胰岛素抵抗对多囊卵巢综合征生殖内分泌及代谢的影响

doi:10.12280/gjfckx.20230032

摘要/Abstract

摘要：

多囊卵巢综合征（polycystic ovary syndrome，PCOS）是育龄期妇女最常见的内分泌功能障碍性疾病，具有多种生殖和代谢表型。其中约50%~70%的PCOS患者合并胰岛素抵抗（insulin resistance，IR）。IR在PCOS的发生及发展过程中起着重要作用，其不仅影响PCOS患者的生殖内分泌功能，还可增加PCOS患者代谢紊乱的发生风险。IR与高雄激素血症相互影响，共同推动PCOS的发展。IR与月经紊乱程度相关，PCOS患者子宫内膜局部的IR可降低子宫内膜容受性。IR加剧PCOS患者脂代谢紊乱，推动非酒精性脂肪性肝病的发生和发展。IR影响脂肪组织的发育和功能，肥胖亦影响机体对胰岛素的敏感性。IR还可减少骨形成，阻碍骨吸收，增加骨质疏松的发生风险，对PCOS患者骨代谢产生不利影响。对以上方面进行阐述，以期为改善PCOS伴IR患者的代谢紊乱及生殖功能提供参考。

关键词: 多囊卵巢综合征, 胰岛素抵抗, 雄激素类, 月经周期, 子宫内膜, 脂代谢障碍, 骨和骨组织

Abstract:

Polycystic ovary syndrome (PCOS) represents the most common disease with endocrine dysfunctional in women of reproductive age with multiple reproductive and metabolic phenotypes. About 50%-70% of the PCOS patients have combined insulin resistance (IR). IR plays a significant role in the occurrence and development of PCOS. Not only does IR affect the reproductive endocrine function of PCOS patients, but also increases the risk of metabolic disorders in PCOS patients. IR and hyperandrogenism interact with each other to promote the development of PCOS. IR is associated with the degree of menstrual disorder. IR in partial endometrium of PCOS patients decreases endometrial receptivity. IR aggravates PCOS patients′ disorder of lipid metabolism，promoting the occurrence and development of non-alcoholic fatty liver disease. IR affects the development and function of adipose tissue. Obesity also affects insulin sensitivity. IR can reduce bone formation, hinder bone resorption, and aggravate the risk of osteoporosis, and adversely affects bone metabolism in patients with PCOS. This article elaborating from the above aspects, is expected to provide reference for improving the metabolic disorder and reproductive function of PCOS patients with IR.

Key words: Polycystic ovary syndrome, Insulin resistance, Androgens, Menstrual cycle, Endometrium, Lipid metabolism disorders, Bone and bones

刘音, 鲁娣, 宋殿荣. 胰岛素抵抗对多囊卵巢综合征生殖内分泌及代谢的影响[J]. 国际妇产科学杂志, 2023, 50(2): 190-195.

LIU Yin, LU Di, SONG Dian-rong. The Effect of Insulin Resistance on Reproductive Endocrine and Metabolism of Polycystic Ovary Syndrome[J]. Journal of International Obstetrics and Gynecology, 2023, 50(2): 190-195.

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