Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Polycystic Ovary Syndrome and Insulin Resistance

다낭성난소증후군과 인슐린 저항성

Hwang, Ju-Youn;Lee, Byung-Seok
황주연;이병석

  • Published : 20060600
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Abstract

Polycysytic Ovary Syndrome (PCOS) is a common endocrine disorder characterized by chronic anovulation and hyperandrogenism. The etiology of PCOS is complex and incompletely understood. Accumulating data conclude that hyperinsulinemia and hyperandrogenemia may cause hormonal abnormalities that lead to disturbance of ovarian function. Although insulin resistance is not a part of the diagnostic criteria for PCOS, its importance in its pathogenesis can not be ignored. Excess insulin is capable of stimulating steroidogenesis and therefore excessive androgen production occurs from the theca cell system. Recently, the effects of insulin sensitizer in PCOS patients are being reported and they include the improvement of menstrual pattern, improvement in hyperandrogenism, increased response in ovulation induction and prevention of cardiovascular diseases. Understanding the relation of PCOS and insulin resistance will offer an improvement in treatment of PCOS in the future.

무배란과 고안드로겐증을 특징으로 하는 내분비 질환인 다낭성 난소 증후군은 전체 가임기 여성의 약 5-10%에서 볼 수 있다. 발생 기전이 정확하게 밝혀져 있지는 않으나 여러 가지 임상 증상을 나타내는 증후군으로서 무배란성 불임과 만성 고안드로겐증 및 인슐린 저항의 흔한 원인이 되고 있다. 인슐린 저항성은 진단 기준에는 속하지는 않으나 다낭성 난소 증후군의 발생 및 치료와 밀접한 연관을 가지고 있는 것으로 알려져 있다. 인슐린에 의한 지속적인 자극으로 인하여 난소에서 스테로이드 합성이 증가하게 되고 성호르몬 결합 단백질의 감소와 연관되어 고안드로겐증 등 병리적 상태가 유발된다. 최근 metformin이나 thiazolidinedione과 같은 인슐린 반응 개선제를 투여한 경우 배란 유도와 월경 주기 정상화에 도움이 된다는 보고들이 있다. 다낭성 증후군과 인슐린 저항성의 관계에 대한 정확한 이해를 통하여 더욱 효과적인 다낭성 증후군의 치료에 기여할 수 있겠다.

Keywords

References

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