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New aspects in the diagnosis and treatment of polycystic ovary syndrome ; Новые аспекты в диагностике и лечении синдрома поликистозных яичников

التفاصيل البيبلوغرافية
العنوان: New aspects in the diagnosis and treatment of polycystic ovary syndrome ; Новые аспекты в диагностике и лечении синдрома поликистозных яичников
المؤلفون: V. V. Efimenko, M. V. Khachaturov, A. M. Gasanova, N. S. Martirosian, I. A. Kuzina, E. V. Goncharova, M. E. Telnova, N. A. Petunina, В. В. Ефименко, М. В. Хачатуров, А. М. Гасанова, Н. С. Мартиросян, И. А. Кузина, Е. В. Гончарова, М. Э. Тельнова, Н. А. Петунина
المصدر: Meditsinskiy sovet = Medical Council; № 6 (2024); 140-147 ; Медицинский Совет; № 6 (2024); 140-147 ; 2658-5790 ; 2079-701X
بيانات النشر: REMEDIUM GROUP Ltd.
سنة النشر: 2024
المجموعة: Medical Council (E-Journal) / Медицинский Совет
مصطلحات موضوعية: инозитол, hyperandrogenism, insulin resistance, anovulation, letrozole, metformin, inositol, гиперандрогения, инсулинорезистентность, ановуляция, летрозол, метформин
الوصف: Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. The relevance is associated with a high degree of prevalence and social significance this disease. The сombination of menstrual dysfunction, anovulatory infertility, metabolic disorders, biochemical and clinical hyperandrogenism cause the importance of this problem. In this regard, Adequate therapy and its timely intensification are the most important aspects. This article highlights basic information about diagnosis and treatment of polycystic ovary syndrome, analyzes in detail the changes in patient management tactic according to the clinical recommendations of ESHRE 2018 and 2023 the issues of the quality of life of women with PCOS. In this review, special attention will be paid to the role of metformin. According to new clinical guidelines, it can be used not only for patients with an increased body mass index (BMI), but also with a normal BMI in order to reduce insulin resistance. A new place of inositol in PCOS therapy is also considered, as an alternative way which increases the sensitivity of receptors to insulin. The treatment with aromatase inhibitors are given to solve such a problem as infertility. The article also highlights the development of treatment methods based on advances in genetics and epigenetics. ; Синдром поликистозных яичников (СПКЯ) – это полигенное эндокринное расстройство, обусловленное как генетическими, так и эпигенетическими факторами. Актуальность проблемы СПКЯ заключается не только в высокой степени распространения данной патологии, но и в ее социальной значимости. Это обусловлено частым сочетанием нарушений менструальной функции, ановуляторного бесплодия, метаболических расстройств, биохимической и клинической гиперандрогенией. В этой связи важнейшими аспектами являются своевременная диагностика и адекватная терапия. В данной статье представлены основные сведения о диагностике и лечении СПКЯ, подробно разобраны изменения тактики ведения пациентов по клиническим ...
