Синдром поликистозных яичников и кардиоваскулярный риск

Синдром поликистозных яичников (СПКЯ) является частным эндокринным заболеванием у женщин репродуктивного возраста. Помимо гиперандрогенемии, нарушений овуляции и фертильности, СПКЯ ассоциирован с повышением частоты выявления таких факторов риска кардиоваскулярных болезней, как ожирение, инсулинорезистентность, нарушенная толерантность к глюкозе, сахарный диабет 2-го типа, артериальная гипертензия и синдром обструктивного апноэ во время сна. Начальные стадии атеросклеротического процесса также хорошо документированы у женщин с СПКЯ. Однако данные проспективных исследований, касающихся конечных точек кардиоваскулярной заболеваемости и смертности, являются скудными и противоречивыми. Возможно, это связано с тем, что СПКЯ представляет собой гетерогенную группу эндокринных, метаболических и репродуктивных нарушений, и разные авторы объединяют в синдром различные совокупности этих нарушений. Разные фенотипы СПКЯ могут быть ассоциированы с разным кардиоваскулярным риском. Максимально он выражен у женщин с «полным» фенотипом (сочетанием всех трех диагностических критериев СПКЯ) и с преобладанием гиперандрогенемии. По данным ряда исследований, основной вклад в повышение риска развития сахарного диабета 2-го типа вносит ожирение, которое выявляется более чем у половины женщин с СПКЯ. Несмотря на слабость доказательной базы в отношении связи СПКЯ с кардиоваскулярной заболеваемостью и смертностью, большинство международных организаций рекомендуют активно выявлять факторы кардиоваскулярного риска у женщин с СПКЯ.

синдром поликистозных яичников, кардиоваскулярный риск, сердечно-сосудистые болезни, сахарный диабет

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