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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。
Polycystic ovary syndrome (PCOS) affects 6.8% of women of childbearing age. Insulin resistance and hyperinsulinemia play a pivotal role in the pathogenesis of PCOS and are high risk factors associated with type 2 diabetes and metabolic abnormalities. According to the mechanism of action of metformin, which can improve insulin sensitivity in adult PCOS patients, improve hyperinsulinemia, but also control or regulate other clinical symptoms of PCOS, the most common role is to reduce body weight, improve insulin resistance, regulate menstrual disorders And treat infertility. For adolescent PCOS women, metformin can lower cholesterol, triglycerides, reduce abdominal and visceral fat. For patients with PCOS, metformin reduces the risk of gestational diabetes mellitus, gestational hypertension and preeclampsia and improves the outcome of newborns, and there is no evidence of serious adverse effects on newborns. In conclusion, available data support the use of metformin in PCOS women to improve metabolic risk and reproductive outcomes.