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: Russian
Relation: https://www.med-sovet.pro/jour/article/view/8278/7299; Адамян ЛВ, Андреева ЕН, Абсатарова ЮС, Григорян ОР, Дедов ИИ, Мельниченко ГА и др. Клинические рекомендации «Синдром поликистозных яичников». Проблемы эндокринологии. 2022;68(2):112–127. https://doi.org/10.14341/probl12874.; Neven ACH, Laven J, Teede HJ, Boyle JA. A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines. Semin Reprod Med. 2018;36(1):5–12. https://doi.org/10.1055/s-0038-1668085.; Helena JT, Marie LM, Michael FC, Anuja D, Joop L, Lisa M. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364–379. https://doi.org/10.1016/j.fertnstert.2018.05.004.; Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447–2469. https://doi.org/10.1210/clinem/dgad463.; Можейко ЛФ, Потоцкая АА. Синдром поликистозных яичников: современный взгляд на проблему (обзор литературы). Репродуктивное здоровье. Восточная Европа. 2022;12(3):390–403. https://doi.org/10.34883/PI.2022.12.3.010.; John EN. Role of Hyperinsulinemia in the Pathogenesis of the Polycystic Ovary Syndrome, and Its Clinical Implications. Semin Reprod Med. 1997;15(2):111–122. https://doi.org/10.1055/s-2007-1016294.; Сутурина ЛВ. Синдром поликистозных яичников в XXI веке. Акушерство и гинекология: новости, мнения, обучения. 2017;(3):86–91. https://doi.org/10.24411/2303-9698-2017-00040.; Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016;106(1):6–15. https://doi.org/10.1016/j.fertnstert.2016.05.003.; Lo JC, Feigenbaum SL, Yang J, Pressman AR, Selby JV, Go AS. Epidemiology and adverse cardiovascular risk profile of diagnosed polycystic ovary syndrome. J Clin Endocrinol Metab. 2006;91(4):1357–1363. https://doi.org/10.1210/jc.2005-2430.; Berni TR, Morgan CL, Berni ER, Rees DA. Polycystic Ovary Syndrome Is Associated With Adverse Mental Health and Neurodevelopmental Outcomes. J Clin Endocrinol Metab. 2018;103(6):2116–2125. https://doi.org/10.1210/jc.2017-02667.; Hung JH, Hu LY, Tsai SJ, Yang AC, Huang MW, Chen PM. Risk of psychiatric disorders following polycystic ovary syndrome: a nationwide populationbased cohort study. PLoS ONE. 2014;9(5):e97041. https://doi.org/10.1371/journal.pone.0097041.; Cooney LG, Dokras A. Depression and Anxiety in Polycystic Ovary Syndrome: Etiology and Treatment. Curr Psychiatry Rep. 2017;19(11):83. https://doi.org/10.1007/s11920-017-0834-2.; Cooney LG, Lee I, Sammel MD, Dokras A. High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2017;32(5):1075–1091. https://doi.org/10.1093/humrep/dex044.; Johnson JE, Daley D, Tarta C, Stanciu PI. Risk of endometrial cancer in patients with polycystic ovarian syndrome: A meta-analysis. Oncol Lett. 2023;25(4):168. https://doi.org/10.3892/ol.2023.13754.; Harris HR, Terry KL. Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review. Fertil Res Pract. 2016;2:14. https://doi.org/10.1186/s40738-016-0029-2.; Risch HA. Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst. 1998;90(23):1774–1786. https://doi.org/10.1093/jnci/90.23.1774.; Althuis MD, Moghissi KS, Westhoff CL, Scoccia B, Lamb EJ, Lubin JH, Brinton LA. Uterine cancer after use of clomiphene citrate to induce ovulation. Am J Epidemiol. 2005;161(7):607–615. https://doi.org/10.1093/aje/kwi084.; Goldstein SR, Siddhanti S, Ciaccia AV, Plouffe LJr. A pharmacological review of selective oestrogen receptor modulators. Hum Reprod Update. 2000;6(3):212–224. https://doi.org/10.1093/humupd/6.3.212.; Endometrial cancer and oral contraceptives: an individual participant meta-analysis of 27 276 women with endometrial cancer from 36 epidemiological studies. Lancet Oncol. 2015;16(9):1061–1070. https://doi.org/10.1016/S1470-2045(15)00212-0.; Colditz GA. Oral contraceptive use and mortality during 12 years of follow-up: the Nurses’ Health Study. Ann Intern Med. 1994;120(10):821–826. https://doi.org/10.7326/0003-4819-120-10-199405150-00002.; Wernli KJ, Ray RM, Gao DL, De Roos AJ, Checkoway H, Thomas DB. Menstrual and reproductive factors in relation to risk of endometrial cancer in Chinese women. Cancer Causes Control. 