多囊卵巢综合征的长期健康结局

IF 3.7 3区 生物学 Q1 DEVELOPMENTAL BIOLOGY
Reproduction Pub Date : 2025-06-01 DOI:10.1530/REP-25-0118
Anuja Dokras, Manuel Luque-Ramírez, Héctor F Escobar-Morreale
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引用次数: 0

摘要

多囊卵巢综合征(PCOS)是一种普遍的疾病,据报道,全世界的患病率为5%至20%。作为一种慢性高雄激素疾病,心血管危险因素聚集在患有该综合征的年轻成年女性中,因为其病理生理也涉及功能失调的脂肪组织、慢性低度亚临床炎症和/或胰岛素抵抗。最近的系统综述和荟萃分析表明,与非高雄激素女性相比,中年和绝经后PCOS女性出现心血管事件(即心肌梗死和中风)的风险增加。多囊卵巢综合征的高雄激素和代谢主诉也对这一广泛人群的心理健康产生负面影响。然而,肥胖在这些关联中发挥了主要作用:当比较体重匹配的人群时,患有多囊卵巢综合征的女性心血管风险似乎与没有这种疾病的女性相似,即使绝经后患者保留其高雄激素特征。重要的是,最近一项纵向前瞻性队列研究的结果在10年随访后未能证明白种人多囊卵巢综合征患者在生殖晚期或绝经后早期心血管事件增加,尽管心血管危险因素在这些患者中非常常见。因此,目前的证据表明,多囊卵巢综合征的长期预后在某种程度上比他们的心脏代谢关联所预期的要好,这主要是由多囊卵巢综合征与肥胖的关联所驱动的。尽管如此,为这些妇女服务的医生仍然必须意识到多囊性卵巢综合征在生育后期和绝经后的潜在健康后果,以便识别和适当管理这些高风险患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Health Outcomes in Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a widespread condition, with reported prevalences ranging from 5% to 20% worldwide. Being a chronic hyperandrogenic condition, cardiovascular risk factors cluster in young adult women with the syndrome because its pathophysiology also involves dysfunctional adipose tissue, chronic low-grade subclinical inflammation and/or insulin resistance. Recent systematic reviews and meta-analysis suggest that middle-aged and postmenopausal women with PCOS present with an increased risk of cardiovascular events, namely myocardial infarction and stroke, when compared with non-hyperandrogenic women. Hyperandrogenic and metabolic complaints of PCOS also have a negative impact on the mental health of this broad segment of population. However, obesity played a major role on these associations: when comparing populations matched for weight, the cardiovascular risk of women with PCOS appears to be similar to that of women without this condition, even though postmenopausal patients retain their hyperandrogenic features. Importantly, recent results from a longitudinal prospective cohort study failed to demonstrate increased cardiovascular events during the late reproductive or early postmenopausal period of Caucasian patients with PCOS after 10 years of follow-up, even though cardiovascular risk factors were very frequent in these patients. Hence, current evidence indicates that the long-term prognosis of PCOS is somehow better that that expected from their cardiometabolic associations, which are largely driven by the association of PCOS with obesity. Nevertheless, physicians attending these women must still be aware of the potential health consequences of PCOS during their late-reproductive years and beyond menopause, in order to identify and properly manage these high risk patients.

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来源期刊
Reproduction
Reproduction 生物-发育生物学
CiteScore
7.40
自引率
2.60%
发文量
199
审稿时长
4-8 weeks
期刊介绍: Reproduction is the official journal of the Society of Reproduction and Fertility (SRF). It was formed in 2001 when the Society merged its two journals, the Journal of Reproduction and Fertility and Reviews of Reproduction. Reproduction publishes original research articles and topical reviews on the subject of reproductive and developmental biology, and reproductive medicine. The journal will consider publication of high-quality meta-analyses; these should be submitted to the research papers category. The journal considers studies in humans and all animal species, and will publish clinical studies if they advance our understanding of the underlying causes and/or mechanisms of disease. Scientific excellence and broad interest to our readership are the most important criteria during the peer review process. The journal publishes articles that make a clear advance in the field, whether of mechanistic, descriptive or technical focus. Articles that substantiate new or controversial reports are welcomed if they are noteworthy and advance the field. Topics include, but are not limited to, reproductive immunology, reproductive toxicology, stem cells, environmental effects on reproductive potential and health (eg obesity), extracellular vesicles, fertility preservation and epigenetic effects on reproductive and developmental processes.
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