POLYCYSTOSIS YA LITLHAKISO (PCOS) LE KOTSI EA KOTSI

Mohopolo oa ho hanyetsa insulin o bolela ho fokotseha ha kutloisiso ea lisele ho hlahisoeng ha insulin. Ena anomaly hangata e bonoa ho bakuli ba nang le lefu la tsoekere, empa maemong a mang, ho hanyetsa insulin ho boetse ho bonahala bathong ba phetseng hantle.

Boloetse bo kang polycystic ovary syndrome (PCOS) bo bonahala maemong a mangata ho basali ba nang le mafu a endocrine. E tšoauoa ka phetoho ea ts'ebetso ea ovari (ho eketseha hoa ovulation kapa ho ba sieo, ho lieha ho ilela khoeli). Ho 70% ea bakuli, PCa e supa boteng ba mofuta oa lefu la tsoekere la mofuta oa 2.

Ho hanyetsa spy le insulin ke likhopolo tse amanang haholo mme hajoale bo-rasaense ba qeta nako e ngata ba ithuta ka kamano ea bona. Ka tlase, lefu ka bolona, ​​kalafo ea lefu la polycystic, tlhahlobo ea monyetla le monyetla oa ho ima ka tlhaho, kamano lipakeng tsa polycystic le insulin ea hormone, le kalafo ea lijo bakeng sa lefu lena li tla hlalosoa ka botlalo.

Polycystic

Lefu lena le fumanoe qalong ea lekholo la ho qetela la lilemo ke bo-rasaense ba babeli ba Amerika - Stein le Leventhal, hoo lefu la polycystic le lona le bitsoang Stein-Leventhal syndrome. Etiology ea lefu lena ha e so ithutoe ka botlalo. E 'ngoe ea matšoao a mantlha ke secretion e eketsehileng ea li-hormone tsa botona ba botona' meleng oa mosali (hyperandrogenism). Sena se bakoa ke ts'ebetso ea "adrenal" e senyehileng kapa ea ovari.

Tabeng ea PCOS, ovary e na le tšobotsi e boletsoeng ea morphological - polycystic, ntle le neoplasms. Ka li-ovary, motsoako oa sebopeho sa Corpus luteum ha o na bothata, tlhahiso ea progesterone e koetsoe, mme mathata a ovulation le ho ilela khoeli a teng.

Matšoao a pele a bontšang lefu la Stein-Leventhal:

• Ho lieha kapa ho lieha ho ilela khoeli ka nako e telele,
• Moriri o feteletseng libakeng tse sa batleheng (sefahleho, mokokotlo, sefuba, lirope tsa ka hare),
• Makhopho, letlalo le nang le mafura, moriri o mafura,
• Phaello e boima ea boima ba kilo tse 10 ka nako e khuts'oane,
• Ho kuta moriri
• Ho hula bohloko bo fokolang ka mpeng e ka tlase nakong ea ho ilela khoeli (syndrome ea bohloko bo boholo ha e tloaelehileng).

Potoloho e tloaelehileng ea mae a bomme ho basali e laoloa ke phetoho ea boemo ba lihormone bo hlahisang pituitary le mae a bomme. Nakong ea ho ilela khoeli, ho hlaha ha ovary ho etsahala hoo e ka bang libeke tse peli pele e qala. Mahe a mangata a hlahisa estrogen ea hormone, hammoho le progesterone, e lokisetsang popelo ho emolisa lehe le emolisitsoeng. Ka tekanyo e nyane, ba hlahisa testosterone ea banna. Haeba ho ima ho sa etsahale, joale litekanyetso tsa li-hormone lia fokotseha.

Ka polycystosis, mae a bomme a etsa hore testosterone e eketsehe. Sena sohle se ka lebisa ho se be le bana le matšoao a ka holimo. Ho bohlokoa ho tseba hore li-hormone tsa botona ba botšehali li hlaha 'meleng feela ka lebaka la boteng ba li-hormone tsa banna, li li fetole. Ha e le hantle, ntle le boteng ba lihormone tsa banna, basali le bona ba ke ke ba etsoa 'meleng oa mosali.

Sena se tlameha ho utloisisoa, hobane liphoso mohokahanong ona li baka ovary ea polycystic.

