Polyzystisches Ovarsyndrom und metabolisches Syndrom

 

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Das Krankheitsbild des polyzystischen Ovarsyndroms (PCOS) ist definiert durch eine primär ovarielle Hyperandrogenämie und chronische Anovulation. Mit einer Prävalenz von 5-7 % stellt das PCOS eine der häufigsten gynäkologisch-endokrinologischen Erkrankungen dar. Als ein wesentlicher pathogenetischer Faktor besteht häufig eine Insulinresistenz. Überdurchschnittlich häufig finden sich auch eine gestörte Glukosetoleranz oder ein Diabetes mellitus Typ 2, eine Adipositas oder ein metabolisches Syndrom. Die Assoziation von kardiovaskulären Risikofaktoren legt eine erhöhte kardiovaskuläre Morbidität und Mortalität nahe. Aktuelle klinische Studien zeigen positive Effekte von Gewichtsreduktion, Metformin und Insulinsensitizern nicht nur auf die Insulinresistenz und das metabolische Syndrom, sondern auch auf die Hyperandrogenämie und die ovarielle Dysfunktion. Ziel dieser Übersichtsarbeit ist es, die zentrale Rolle der Insulinresistenz in der Pathogenese des PCOS darzustellen und aktuelle Therapiemöglichkeiten der Insulinresistenz beim PCOS zu diskutieren.

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Dr. med. Christoph J. Auernhammer

Medizinische Klinik II, Klinikum der Ludwig-Maximilians-Universität, Standort Grosshadern

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81377 München

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