Синдром поликистозных яичников и метаболический синдром: возможные пути коррекции метаболических нарушений

Синдром поликистозных яичников (СПКЯ) - распространенное эндокринное заболевание у женщин репродуктивного возраста. Распространенность этой патологии составляет примерно 15-20%. СПКЯ характеризуется гиперандрогенией, гирсутизмом, нарушениями менструального цикла и поликистозом яичников. Более половины пациенток с СПКЯ имеют метаболический синдром, основным компонентом которого является висцеральное ожирение и инсулинорезистентность, играющие важную роль в патофизиологии СПКЯ. Резистентность к инсулину является маркером кардиометаболического риска и может приводить к сердечно-сосудистым заболеваниям (ССЗ) и нарушениям углеводного обмена вплоть до возникновения сахарного диабета 2 типа (СД2). Поэтому при лечении пациенток с СПКЯ важным аспектом является воздействие на чувствительность к инсулину и массу тела. Данный обзор посвящен различным группам препаратов, которые потенциально могут оказывать положительное влияние на метаболические нарушения при СПКЯ. Среди них метформин, препараты с инкретиновым эффектом, а также препараты для снижения веса. Учитывая сходство метаболических и патологических особенностей СПКЯ и СД2, а также разнообразие терапевтических возможностей, существует потенциал для расширения стратегии лечения метаболических нарушений при СПКЯ за счет, в том числе, и противодиабетических препаратов, что, однако, требует дальнейшего изучения. Стоит отметить, что хирургическое лечение ожирения также оказывает благоприятный эффект и способствует нормализации менструального цикла и нормализации гормонально-метаболического профиля у пациенток с СПКЯ и выраженным ожирением.

синдром поликистозных яичников, метаболический синдром, метформин, агонисты глюкагоноподобного пептида-1, ингибиторы дипептидилпептидазы-4, орлистат, мио-инозитол, статины, бариатрическая хирургия

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