PCOS LE INSULIN RESISTance

Lilemong tse 20 tse fetileng, ho fumanoe hore hyperinsulinemia ke sesosa se ka sehloohong sa polycystic ovary syndrome (PCOS) ka karolo e kholo ea basali. Bakuli ba joalo ba na le "metabolic PCOS," e ka nkoang e le boemo ba prediabetesic. Hangata, banana bana ba na le botenya, ho ilela khoeli, ebile ba na le ba amanang le lefu la tsoekere.

Boholo ba basali ba nang le polycystic ovary syndrome (PCOS) ha ba na insulin ebile ba batenya. Boima bo bongata ka bo bona ke sesosa sa ho ferekanya ha metabolic. Empa ho hanyetsa insulin ho boetse ho fumanoa ho basali ba nang le PCOS ba sa bateng haholo. Sena se bakoa haholo ke maemo a LH le testosterone ea mahala ea serum.

Ntho e mpe e nyarosang bakeng sa basali ba nang le ovary ea polycystic ke hore mefuta e meng ea lisele tse 'meleng - hangata mesifa le mafura - e kanna ea ba le insulin, ha lisele tse ling le litho li kanna tsa se be joalo. Ka lebaka leo, gland ea pituitary, mae a bomme le litšoelesa tsa adrenal ho mosali ea hanyetsang insulin li arabela maemong a phahameng feela a insulin (mme u se ke oa arabela ka mokhoa o tloaelehileng), e leng ho eketsang li-luteinizing li-hormone le androgens. Ketsahalo ena e bitsoa "ho hanyetsa ka mokhoa o ikhethileng."

Mabaka

Ho lumeloa hore e 'ngoe ea lisosa tse ka sehloohong tsa ho hanyetsa insulin ke keketseho ea palo ea mafura. Liphuputso tse ngata li bonts'a hore litaba tse phahameng tsa mafura a mangata maling li lebisa ntlheng ea hore lisele, ho kenyelletsa le lisele tsa mesifa, li khaotsa ho araba insulin ka mokhoa o tloaelehileng. Sena se ka bakoa haholo ke mafura le metabolites ea mafura acid e ntseng e hola ka har'a lisele tsa mesifa (mafura a methapo ea kutlo). Lebaka le ka sehloohong la ho eketsa mafura acids a mangata ke ho ja lik'hilojule tse ngata haholo le ho ba motenya haholo. Ho nona haholo, ho nona le ho nona haholo li amana ka matla le ho hanyetsa insulin. Mafura a visceral ka mpeng (ho potoloha litho) a kotsi haholo. E ka ntša li-acid tse ngata tse sa lefelloeng maling le ho lokolla lihormone tse sa foleng tse lebisang ho hanyetsaneng ha insulin.

Basali ba nang le boima bo tloaelehileng (esita le bo bobebe) ba kanna ba ba le PCOS le ho hanyetsoa ke insulin, empa bokuli bona bo atile haholo bathong ba nonneng haholo.

Ho na le lisosa tse 'maloa tse ka bakang lefu lena:

Ho ja lijo tse matlafatsang (ho tsoa ho tsoekere eseng litholoana) ho hokahane le ho hanyetsa insulin.

Ho eketseha ha khatello ea oxidative le ho ruruha 'meleng ho ka lebisa ho hanyetsanang le insulin.

Ho ikoetlisa ho matlafatsa kutloisiso ea insulin, ha ho ikoetlisa, ho fapana le hoo, hoa fokotseha.

Ho na le bopaki ba hore tlolo ea tikoloho ea kokoana-hloko ka ka popelong e ka baka ho ruruha, e eketsang mamello ea insulin le mathata a mang a metabolic.

Ntle le moo, ho na le liphatsa tsa lefutso le maemo sechabeng. Ho hakanngoa hore mohlomong batho ba 50% ba na le tloaelo e futsitsoeng ea lefu lena. Mosali a ka ba sehlopheng sena haeba a e-na le nalane ea lelapa ea lefu la tsoekere, lefu la pelo, khatello ea mali kapa PCOS. Ho a mang, ho hanyetsa insulin ka 50% ho hlaha ka lebaka la phepelo e se nang phepo, botenya le ho se ikoetlise.

Ts'oaetso

Haeba ovary ea polycystic e belaelloa, lingaka kamehla li beha liteko tsa ho hanyetsa insulin bakeng sa basali.

Ho potlakisa insulin e ngata ke sesupo sa ho hana.

