Nove spoznaje metaboličkih rizika u žena sa sindromom policističnih jajnika

master's thesis

• Title (english): New insights on metabolic risks in women with polycystic ovary syndrome
• Author: Ivana Vručina
• Mentor: Marina Šprem Goldštajn (mentor)
• Committee member: Miro Kasum (predsjednik povjerenstva)
• Committee member: Dinka Pavičić-Baldani (član povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Sindrom policističnih jajnika ili Stein-Leventhalov sindrom je najčešći endokrino-metabolički poremećaj žena reproduktivne dobi koji implicira različite ozbiljne posljedice za zdravlje žena uključujući alarmantne stope infertilnosti. Zato je u zadnja dva desetljeća uložen velik trud kako bi se taj sindrom definirao. Točna prevalencija PCOS-a varira ovisno o tome koje kriterije primjenjujemo u dijagnostici, ali može iznositi i 15-20% pri upotrebi kriterija Europskog društva za humanu reprodukciju i embriologiju.
Klinička slika uključuje oligomenoreju ili amenoreju, hiperandrogenizam i počesto infertilitet. Iako je točna etiologija nejasna, poznato je više hormonalnih poremećaja među kojima se ističu hiperandrogenemija, inzulinska rezistencija i hiperinzulinemija. Čini se da inzulin remeti sve komponente hipotalamo-hipofizno-ovarijske osi, a inzulinska rezistencija tkiva jajnika uzrokuje poremećenu metaboličku funkciju, ali netaknutu mitogenu i steroidogenu aktivnost, pogotovo kad su androgeni u pitanju.
Mnoge kliničke studije su istaknule povezanost PCOS-a i rizika kardiovaskularnih bolesti kod tih pacijentica koja proizlazi iz promijenjenog metabolizma lipida i glukoze, hipertenzije i sustavnog upalnog stanja. Osim tih poznatih faktora rizika, novije studije otkrivaju druge zanimljive značajke među tim pacijenticama kao što je povišena razina homocisteina u serumu i obrazac krvnog tlaka koji ne opada tijekom noći, čime se PCOS može smatrati zasebnim kardiovaskularnim rizičnim faktorom koji ozbiljno utječe na kvalitetu života.
S obzirom na te ozbiljne posljedice, važno je temeljito razumjeti patofiziološke poveznice koje čine ishodište PCOS-a kako bi se moglo pružiti djelotvornu strategiju liječenja i jamčiti poboljšanu kvalitetu života ženama s ovim sindromom.

Abstract (english)

Polycystic ovary syndrome or Stein-Leventhal syndrome is the most common endocrine-metabolic disorder of reproductive-aged women that implies various severe consequences to female health, including alarming rates of infertility. Great efforts have been made in the last 2 decades to define the syndrome. The exact prevalence of PCOS varies depending on which criteria are used to make the diagnosis, but is as high as 15%–20% when the European Society for Human Reproduction and Embryology criteria are used.
Clinical manifestations include oligomenorrhea or amenorrhea, hyperandrogenism, and frequently infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance, and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia.
Many clinical studies have underlined the connection between PCOS and the cardiovascular risk profile of such female patients, due to a lipid/glucose altered metabolism, hypertension, and systemic inflammatory condition. Apart from well-known cardiovascular risk factors, the recent studies underline interesting common features among these patients such as “non dipping” pattern of blood pressure and increased serum levels of homocysteine. Therefore, PCOS could be considered as a real cardiovascular risk factor which affects the quality of life seriously.
Given these severe implications, it is important to thoroughly understand the pathophysiologic interconnections underlying PCOS, in order to provide superior therapeutic strategies and warrant improved quality of life to women with this syndrome.

• Keywords: sindrom policističnih jajnika; amenoreja; inzulinska rezistencija; hiperandrogenizam; kardiovarskularni rizik
• Keywords (english): polycystic ovary syndrome; amenorrhea; insulin resistance; hyperandrogenism; cardiovascular risk
• Language: croatian
• URN:NBN: urn:nbn:hr:105:568691
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-11-24 13:33:25