在更年期过渡期间和更年期后的PCOS:系统性审查和元分析
Mercedes Millán-de-Meer1, Manuel Luque-Ramírez1,2,3, Lía Nattero-Chávez2,3
1Universidad de Alcalá, Madrid, Spain.
Human reproduction update
|June 24, 2023
概括
绝经后女性的多囊性卵巢综合征 (PCOS) 显示出持续的高雄性和增加的心脏代谢风险,通常与肥胖有关. 需要进行更多的研究,以便为这一群体制定明确的管理准则.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 代谢健康 代谢健康
- 妇女健康 妇女健康
背景情况:
- 关于多囊性卵巢综合征 (PCOS) 在晚期生殖和绝经后阶段的后果的知识有限.
- 了解老年妇女PCOS对于长期健康管理至关重要.
研究的目的:
- 系统地审查和分析45岁及以上女性PCOS数据.
- 研究PCOS的病理生理学,临床表现,诊断,预后和治疗近期和绝经后妇女.
主要方法:
- 系统审查和对2023年4月之前发表的研究进行元分析.
- 包括对患有PCOS (年龄≥45岁) 的更年期前或更年期后妇女的横截面或前性研究.
- 用于证据质量评估的GRADE系统.
主要成果:
- 患有PCOS的绝经后妇女表现出较高的雄激素 (,安德罗) 和减少的性激素结合型球蛋白.
- 增加的BMI,腰围,胰岛素抵抗,禁食葡萄糖,以及糖尿病和高血压的更高几率被观察到.
- 虽然高密度胆固醇较低,甘油三较高,但总胆固醇和LDL与对照人群相似;心肌梗塞和中风更为普遍.
结论:
- 在患有PCOS的女性中,不论肥胖程度如何,高雄性异常症在绝经后仍然存在.
- 心脏代谢性并发症受到肥胖和PCOS的相互作用的显著影响.
- 证据质量较低,需要进一步进行大规模的前性研究,以制定最终的管理准则.
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