Teko ea HOMA-IR e lekanya index ea ho hanyetsa insulin, hobane ho fanoa ka glucose ena le insulin e potlakileng. Ha e le holimo, e mpe le ho feta.

Teko ea ho mamella glucose e lekanya tsoekere e potlakileng le lihora tse peli ka mor'a ho nka tsoekere e itseng.

Glycated hemoglobin (A1C) e lekanya boemo ba glycemia likhoeling tse tharo tse fetileng. Sekhahla se loketseng se lokela ho ba ka tlase ho 5.7%.

Haeba mosali a na le botenya bo bongata, botenya le bongata ba mafura a lethekeng la hae, menyetla ea ho hanyetsa insulin e phahame haholo. Ngaka e boetse e lokela ho ela hloko sena.

1. Letsoalo le letšo (Negroid)

Lena ke lebitso la boemo ba letlalo leo ho lona ho bonoang matheba a lefifi libakeng tse ling, ho kenyelletsa le mabota (armpits, molala, libaka tse ka tlasa sefuba). Ho ba teng ha eona ho boetse ho bontša ho hanyetsa insulin.

Li-cholesterol tse tlase tsa "HDL" "e ntle" le "triglycerides" tse ling tse peli tse amanang ka matla le insulin.

Insulin e phahameng le tsoekere ke matšoao a bohlokoa a ho hanyetsoa ha insulin li-ovary tsa polycystic. Matšoao a mang a kenyelletsa mafura a mangata ka mpeng, li-triglycerides tse phahameng, le HDL e tlaase.

Mokhoa oa ho fumana hore na Resistance ea Insulin

Mosali a ka ba le bothata bona haeba a e-na le matšoao a mararo kapa ho feta moo:

• khatello e phahameng ea mali e sa foleng (e feta 140/90),
• boima ba 'nete bo feta bo loketseng ka kilo tse 7 kapa ho feta,
• triglycerides li phahamisitsoe,
• Kakaretso ea k'holeseterole e phahame ho feta e tloaelehileng
• Cholesterol e "ntle" e tlase ho 1/4 ea kakaretso,
• uric acid e phahameng le tsoekere e phahameng,
• hemoglobin e ngata
• li-enzyme tse phahameng tsa sebete (ka linako tse ling)
• magnesium e tlase.

Liphetho tsa insulin e eketsehileng:

• polycystic ovary syndrome,
• makhopho
• hirsutism
• ho hloka thari
• lefu la tsoekere
• litakatso tsa tsoekere le lik'habohaedreite,
• apole ea mofuta oa apole le bothata ba ho fokotsa boima ba 'mele
• khatello e phahameng ea mali
• lefu la pelo
• ho ruruha
• mofets'e
• mafu a mang a mpefatsang
• fokotsa bophelo.

HO FIHLA INSULIN, PCOS LE METABOLIC SYNDROME

Ho hanyetsa insulin ke letšoao la maemo a mabeli a tloaelehileng haholo - metabolic syndrome le lefu la tsoekere la mofuta oa 2. Metabolic syndrome ke maemo a kotsi a amanang le lefu la tsoekere la 2, lefu la pelo le mathata a mang. Matšoao a kenyelletsa triglycerides e phahameng, HDL e tlase, khatello e phahameng ea mali, botenya bohareng (mafura a lethekeng), le tsoekere e phahameng ea mali. Ho hanyetsa insulin le hona ke ntho e ka sehloohong ntlafatsong ea lefu la tsoekere la mofuta oa 2.

Ka ho thibela tsoelo-pele ea khatello ea insulin, maemo a mangata a lefu la tsoekere le mofuta oa 2 lefu la tsoekere a ka thibeloa.

Ho hanyetsa insulin ho teng pelong ea lefu la metabolic, lefu la pelo le lefu la tsoekere la mofuta oa 2, tseo hona joale e leng a mang a mathata a tloaelehileng a bophelo lefatšeng. Maloetse a mang a mangata a boetse a amana le ho hanyetsa insulin. Tsena li kenyelletsa lefu la mafura a sebete a sa noeng joala, polycystic ovary syndrome (PCOS), lefu la Alzheimer's le mofets'e.

