REVIEW

Pharmacotherapy and Neoteric Dietary Approaches for Polycystic Ovary Syndrome: A Systematic Review
Polikistik Over Sendromu İçin Farmakoterapi ve Neoterik Diyet Yaklaşımları: Sistematik Bir Derleme
Received Date : 15 Sep 2020
Accepted Date : 31 Dec 2020
Available Online : 09 Mar 2021
Doi: 10.25179/tjem.2020-78987 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:113-122
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Polycystic ovary syndrome (PCOS) is an ovarian disorder secondary to the dysregulated hypothalamic-pituitary-adrenal axis leading to androgen excess. Numerous studies have documented that insulin resistance is the key pathophysiological element for the development of PCOS. Insulin acts synergistically with luteinizing hormone (LH) to increase androgen production in the theca of the follicles. PCOS is the most malignant endocrine disorder affecting females (7%; from adolescence to menopause). PCOS results in multi-organs derangements categorized by raised androgen levels, irregular menses, and infertility with microcysts formation. The manifestation of PCOS can be specified as polycystic ovaries (morphological) and hyperandrogenemia & hyperlipidemia (metabolic derangements). Clinical hallmarks in PCOS are dyslipidemia, impaired glucose tolerance, hyperandrogenism, microcysts in ovaries, menstrual irregularities, anovulation, and obesity. During clinical examination, a woman’s identity is markedly threatened due to hirsutism, acne, alopecia, obesity, irregular menses, and infertility symptoms. Diagnosis is based on European Society for Human Reproduction and Embryology/ The American Society for Reproductive Medicine or Rotterdam consensus criteria. In this article, we present a precise and comprehensible glimpse of updated and efficient patient management via pharmacotherapy and diet therapy with the most practicable type of diets and their positive outcomes. Nutrients (inositol, isoflavonoids, omega-3) and their dose regimens are discussed. A calorie deficit of 500-1,000 kcal based on the patient profile has proven effective in revamping biochemical values and weight loss.
ÖZET
Polikistik over sendromu (PKOS), androjen fazlalığına yol açan hipotalamus-hipofiz-adrenal aksındaki bozulmaya sekonder bir over hastalığıdır. Çok sayıda çalışma, insülin direncinin PKOS gelişiminde anahtar patofizyolojik unsur olduğunu ortaya koymuştur. İnsülin, foliküllerin teka hücrelerinde androjen üretimini artırmak için luteinize edici hormon (LH) ile sinerjik olarak hareket eder. PKOS, kadınları etkileyen (%7; ergenlikten menopoza kadar) en kötü huylu endokrin bozukluktur. PKOS, yüksek androjen seviyeleri, düzensiz adetler, mikrokist oluşumu ve infertilite ile karakterize olan çoklu organ bozukluklarına neden olur. PKOS’un manifestasyonu polikistik overler (morfolojik), hiperandrojenemi ve hiperlipidemi (metabolik bozukluklar) olarak belirtilebilir. PKOS'un klinik karakteristikleri dislipidemi, bozulmuş glukoz toleransı, hiperandrojenizm, overlerde mikrokistler, adet düzensizlikleri, anovülasyon ve obezitedir. Klinik muayenede, kadınlık özeliklerinin hirsutizm, akne, alopesi, obezite, düzensiz adet kanaması ve kısırlık semptomları nedeniyle önemli ölçüde tehdit altında olduğu görülebilir. Tanı, Avrupa İnsan Üremesi ve Embriyoloji Derneği (ESHRE)/Amerikan Üreme Tıbbı Derneği (ASRM) veya Rotterdam konsensüsü kriterlerine dayanmaktadır. Bu yazıda, en uygulanabilir diyet türleri ve olumlu sonuçları ile diyet tedavisi ve farmakoterapi üzerinden güncellenmiş ve etkili hasta yönetimine dair kesin ve anlaşılır bir bakış sunulmuştur. Besinler (inositol, izoflavonoidler, omega-3) ve bunların doz rejimleri tartışılmıştır. Hasta profiline göre 500-1.000 kcal’lik bir kalori açığının, biyokimyasal değerlerin düzeltilmesinde ve kilo kaybında etkili olduğu kanıtlanmıştır.
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