多囊卵巢综合征与多种健康因素和不良妊娠结局的关系

L. Markin, O.O. Korutko, T. Fartushok, N. Fartushok, Yuriy Fedevych, E. A. Dzhalilova, V. Zhykovskiy
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摘要

多囊卵巢综合征(PCOS)是育龄妇女的一种内分泌和代谢紊乱,其特点是雄激素水平高,月经不规律,卵巢小囊肿。多囊卵巢综合征影响大约10%的所有种族和民族的育龄妇女。多囊卵巢综合征自古以来就被认为是影响育龄妇女的疾病,在21世纪,它成为世界上最普遍和最严重的生殖代谢疾病。多囊卵巢综合征是一种影响女性生殖和代谢健康的多因素疾病。此外,多囊卵巢综合征是女性不孕的主要症状。然而,不幸怀孕的多囊卵巢综合征妇女发生并发症的风险增加,如妊娠期糖尿病(GDM)、早产。许多人认为GDM在分娩后就会消失,尽管事实上GDM是2型糖尿病、代谢综合征和心血管疾病的前兆症状。越来越多的证据表明,40%的多囊卵巢综合征妊娠伴有GDM,这表明多囊卵巢综合征是GDM的一个危险因素。因此,多囊卵巢综合征是一种终身疾病,最终可导致各种长期健康并发症,包括慢性月经不调、不孕症、子宫内膜增生和子宫内膜癌。因此,PCOS和GDM之间存在着显著的相关性,这是一个科学事实。然而,大多数关于PCOS患者GDM风险的研究都是回顾性的。因此,没有强有力的证据表明PCOS是否是GDM的危险因素或任何其他相关因素。多囊卵巢综合征是一种多基因内分泌疾病,是真正意义上的一组使身体状况恶化的疾病。与多囊卵巢综合征相关的生殖和代谢紊乱会引起几种临床症状,如月经不规律和疼痛、多毛症、黑棘皮症、痤疮、牛皮癣、焦虑、情绪波动、斑秃、心血管问题、2型糖尿病、不孕症、盆腔疼痛、性欲低下、自卑等。需要进一步的研究来了解多囊卵巢综合征的遗传和表观遗传贡献,多囊卵巢综合征相关的合并症,胎盘在营养可利用性中的作用,以及可能影响后代长期健康的药物的影响。
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Association of polycystic ovary syndrome with multiple health factors and adverse pregnancy outcomes
Polycystic ovary syndrome (PCOS), an endocrine and metabolic disorder in women of reproductive age, is characterized by high androgen levels, irregular periods, and small cysts in the ovaries. PCOS affects approximately 10 % of reproductive age women of all races and ethnicities. PCOS has been recognized to affect women of reproductive age since antiquity and in the 21st century, it emerges as the most widespread and serious reproductive metabolic disorder in the world. PCOS is a multifactorial disorder that affects both the reproductive and metabolic health of women. In addition, PCOS is a leading symptom of infertility in women. Nevertheless, women with PCOS who become pregnant unfortunately have an increased risk of complications, such as gestational diabetes mellitus (GDM), preterm birth. Many people believe GDM disappears after childbirth, despite the fact that GDM is a war­ning symptom of type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. According to growing evidence, GDM complicates 40 % of PCOS pregnancies, suggesting that PCOS is a risk factor for GDM. Hence, PCOS is a lifelong disorder that can eventually lead to various long-term health complications, including chronic menstrual irregularity, infertility, endometrial hyperplasia, and endometrial cancer. Thus, it’s a scientific fact that both PCOS and GDM are significantly associated with each other. However, most studies on the risk of GDM in PCOS patients are retrospective. Therefore, there is no strong evidence whether PCOS is a risk factor for GDM or any other related factor. PCOS, a polygenic endocrinopathy, is in a true sense a set of diseases that worsen the state of the body. Reproductive and metabolic disorders associated with PCOS cause several clinical symptoms, such as irregular and painful periods, hirsutism, acanthosis nigricans, acne, psoriasis, anxiety, mood swings, patterned baldness, cardiovascular problems, type 2 diabetes, infertility, pelvic pain, low libido, low self-esteem, etc. Further studies are needed to understand the genetic and epigenetic contributions of PCOS, PCOS-related comorbidities, the role of placenta in nutrient availability, and influence of medications that may affect the long-term offspring health.
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