KAMOO U KA BULEHANG BOTSOALLE KATENG HO PHETHA LEBITSO LA POLYCYSTOSIS OF OVARIES

Le ha ho hanyetsa insulin e le tlolo e tebileng e lebisang liphellong tse mpe, e ka loants'oa. Moriana o nang le metformin ke kalafo ea mantlha e boletsoeng ke lingaka. Leha ho le joalo, basali ba nang le mofuta o thibelang insulin ea PCOS ba hlile ba ka phekoloa ka ho fetola tsela eo ba phelang ka eona.

Mohlomong ena ke eona tsela e bonolo ka ho fetisisa ea ho ntlafatsa kutloisiso ea insulin. Tšusumetso e tla bonahala hang-hang. Khetha tšebetso ea 'mele eo u e ratang haholo: ho matha, ho tsamaea, ho sesa, ho palama baesekele. Ho molemo ho kopanya lipapali le yoga.

Ho bohlokoa ho lahleheloa ke mafura a visceral hantle, a teng ka mpeng le sebete.

Lisakerete li ka baka ho hanyetsa insulin le ho mpefatsa boemo ba basali ba nang le ovary ea polycystic.

1. Fokotsa tsoekere

Leka ho fokotsa tekanyo ea tsoekere, haholo-holo ho tsoa lino tse tsoekere tse tsoekere.

1. E ja Tse Phelang

Lijo tsa ovary ea polycystic li lokela ho thehiloe lijong tse se nang phepo. Kenyelletsa linate le litlhapi tse nang le mafura lijong tsa hau.

Ho ja mafura a omega-3 acid ho ka fokotsa triglycerides ea mali, eo hangata e phahamisoang ka lefu la polycystic ovary le ho hanyetsa insulin.

Nka li-supplements ho eketsa maikutlo a insulin le tsoekere e tlase ea mali. Tsena li kenyelletsa, mohlala, magnesium, berberine, inositol, vithamine D le litlhare tse joalo tsa sinamone.

Ho na le bopaki ba hore boroko bo fokolang, bo bokhutšoaane hape bo baka insulin.

Ho bohlokoa ho banana ba nang le ovary ea polycystic ho ithuta ho sebetsana le khatello ea maikutlo, khatello ea maikutlo le matšoenyeho. Yoga le li-supplements tse nang le livithamini tsa B le magnesium le tsona li ka thusa mona.

Tekanyo e phahameng ea tšepe e amahanngoa le ho hanyetsa insulin. Maemong ana, monehelo oa mali o fanang ka mali, phetoho ea ho tloha ho nama ho ea lijong tsa meroho, le ho kenyelletsoa ha lihlahisoa tse ngata tsa lebese lijong ho ka thusa basali ba postmenopausal.

Ho hanyetsa insulin ho basali ba nang le ovary ea polycystic ho ka fokotsoa haholo le ho phekoloa ka botlalo ka liphetoho tse bonolo tsa mokhoa oa bophelo, o kenyelletsang lijo tse nang le phepo e ntle, tlatsetso, ho ikoetlisa ka 'mele, ho theola boima ba' mele, ho robala hantle le ho fokotsa khatello ea maikutlo.

Sengoloa sa sengoloa sa mahlale ho tsa bongaka le tsa bophelo bo botle, mongoli oa pampiri ea mahlale ke Matsneva I.A., Bakhtiyarov K.R., Bogacheva N.A., Golubenko E.O., Pereverzina N.O.

Polycystic ovary syndrome (PCOS) ke e 'ngoe ea mefuta e atileng haholo ea endocrinopathies. Leha ho na le ts'oaetso e phahameng ea PCOS le nalane e telele ea lipatlisiso, etiology, pathogeneis, ho fumanwa ha kalafo le kalafo ea lefutso e ntse e le tsona tse ka tsejoang haholo. Lilemong tsa morao tjena, tlhokomelo e ntseng e eketseha ea bo-ramahlale e hapiloe ke potso ea tlatsetso ea hyperinsulinemia ho nts'etsopele ea PCOS. Hoa tsebahala hore maemong a 50-70%, PCOS e kopantsoe le botena, hyperinsulinemia, le liphetoho liponong tsa mali, tse eketsang kotsi ea ho ba le mafu a pelo, mofuta oa 2 oa lefu la tsoekere 'me li lebisa ho fokotseha ha nako e telele ea bophelo. Bafuputsi ba bangata ba supa boikemelong ba liphatsa tsa lefutso tsa metabolic ho PCOS, ponahatso ea eona e eketsoa le ho feta ha boima ba 'mele bo feteletseng. Karolo ea hajoale thutong ea pathogenesis ea PCOS e bontšoa ke tlhahlobo e tebileng ea mafu a metabolic: ho hanyetsa insulin, hyperinsulinemia, botenya, hyperglycemia, dyslipidemia, ts'oaetso ea methapo, ho ithuta ka phello e sa tobang ea ts'ebetso ea methapo ea methapo ea mafu ka mafu a sefuba, le mafu a amanang le lefu la tsoekere le a sa ts'oaneng le "insulin" mafu. Sena se ka hlalosa ho batloa ha tlhahlobo e ncha e khethehileng ho bona hore na ke matšoao afe a ka sebelisoang ts'ebetsong ea letsatsi le letsatsi e le ba boletsoeng esale pele ba kotsing ea metabolic le pelo le bakuli ba PCOS.

