medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-205medsovet-8278Research ArticleДРУГИЕ ПРОБЛЕМЫ ЭНДОКРИНОЛОГИИOTHER PROBLEMS OF ENDOCRINOLOGYНовые аспекты в диагностике и лечении синдрома поликистозных яичниковNew aspects in the diagnosis and treatment of polycystic ovary syndromehttps://orcid.org/0009-0006-5222-5035ЕфименкоВ. В.EfimenkoV. V.

Ефименко Валерия Викторовна, студент

119991, Москва, ул. Трубецкая, д. 8, стр. 2

 

Valeria V. Efimenko, Student

8, Bldg. 2, Trubetskaya St., Moscow, 119991

penkina20003@gmail.comhttps://orcid.org/0000-0001-7606-6565ХачатуровМ. В.KhachaturovM. V.

Хачатуров Михаил Викторович, студент

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Mikhail V. Khachaturov, Student

8, Bldg. 2, Trubetskaya St., Moscow, 119991

khachaturov.michael@gmail.comhttps://orcid.org/0009-0009-4181-1620ГасановаА. М.GasanovaA. M.

Гасанова Айнур Малик кызы, студент

625023, Тюмень, ул. Одесская, д. 54

Ainur M. Gasanova, Student

54, Odesskaya St., Tyumen, 625023

ainur180100@gmail.comhttps://orcid.org/0000-0002-0202-1257МартиросянН. С.MartirosianN. S.

Мартиросян Нарине Степановна, к.м.н., доцент кафедры эндокринологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Narine S. Martirosian, Associate Professor, Endocrinology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

martirosyan_n_s@staff.sechenov.ruhttps://orcid.org/0000-0001-7923-4894КузинаИ. А.KuzinaI. A.

Кузина Ирина Александровна, ассистент кафедры эндокринологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

 

Irina A. Kuzina, Assistant Professor, Endocrinology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

kuzina_i_a@staff.sechenov.ruhttps://orcid.org/0000-0001-7025-8427ГончароваЕ. В.GoncharovaE. V.

Гончарова Екатерина Валерьевна, к.м.н., доцент кафедры эндокринологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Ekaterina V. Goncharova, Associate Professor, Endocrinology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

goncharova_e_v_2@staff.sechenov.ruhttps://orcid.org/0000-0001-8007-9721ТельноваМ. Э.TelnovaM. E.

Тельнова Милена Эдуардовна, к.м.н., доцент кафедры эндокринологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Milena E. Telnova, Associate Professor, Endocrinology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

telnova_m_e@staff.sechenov.ruhttps://orcid.org/0000-0001-9390-1200ПетунинаН. А.PetuninaN. A.

Петунина Нина Александровна, чл.корр. РАН, д.м.н., профессор, заведующая кафедрой эндокринологии

119991, Москва, ул. Трубецкая, д. 8, стр. 2

 

Nina A. Petunina, Сorr. Member RAS, Dr. Sci. (Med.), Professor, Head of Endocrinology Department

8, Bldg. 2, Trubetskaya St., Moscow, 119991

etunina_n_a@staff.sechenov.ruПервый Московский государственный медицинский университет имени И.М. Сеченова (Сеченовский Университет)РоссияSechenov First Moscow State Medical University (Sechenov University)Russian FederationТюменский государственный медицинский университетРоссияTyumen State Medical UniversityRussian Federation20241905202406140147Copyright © Ефименко В.В., Хачатуров М.В., Гасанова А.М., Мартиросян Н.С., Кузина И.А., Гончарова Е.В., Тельнова М.Э., Петунина Н.А., 20242024Ефименко В.В., Хачатуров М.В., Гасанова А.М., Мартиросян Н.С., Кузина И.А., Гончарова Е.В., Тельнова М.Э., Петунина Н.А.Efimenko V.V., Khachaturov M.V., Gasanova A.M., Martirosian N.S., Kuzina I.A., Goncharova E.V., Telnova M.E., Petunina N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8278

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 рекомендациям ESHRE 2018 и 2023 гг., сделаны акценты на проблеме качества жизни женщин с СПКЯ. С момента выхода клинических рекомендаций ESHRE 2018 г. прошло 5 лет, были пересмотрены критерии диагностики и линии терапии данного заболевания. В этом обзоре особое внимание будет уделено роли метформина. Согласно новым клиническим рекомендациям его можно использовать не только пациентам с повышенным индексом массы тела (ИМТ), но и при нормальном ИМТ с целью снижения инсулинорезистентности. Также рассмотрено новое место инозитола в терапии СПКЯ как альтернативного средства, повышающего чувствительность рецепторов к инсулину. Приведены схемы лечения ингибиторами ароматазы для решения такой проблемы, как бесплодие. В связи с тем что пока еще не определена этиология синдрома поликистозных яичников (СПКЯ), терапевтические вмешательства на данный момент носят преимущественно симптоматический характер, поэтому в статье освещен процесс разработки методов лечения, которые основываются на достижениях в генетике и эпигенетике.

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.

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The authors declare that there are no conflicts of interest present.