2006;17(7):949–955. https://doi.org/10.1007/s10552-006-0034-6.; Ramezani Tehrani F, Amiri M, Behboudi-Gandevani S, Bidhendi-Yarandi R, Carmina E. Cardiovascular events among reproductive and menopausal age women with polycystic ovary syndrome: a systematic review and meta-analysis. Gynecol Endocrinol. 2020;36(1):12–23. https://doi.org/10.1080/09513590.2019.1650337.; Gallo MF, Nanda K, Grimes DA, Lopez LM, Schulz KF. 20 µg versus >20 µg estrogen combined oral contraceptives for contraception. Cochrane Database Syst Rev. 2013;2013(8):CD003989. https://doi.org/10.1002/14651858.CD003989.pub5.; Basdevant A, Conard J, Pelissier C, Guyene TT, Lapousterle C, Mayer M et al. Hemostatic and metabolic effects of lowering the ethinyl-estradiol dose from 30 mcg to 20 mcg in oral contraceptives containing desogestrel. Contraception. 1993;48(3):193–204. https://doi.org/10.1016/0010-7824(93)90141-s.; Kaunitz AM, Burkman RT, Fisher AC, LaGuardia KD. Cycle control with a 21-day compared with a 24-day oral contraceptive pill: a randomized controlled trial. Obstet Gynecol. 2009;114(6):1205–1212. https://doi.org/10.1097/AOG.0b013e3181beab47.; Notaro ALG, Neto FTL. The use of metformin in women with polycystic ovary syndrome: an updated review. J Assist Reprod Genet. 2022;39(3):573–579. https://doi.org/10.1007/s10815-022-02429-9.; Misso ML, Costello MF, Garrubba M, Wong J, Hart R, Rombauts L. Metformin versus clomiphene citrate for infertility in non-obese women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2013;19(1):2–11. https://doi.org/10.1093/humupd/dms036.; Wang R, Li W, Bordewijk EM, Legro RS, Zhang H, Wu X. First-line ovulation induction for polycystic ovary syndrome: an individual participant data meta-analysis. Hum Reprod Update. 2019;25(6):717–732. https://doi.org/10.1093/humupd/dmz029.; DiNicolantonio JJ, H O’Keefe J. Myo-inositol for insulin resistance, metabolic syndrome, polycystic ovary syndrome and gestational diabetes. Open Heart. 2022;9(1):e001989. https://doi.org/10.1136/openhrt-2022-001989.; Croze ML, Soulage CO. Potential role and therapeutic interests of myo-inositol in metabolic diseases. Biochimie. 2013;95(10):1811–1827. https://doi.org/10.1016/j.biochi.2013.05.011.; Roy KK, Baruah J, Singla S, Sharma JB, Singh N, Jain SK, Goyal M. A prospective randomized trial comparing the efficacy of Letrozole and Clomiphene citrate in induction of ovulation in polycystic ovarian syndrome. J Hum Reprod Sci. 2012;5(1):20–25. https://doi.org/10.4103/0974-1208.97789.; Mitwally MF, Casper RF. Aromatase inhibition improves ovarian response to follicle-stimulating hormone in poor responders. Fertil Steril. 2002;77(4):776–780. https://doi.org/10.1016/s0015-0282(01)03280-0.; Begum MR, Ferdous J, Begum A, Quadir E. Comparison of efficacy of aromatase inhibitor and clomiphene citrate in induction of ovulation in polycystic ovarian syndrome. Fertil Steril. 2009;92(3):853–857. https://doi.org/10.1016/j.fertnstert.2007.08.044.; Dehbashi S, Parsanezhad ME, Alborzi S, Zarei A. Effect of clomiphene citrate on endometrium thickness and echogenic patterns. Int J Gynaecol Obstet. 2003;80(1):49–53. https://doi.org/10.1016/s0020-7292(02)00341-7.; Thompson LA, Barratt CL, Thornton SJ, Bolton AE, Cooke ID. The effects of clomiphene citrate and cyclofenil on cervical mucus volume and receptivity over the periovulatory period. Fertil Steril. 1993;59(1):125–129. https://doi.org/10.1016/s0015-0282(16)55627-1.; Gelety TJ, Buyalos RP. The effect of clomiphene citrate and menopausal gonadotropins on cervical mucus in ovulatory cycles. Fertil Steril. 1993;60(3):471–476. https://doi.org/10.1016/s0015-0282(16)56163-9.; Moll E, Bossuyt PM, Korevaar JC, Lambalk CB, van der Veen F. Effect of clomifene citrate plus metformin and clomifene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome: randomised double blind clinical trial. BMJ. 2006;332(7556):1485. https://doi.org/10.1136/bmj.38867.631551.55.; Tang T, Lord JM, Norman RJ, Yasmin E, Balen AH. Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility. Cochrane Database Syst Rev. 2012;(5):CD003053. https://doi.org/10.1002/14651858.CD003053.pub5.; Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP, Carson SA. Clomiphene, metformin, or both for infertility in the polycystic ovary syndrome. 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DOI: 10.21518/ms2024-205