HO SIRELETSA SYSTEM LE TLHOMPELISO EA PUSO BOPHELO BA POLYCYSTIC OVARIAN SYNDROME

Polycystic ovarian syndrome (PCOS) ke e 'ngoe ea mefuta ea endocrinopathies hangata. Leha ho na le khaello e phahameng ea PCOS le pale e telele ea boithuto, litaba tsa etiology, pathogeneis, ho hlahloba lefu lena le kalafo ea lefu lena e ntse e le tseko e kholo. Lilemong tsa morao tjena, tlhokomelo e ntseng e eketseha ea bo-ramahlale e hapiloe ke potso ea tlatsetso ea hyperinsulinemia ho nts'etsopele ea PCOS. Hoa tsebahala hore ho 50-70% ea linyeoe PCOS e kopantsoe le botena, hyperinsulinemia le liphetoho molomong> ho hanyetsa insulin, hyperinsulinemia, botenya, hyperglycemia, dyslip> systemic kuvimba mae a bomalimabe, le mafu a amanang le ona a kang lefu la tsoekere le ikemetseng la lefu la tsoekere le lefu la pelo. Sena se ka hlalosa ho batloa ha tlhahlobo e ncha ea tlhahlobo ho tseba hore na ke matšoao afe a ka sebelisoang ts'ebetsong ea letsatsi le letsatsi e le ba boletsoeng esale pele ba kotsi ea metabolic le pelo le bakuli ba PCOS.

Sengoloa sa mosebetsi oa mahlale ka sehlooho "Ho ruruha ha systemic le ho hanyetsa insulin ho" polycystic ovary syndrome "

HO FIHLELA SYSTEM LE HO FIHLELA INSULIN SYNDROME

Matsneva I.A., Bakhtiyarov K.R., Bogacheva N.A., Golubenko E.O., Pereverzina N.O.

FGAOU VO University ea bongaka ea pele ea bongaka ea Moscow State e reheletsoeng ka I.M. Sechenov (Univesithi ea Sechenov), Moscow, Russia Federation

Tsebiso. Polycystic Ovary Syndrome (PCOS) ke e 'ngoe ea mefuta e atileng haholo ea endocrinopathies. Leha ho na le ts'oaetso e phahameng ea PCOS le nalane e telele ea lipatlisiso, etiology, pathogeneis, ho hlahlojoa le kalafo ea lefu la tsoekere e ntse e le tsona tse qholotsoang haholo. Lilemong tsa morao tjena, tlhokomelo e ntseng e eketseha ea bo-ramahlale e hapiloe ke potso ea tlatsetso ea hyperinsulinemia ho nts'etsopele ea PCOS. Hoa tsebahala hore maemong a 50-70%, PCOS e kopantsoe le botena, hyperinsulinemia, le liphetoho liponong tsa mali, tse eketsang kotsi ea ho ba le mafu a pelo, mofuta oa 2 oa lefu la tsoekere 'me li lebisa ho fokotseha ha nako e telele ea bophelo. Bafuputsi ba bangata ba supa boikemelong ba liphatsa tsa lefutso tsa metabolic ho PCOS, ponahatso ea eona e eketsoa le ho feta ha boima ba 'mele bo feteletseng. Karolo ea hajoale thutong ea pathogenesis ea PCOS e bontšoa ke tlhahlobo e tebileng ea mafu a metabolic: ho hanyetsa insulin, hyperinsulinemia, botenya, hyperglycemia, dyslipidemia, ts'oaetso ea methapo, ho ithuta ka phello e sa tobang ea ts'ebetso ea methapo ea methapo ea mafu ka mafu a sefuba, le mafu a amanang le lefu la tsoekere le a sa ts'oaneng le "insulin" mafu.

