胰岛素抵抗在多囊卵巢综合征诊断中的意义

Significance of insulin resistance in diagnosis of polycystic ovary syndrome

多囊卵巢综合征是人类常见的内分泌疾病之一。诊断标准中，多囊卵巢综合征主要以高雄激素症状为特征，而没有把胰岛素及代谢参数的评估纳入，大多数多囊卵巢综合征患者存在胰岛素抵抗、肥胖、高脂血症等代谢综合征的特征。多囊卵巢综合征与2型糖尿病密切相关，但是否为心血管疾病的诱因还不太清楚。在多囊卵巢综合征的发病中强调胰岛素抵抗的重要性，不仅能使诊断更有说服力，而且能预防心血管疾病的高危因素。对多囊卵巢综合征患者进行代谢症状的综合评价，有助于识别心血管疾病的高危因素，并进行恰当的治疗。对于肥胖的多囊卵巢综合征患者，改变生活方式仍然是首选方法，但通常这些患者很难减轻体重。胰岛素增敏剂是长期治疗多囊卵巢综合征主要和唯一的方法。

Polycystic ovary syndrome （PCOS） is one of the most common endocrine disorders in human beings, which affects approximately7% -8% of women in childbearing age. But in the diagnosis, PCOS is considered to mainly be characterized by hyperandrogenetic syndrome while insulin sensitivity and metabolic parameters are not included in its diagnostic criteria. In fact, most women with PCOS also exhibit features of metabolic syndrome（ MS）, such as insulin resistance （IR）, obesity and hyperlipemia. There is an association between PCOS and type 2 diabetes mellitus, only whether PCOS is an predisposing cause of cardiovascular disease remains unclear. Emphasizing importance of IR in pathogenesis of PCOS not only make the diagnosis more persuasive, but also prevent high risk of cardiovascular disease. The comprehensive evaluation of metabolic situation for those women with PCOS is helpful to identify risk factors of cardiovascular disease and give them proper treatment. Changing lifestyles remain the first-line therapy for all obese women with PCOS. However, most of these women are difficult to lose their body weight. Insulin-sensitizing drugs are regarded as a promising and unique therapeutic option for chronic treatment of PCOS.