多囊卵巢综合征致子宫内膜病变相关影响因素研究进展

Influencing Factors Related to Endometrial Disease Caused by Polycystic Ovary Syndrome

多囊卵巢综合征(polycystic ovary syndrome,PCOS)是一种多病因引起的生殖内分泌代谢性疾病,临床多表现为多毛、痤疮、排卵障碍、月经稀发甚至闭经,其远期并发症有代谢综合征、心血管疾病和子宫内膜癌(endometrial carcinoma,EC)等。子宫内膜病变是指各种原因所致内分泌失调引起妇女不规则阴道出血、经期延长和经量增多等,包括子宫内膜增生(endometrial hyperplasia,EH)和EC。PCOS患者因内分泌代谢紊乱(包括各种原因所致雌激素、雄激素分泌失调,胰岛素抵抗及高胰岛素血症)、炎症反应、微卫星不稳定性、微小RNA(miRNA)表达失调及其远期合并症(肥胖、糖尿病等)致子宫内膜病变风险增加,发生EH甚至EC从而影响妇女身心健康。就PCOS致子宫内膜病变影响因素的研究进展进行了综述。

Polycystic ovary syndrome(PCOS)is a reproductive endocrine and metabolic disease caused by multiple etiologies.It is clinically manifested as hirsutism,acne,ovulation disorders,oligomenorrhea and amenorrhea.The long-term complications of PCOS include metabolism syndrome,cardiovascular disease,endometrial carcinoma(EC),etc.Endometrial disease refers to the irregular vaginal bleeding,prolonged menstrual period and increased menstrual flow caused by endocrine disorders.Endometrial disease includes endometrial hyperplasia(EH)and EC.The risk of endometrial disease in PCOS patients is increased due to their endocrine and metabolic disorders(including the disorder of estrogen and androgen secretion,insulin resistance and hyperinsulinemia),inflammation,microsatellite instability,miRNA expression disorders and their long-term comorbidities(such as obesity,diabetes,etc.).The EH and EC in PCOS patients affect their physical and mental health.This article summarizes the research progress of PCOS-related endometrial disease and influencing factors.