Sena se kanna sa hlalosa ho batloa ha tlhahlobo e ncha e khethehileng ho bona hore na ke lipontšo life tse ka sebelisoang ts'ebetsong ea letsatsi le letsatsi e le ba bolelang esale pele kotsi ea metabolic le pelo le bakuli ba PCOS.

Mantsoe a bohlokoa: ho hanyetsa insulin, ho ruruha hoa systemic, polycystic ovary syndrome, hyperinsulinemia, hyperandrogenism.

Mathata a ho khetholla lefu la ovary polycystic a sebetsa hona joale, leha taba ea hore PCOS e qalile ho hlalosoa ke Stein le Leventhal ka 1935. Mekhoa e nepahetseng ea tlhahlobo ea tšoaetso ha ea ka ea ba teng ho fihlela 2003, ha ho hlahlojoa mekhoa ea Rotterdam. Mekhoa ena e kenyelletsa:

1. Potoloho e sa tsamaisaneng /

2. Clinical / laboratori hyperandrogenism.

3. Li-ovaries tsa Polycystic.

Empa le hajoale, ho hlahlojoa ha PCOS ho baka mathata a itseng, tlhahlobo e nepahetseng ea mafu hangata e thehiloe kamora nako e telele, hangata, tlhahlobo le kalafo e sa utloahaleng. Sena ho fihlela joale se ka hlalosa ho khahla ha bafuputsi bothateng bona.

Polycystic ovary syndrome e hlaha ho 2% -20% ea basali, mme ke endocrinopathy e atileng haholo ho basali ba lilemo tsa ho ba le bana. Keketseho e felletseng lefats'e ke 3.5%.

Lilemong tsa morao tjena, tlhokomelo e ntseng e eketseha ea bo-ramahlale e hapiloe ke potso ea tlatsetso ea hyperinsulinemia ho nts'etsopele ea PCOS. Hoa tsebahala hore bakuli ba bangata ba nang le PCOS ha ba haneloe ke insulin, mme bakuli ba ka bang 50% ba fihlela litekanyetso tsa metabolic syndrome 2,3. PCOS hangata e amahanngoa le ho se sebetse hantle ha B-cell, e eketsang kotsi ea lefu la tsoekere la mofuta oa 2. Ho basali ba nang le PCOS, kotsi ena e phahame haholo ha e bapisoa le basali ba phetseng hantle ba boima bo lekanang le ba lilemo. Insulin e phahamisa tšebetso ea p450c17 ka mahetleng le litšoeleng tsa adrenal, e lebisang keketseho ea tlhahiso ea androgen.

Pathogenesis ea PCOS e kenyelletsa hyperandrogenism, botenya bohareng le khatello ea "insulin" (hyperinsulinemia). Tekanyo e phahameng ea testosterone e thusa ho nona ka mpeng, e leng eona e ka bakang insulin. Khanyetso ea insulin e etsa hore hyperinsulinemia ebe e hlohlelletsa keketseho ea li-secretion tsa li-ovary le litsoelesa tsa adrenal, e thibelang tlhahiso ea lihormone tsa thobalano tse tlamang globulin (SHBG), 'me ka tsela eo e eketsa ts'ebetso ea testosterone. Hape ho hanyetsa insulin

le botenya bo bohareng ba sephetho sa hyperandrogenism ho PCOS li amahanngoa le ts'ebetso e eketsehileng ea ho ruruha le secretion e eketsehileng ea adipokine, li-interleukin le chemokine, tse ka eketsang kotsi

nts'etsopele ea lefu la tsoekere le lefu la pelo.

Lintho tse nang le tšireletso le tse sa tsejoeng

Sa feiga 1. Potoloho e mpe ho PCOS.

