二甲双胍对多囊卵巢综合征的影响

Clinical Application of Metformin in Polycystic Ovary Syndrome

多囊卵巢综合征(PCOS)影响6.8%的育龄女性。胰岛素抵抗和高胰岛素血症在PCOS患者的发病机制中起关键作用,并且是与2型糖尿病和代谢异常相关的高风险因素。根据二甲双胍的作用机制,其能够提高成年PCOS患者胰岛素的敏感性、改善高胰岛素血症,还能控制或调节PCOS的其他临床症状,最常见的作用有减轻体质量、改善胰岛素抵抗、调节月经紊乱和治疗不孕。针对青春期PCOS女性,二甲双胍能够降低胆固醇、三酰甘油,减少腹部及内脏脂肪。对于PCOS妊娠患者来说,使用二甲双胍能够减少其妊娠期糖尿病、妊娠期高血压及先兆子痫的风险,改善新生儿的结局,并且尚无证据表明其对新生儿会产生严重不良反应。总之,现有的数据支持PCOS妇女使用二甲双胍可改善代谢风险及生殖结局。

Polyeystic ovary syndrome （PCOS） affects 6.6%-6.8% of women in reproductive age. Insulin resistance and hyperinsulinemia play a critical role in the pathogenesis of PCOS, which are associated with a high risk of type 2 diabetes mellitus and cardiometabolic abnormaIities. According to its mechanism, mefformin can improve insulin sensitivity ,reduce hyperinsulinaemia and mediate other clinical symptoms of adult PCOS patients. Metformin is mainly used for losing weight,alleviatlng insulin resistance,regulating the menstrual period, and treating infertility. In puberty PCOS patients, metformin is used for reducing cholesterol, triglycerides,abdominal and visceral fat. In PCOS women with pregnant, mefformin can lower the risks of gestational diabetes,gestational hypertension,preeclampsia, and improve neonatal outcome without any serious side effects. Overall,many available data supported that mefformin could lower the cardiometabolic risk , and improve reproductive outcome, in PCOS women.