الاتاحة: https://www.med-sovet.pro/jour/article/view/8278
https://doi.org/10.21518/ms2024-205
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رقم الانضمام: edsbas.361856DB
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Array ( [Name] => Abstract [Label] => Description [Group] => Ab [Data] => Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. The relevance is associated with a high degree of prevalence and social significance this disease. The сombination of menstrual dysfunction, anovulatory infertility, metabolic disorders, biochemical and clinical hyperandrogenism cause the importance of this problem. In this regard, Adequate therapy and its timely intensification are the most important aspects. This article highlights basic information about diagnosis and treatment of polycystic ovary syndrome, analyzes in detail the changes in patient management tactic according to the clinical recommendations of ESHRE 2018 and 2023 the issues of the quality of life of women with PCOS. In this review, special attention will be paid to the role of metformin. According to new clinical guidelines, it can be used not only for patients with an increased body mass index (BMI), but also with a normal BMI in order to reduce insulin resistance. A new place of inositol in PCOS therapy is also considered, as an alternative way which increases the sensitivity of receptors to insulin. The treatment with aromatase inhibitors are given to solve such a problem as infertility. The article also highlights the development of treatment methods based on advances in genetics and epigenetics. ; Синдром поликистозных яичников (СПКЯ) – это полигенное эндокринное расстройство, обусловленное как генетическими, так и эпигенетическими факторами. Актуальность проблемы СПКЯ заключается не только в высокой степени распространения данной патологии, но и в ее социальной значимости. Это обусловлено частым сочетанием нарушений менструальной функции, ановуляторного бесплодия, метаболических расстройств, биохимической и клинической гиперандрогенией. В этой связи важнейшими аспектами являются своевременная диагностика и адекватная терапия. В данной статье представлены основные сведения о диагностике и лечении СПКЯ, подробно разобраны изменения тактики ведения пациентов по клиническим ... )
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Array ( [Name] => NoteTitleSource [Label] => Relation [Group] => SrcInfo [Data] => https://www.med-sovet.pro/jour/article/view/8278/7299; Адамян ЛВ, Андреева ЕН, Абсатарова ЮС, Григорян ОР, Дедов ИИ, Мельниченко ГА и др. Клинические рекомендации «Синдром поликистозных яичников». Проблемы эндокринологии. 2022;68(2):112–127. https://doi.org/10.14341/probl12874.; Neven ACH, Laven J, Teede HJ, Boyle JA. A Summary on Polycystic Ovary Syndrome: Diagnostic Criteria, Prevalence, Clinical Manifestations, and Management According to the Latest International Guidelines. Semin Reprod Med. 2018;36(1):5–12. https://doi.org/10.1055/s-0038-1668085.; Helena JT, Marie LM, Michael FC, Anuja D, Joop L, Lisa M. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3):364–379. https://doi.org/10.1016/j.fertnstert.2018.05.004.; Teede HJ, Tay CT, Laven JJE, Dokras A, Moran LJ, Piltonen TT et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447–2469. https://doi.org/10.1210/clinem/dgad463.; Можейко ЛФ, Потоцкая АА. Синдром поликистозных яичников: современный взгляд на проблему (обзор литературы). Репродуктивное здоровье. Восточная Европа. 2022;12(3):390–403. https://doi.org/10.34883/PI.2022.12.3.010.; John EN. Role of Hyperinsulinemia in the Pathogenesis of the Polycystic Ovary Syndrome, and Its Clinical Implications. Semin Reprod Med. 1997;15(2):111–122. https://doi.org/10.1055/s-2007-1016294.; Сутурина ЛВ. Синдром поликистозных яичников в XXI веке. Акушерство и гинекология: новости, мнения, обучения. 2017;(3):86–91. https://doi.org/10.24411/2303-9698-2017-00040.; Lizneva D, Suturina L, Walker W, Brakta S, Gavrilova-Jordan L, Azziz R. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. 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