DANISH MEDICAL JOURNAL. Litšoaneleho tsa endocrine le metabolic ho polycystic ovary syndrome. Dan med j

Khanyetso ea insulin. Ho hanyetsa insulin ho amana haufi le index ea 'mele (BMI), empa e teng le ho bakuli ba nang le boima bo tloaelehileng ho PCOS. Mokhoa o nepahetseng oa ho hanyetsa insulin ho PCOS o ntse o sa tsejoe. Bakuli ba PCOS ba na le tekanyo e ts'oanang le tumellano e ts'oanang ea li-insulin receptor ha li bapisoa le basali ba phetseng hantle, ka hona, ho hanyetsa insulin ho kanna ha ba ha fetoloa ka liphetoho lipapatsong tsa phetisetso ea lets'oao le kopantsoeng le insulin receptor. Ntle le moo, metabolism ea oxidative le e se nang oxidative e ile ea kenngoa ho bakuli ba nang le PCOS lithutong tse sebelisang mekhoa e sa tsejoeng ea calorimetry. Lithutong tsena, metabolism ea "glucose" e sa khothalletsoang ke "insulin" e entsoe ka matla haholo ho feta metabolism ea oxidative glucose, e tšehetsang ho fokotseha hoa ts'ebetso ea glycogen synthase ho PCOS. Ts'ebetso e fokolang ea glycogen synthase e netefatsoa ke lithuto tsa mesifa biopsy ho bakuli. Lithuto tsena li bontšitse hore bakuli ba nang le PCOS ba imetse insulin ho saena ka Akt le AS160, hammoho le ts'ebetso ea insulin-induction ea glycogen synthetase e kentsoeng ha e bapisoa le sehlopha sa taolo. Ho bakuli ba bang ba nang le PCOS, phofo ea serine e ile ea eketseha.

insulin receptor b, empa likarolo tse hole tsa insulin receptor cascade 6.7 le tsona li ile tsa ameha.

Khanyetso ea "insulin" ho basali ba nang le PCOS e kanna ea ba ka lebaka la liphatsa tsa lefutso kapa mekhoa e meng e joalo e ka bakoang ke botena le hyperandrogenism. Mechine ena e ile ea hlahlojoa le ho feta mefuteng ea mesifa e tlotsitsoeng e fumanoang ho bakuli ba hanyetsang insulin ho PCOS le basali ba phetseng hantle ba 8.9. Liphoso ketsong ea insulin, e phehellang liseleng tse tlositsoeng khubung ea vivo, e fana ka maikutlo a hore liphetoho tsena ke phello ea liphetoho tse bang teng liphatseng tsa lefutso tse laolang tsela ea ho tsamaisa lipontšo. Bo-rasaense ba fumane hore tsoekere ea tsoekere le oxidation, synthetic ea glycogen, le ho fumanoa ha lipid li ne li bapisoa pakeng tsa bakuli ba nang le PCOS le basali ba phetseng hantle, hape ba bile le ts'ebetso e tšoanang ea mitochondrial ea 6.7. Liphetho tsena li bonts'itse hore ho hanyetsa insulin ho PCOS le hona ke sephetho sa methapo e sebetsang. Pancreatic beta cell insulin secretion e eketsoa ho etsa tefo ea ho hanyetsa insulin. Kahoo, hyperinsulinemia ho PCOS le eona e ka ba mochine o sebetsang oa ho hanyetsa insulin.

Boithuto bo bontšitse hore li-insulin receptors li teng ka har'a mahe a tloaelehileng le a polycystic. Tšebelisanong le LH, insulin e ntlafatsa tšebetso ea p450c17 ka mahetleng le liteng tsa adrenal mme e lebisa keketsehong ea tlhahiso ea androgens. Boithuto bo netefatsa hore lisele tsa theca ho bakuli ba nang le PCOS li tsotella haholo litlamorao tsa androgen tsa insulin ho feta maeheng a tloaelehileng. Kahoo, insulin e ka sebetsa e le gonadotropin, e kenya letsoho keketseho ea tlhahiso ea androgens e tsoang liseleng tsa theknoloji. Ntle le moo, hyperinsulinemia e fokotsa tlhahiso ea SHBG sebeteng. Ka lebaka la mochine ona, maemo a mahala a testosterone a eketseha. Hape, maemo a tlase a SHBG a ile a sebelisoa ho hlahlobisiseng PCOS mme a ikamahanya le sensitivity e tlase ea insulin litekong tsa euglycemic hyperinsulinemic.

