METABOLIC SYNDROME AND POLYCYSTIC OVARY
Keywords:
polycystic ovary syndrome, metabolic syndrome, obesity, insulin resistance, hyperandrogenismAbstract
Polycystic ovary syndrome is a heterogeneous endocrine pathology affecting up to 10-15% of women of
reproductive age and is one of the leading causes of infertility in developed countries. Polycystic ovary syndromeе is
associated with many metabolic symptoms, such as obesity, insulin resistance, and hyperandrogenism. Pathogenesis
of these metabolic manifestations is still not fully understood. This can be explained by multiple factors, including
genetic, environmental and lifestyle factors. Polycystic ovary syndrome also shows heterogeneity in metabolic
disorders as well. This supports the hypothesis of the influence of daily lifestyle and diet as well as generated
metabolites on the pathogenesis of Polycystic ovary syndrome. Irving F. Stein and Michael L. Leventhal first
identified this syndrome in 1935 based on the simultaneous presence of polycystic ovaries and anovulation. The
diagnosis of Pоlycystic ovary syndrome is based on three criteria, which are: Rotterdam 2003, Androgen Excess and
Polycystic ovary syndrome Society 2006, and National Institutes of Health Consensus 2012. Among these criteria,
the Rotterdam criteria are the most extensive and widely used. According to these criteria, the diagnosis is based on
three features: clinical or biochemical hyperandrogenism or both, oligo-anovulation, and polycystic ovary
morphology (ultrasound examination showing the presence of ≥12 follicles with a maximum diameter of 2 –9 mm
or any ovarian volume >10 mL). Patients with Polycystic ovary syndrome must meet at least two of the three criteria
and other causes of hyperandrogenism, such as non-classical congenital adrenal hyperplasia, hyperprolactinemia,
and hyperthecosis, must be excluded. Metabolic syndrome is a group of at least three of five cardiometabolic
disorders that occur simultaneously. These include abdominal obesity, hyperglycemia, hypertriglyceridemia, low
high-density cholesterol and hypertension. In practice, the body mass index, graded according to the criteria of the
World Health Organization, is widely used to assess obesity. Metabolic syndrome and polycystic ovary syndrome
are interrelated conditions in which excess androgens are thought to initiate a vicious cycle of metabolic
disturbances in patients with polycystic ovary syndrome. This article aims to focus attention on the precise
assessment of the components of the metabolic syndrome in patients with proven polycystic ovary syndrome and
thus to identify patients with increased cardiometabolic risk and the appointment of appropriate lifestyle changes
and possibly therapeutic interventions.
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Работна група към БИМС. 2010 Консенсус на Българския институт „Метаболитен синдром” за поведение при метаболитен синдром. Наука Ендокринология.
