original source...
Go to PubMed...
- Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women. J Clin Endocrinol Metab 1999; 84: 1897-1899.
Go to original source...
Go to PubMed...
- Cibula D, Skrha J, Hill M, Fanta M, Haakova L, Vrbíkova J, Zivny J. Prediction of insulin sensitivity in nonobese women with polycystic ovary syndrome. J Clin Endocrinol Metab 2002; 87: 5821-5825.
Go to original source...
Go to PubMed...
- Clayton RN, Ogden V, Hodgkinson J, Worswick L, Rodin DA, Dyer S, Meade TW. How common are polycystic ovaries in normal women and what is their significance for the fertility of the population? Clin Endocrinol (Oxf) 1992; 37: 127-134.
Go to original source...
Go to PubMed...
- Conway GS, Agrawal R, Betteridge DJ, Jacobs HS. Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome. Clin Endocrinol (Oxf) 1992; 37: 119-125.
Go to original source...
Go to PubMed...
- Dunaif, A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev 1997; 18: 774-800.
Go to original source...
- Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes 1989; 38: 1165-1174.
Go to original source...
Go to PubMed...
- Dunaif A, Thomas A. Current concepts in the polycystic ovary syndrome. Annu Rev Med 2001; 52: 401-419.
Go to original source...
Go to PubMed...
- Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care 1999; 22: 141-146.
Go to original source...
Go to PubMed...
- Givens JR. Familial polycystic ovarian disease. Endocrinol Metab Clin North Am 1988; 17: 771-783.
Go to original source...
Go to PubMed...
- Guzick D. Polycystic ovary syndrome: symptomatology, pathophysiology, and epidemiology. Am J Obstet Gynecol 1998; 179: S89-S93.
Go to original source...
Go to PubMed...
- Haakova L, Cibula D, Rezabek K, Hill M, Fanta M, Zivny J. Pregnancy outcome in women with PCOS and in controls matched by age and weight. Hum Reprod 2003; 18: 1438-1441.
Go to original source...
Go to PubMed...
- Harborne L, Fleming R, Lyall H, Norman J, Sattar N. Descriptive review of the evidence for the use of metformin in polycystic ovary syndrome. Lancet 2003; 361: 1894-1901.
Go to original source...
Go to PubMed...
- Holte J, Bergh T, Berne C, Berglund L, Lithell, H. Enhanced early insulin response to glucose in relation to insulin resistance in women with polycystic ovary syndrome and normal glucose tolerance. J Clin Endocrinol Metab 1994; 78: 1052-1058.
Go to original source...
- Holte J, Gennarelli G, Berne C, Bergh T, Lithell H. Elevated ambulatory day-time blood pressure in women with polycystic ovary syndrome: a sign of a pre-hypertensive state? Hum Reprod 1996; 11: 23-28.
Go to original source...
Go to PubMed...
- Homburg R. What is polycystic ovarian syndrome? A proposal for a consensus on the definition and diagnosis of polycystic ovarian syndrome. Hum Reprod 2002; 17: 2495-2499.
Go to original source...
Go to PubMed...
- Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.
Go to original source...
Go to PubMed...
- Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women (see comments). J Clin Endocrinol Metab 1999; 84: 165-169.
Go to original source...
- Lord J, Flight I, Norman R. Insulin-sensitising drugs (metformin, troglitazone, rosiglitazone, pioglitazone, D-chiro-inositol) for polycystic ovary syndrome. Cochrane Database Syst Rev 2003; 3: CD003053.
- Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol (Oxf) 1999; 51: 779-786.
Go to original source...
Go to PubMed...
- Norman RJ, Masters L, Milner CR, Wang JX, Davies MJ. Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome. Hum Reprod 2001; 16: 1995-1998.
Go to original source...
Go to PubMed...
- Polson DW, Adams J, Wadsworth J, Franks S. Polycystic ovaries a common finding in normal women. Lancet 1988; 1: 870-872.
Go to original source...
Go to PubMed...
- Seli E, Duleba AJ. Should patients with polycystic ovarian syndrome be treated with metformin? Hum Reprod 2002; 17: 2230-2236.
Go to original source...
Go to PubMed...
- Stárka L, Hill M, Dušková M, Čermáková I. Jak je to s mužským ekvivalentem syndromu polycystických ovarií. Diabetes, Metabolismus, Endokrinologie a Výživa 2003; 6: 88-92.
- Taylor AE. Understanding the underlying metabolic abnormalities of polycystic ovary syndrome and their implications. Am J Obstet Gynecol 1998; 179: S94-S100.
Go to original source...
Go to PubMed...
- Vrbikova J, Cifkova R, Jirkovska A, Lanska V, Platilova H, Zamrazil V, Starka L. Cardiovascular risk factors in young Czech females with polycystic ovary syndrome. Hum Reprod 2003; 18: 980-984.
Go to original source...
Go to PubMed...
- Wild RA. Polycystic ovary syndrome: a risk for coronary artery disease? Am J Obstet Gynecol 2002; 186: 35-43.
Go to original source...
Go to PubMed...
- Wild S, Pierpoint T, McKeigue P, Jacobs H. Cardiovascular disease in women with polycystic ovary syndrome at long-term follow-up: a retrospective cohort study. Clin Endocrinol (Oxf) 2000; 52: 595-600.
Go to original source...
Go to PubMed...