Polycystic ovary syndrome

被引:124
作者
Stener-Victorin, Elisabet [1 ]
Teede, Helena [2 ,3 ]
Norman, Robert J. [4 ]
Legro, Richard [5 ,6 ]
Goodarzi, Mark O. [7 ]
Dokras, Anuja [8 ]
Laven, Joop [9 ]
Hoeger, Kathleen [10 ]
Piltonen, Terhi T. [11 ]
机构
[1] Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden
[2] Monash Hlth, Monash Ctr Hlth Res & Implementat, Melbourne, Vic, Australia
[3] Monash Univ, Melbourne, Vic, Australia
[4] Adelaide Med Sch, Robinson Res Inst, Adelaide, SA, Australia
[5] Penn State Coll Med, Dept Obstet & Gynecol, Hershey, PA USA
[6] Penn State Coll Med, Dept Publ Hlth Sci, Hershey, PA USA
[7] Cedars Sinai Med Ctr, Dept Med, Div Endocrinol Diabet & Metab, Los Angeles, CA USA
[8] Univ Penn, Dept Obstet & Gynecol, Philadelphia, PA USA
[9] Erasmus MC, Dept Obstet & Gynecol, Div Reprod Endocrinol & Infertil, Rotterdam, Netherlands
[10] Univ Rochester, Sch Med & Dent, Dept Obstet & Gynecol, Rochester, NY USA
[11] Univ Oulu, Oulu Univ Hosp, Med Res Ctr Oulu, Dept Obstet & Gynecol,Res Unit Clin Med, Oulu, Finland
基金
英国医学研究理事会; 瑞典研究理事会; 澳大利亚国家健康与医学研究理事会;
关键词
QUALITY-OF-LIFE; BODY-MASS INDEX; FOLLICLE-STIMULATING-HORMONE; SYMPATHETIC-NERVE ACTIVITY; GENOME-WIDE ASSOCIATION; NORMAL-WEIGHT WOMEN; FAT-CELL LIPOLYSIS; ADIPOSE-TISSUE; INSULIN-RESISTANCE; CARDIOVASCULAR-DISEASE;
D O I
10.1038/s41572-024-00511-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Despite affecting similar to 11-13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men's health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria - clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Mullerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Mullerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.
引用
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页数:23
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