Testosterone e ka ntlafatsa ho hanyetsa ha insulin ka kotloloho kapa ka kotloloho. Testosterone e sebelisitsoeng ho litekanyetso tsa supraphysiological ho basali e ne e tsamaisana ka ho toba le ho hanyetsa insulin, ho hlahlojoa ho sebelisoa tlhahlobo ea euglycemic. Ntle le moo, litekanyetso tse phahameng tsa testosterone li ka kenya letsoho ho nona ka mpeng, e ka etsang hore insulin e hanyetsane. Li-phenotypes tsa PCOS tse nang le hyperandrogenism li ne li le khahlanong le insulin haholo ho feta phenotypes ntle le hyperandrogenism, e ileng ea boela ea tiisa bohlokoa ba hyperandrogenism ka ho hanyetsa insulin ho PCOS.

Ts'oaetso ea systemic le matšoao a tšoaetso. Ho latela liphuputso, bakuli ba nang le PCOS ba ka bang 75% ba boima bo feteletseng, 'me botenya bo bohareng bo bonoa ho bakuli ba nang le maemo a tloaelehileng le a boima haholo. Ho ata ha mathata a ho ja ho ne ho batla ho le 40% ho basali ba nang le hirsutism, mme ka lehlakoreng le leng, ho basali ba nang le PCOS, bulimia e ne e atile haholo. Sekhahla sa metabolic ha sea ka sa fokotseha ho bakuli ba nang le PCOS, 'me litekong tse sa reroang ho ne ho se na phapang bokhoni ba ho fokotsa boima pakeng tsa bakuli ba nang le PCOS le basali ba phetseng hantle lijong tse tšoanang. Leha ho le joalo, secretion ea ghrelin ka mor'a lijo e ne e sa hatelloe haholo ho PCOS ha e bapisoa le basali ba phetseng hantle, ho fana ka maikutlo a ho hloka takatso ea lijo. Grelin e sirelletsoa haholo ke lisele tsa endocrine tsa mpa. Maemo a Ghrelin a eketseha nakong ea tlala le ho fokotseha nakong ea lijo. Grecin secretion e fokotseha nakong ea tekanyo e ntle ea matla, joalo ka botenya. Ghrelin e hlahisoa ka lisele tsa pancreatic beta mme e ka thibela secretion ea insulin. Ghrelin e tlase e amahanngoa le ho hanyetsa insulin le lefu la tsoekere. Ghrelin e lumellana hantle le

adiponectin le morao le leptin. Liphuputso tse fetileng li tlalehile maemo a tlase a ghrelin ho bakuli ba nang le PCOS ha a bapisoa le basali ba phetseng hantle.

Boithuto bo bontšitse hore ho fokotseha hoa boleng ba bophelo ho PCOS ho ne ho amana le keketseho ea boima ba 'mele. Ho nona haholo ha Visceral ho tsamaisana le ho hanyetsa insulin le ho fokola ha moriana, ka mokhoa o batlang o kopantsoe le boemo ba ho ruruha ho ntseng ho hola butle. Adipose tiske e hlahisa le ho hlahisa liprotheine tse 'maloa tsa bioactive, ka kakaretso li bitsoa adipokins. Ntle le leptin le adiponectin, li-adipokine ha li hlahisoe feela ke li-adipocytes, li sirelelitsoe haholo ke li-macrophages tse mafura. Ka botenya, palo ea li-macrophages tse mafura li eketseha ka bobeli ho li-tiske tsa subcutaneous le visceral adipose, mme lisele tse potolohang li-mononuclear li sebetsa haholoanyane. Secretion e eketsehileng ea li-adipokines e bolela esale pele ka metabolic syndrome mme e eketsa kotsi ea ho ba le lefu la tsoekere.

Adiponectin ke protheine e tloaelehileng ka ho fetisisa e patiloeng mme e patiloe ka ho khetheha ke lithane tsa adipose. Secretion ea Adiponectin e fokotseha ka botenya. Adiponectin ea potoloho e tlase e amahanngoa le kotsi e eketsehileng ea ho hanyetsa insulin le nts'etsopele ea lefu la tsoekere la mofuta oa 2. Mekhoa eo adiponectin e amang kutloisiso ea insulin ha e utloisisehe ka botlalo. Liphuputso tsa liphoofolo le tsa vitro li bontšitse hore li-adiponectin tse pheta-phetoang li matlafatsa tsoekere ea mmele le hepatic, li fokotsa boemo ba gluconeogenesis sebeteng, le ho nts'etsapele oxidation ea mafura a mahala mafung a mesifa ea marapo. Ka hona, li-adiponectin li fokotsa maemo a triglyceride mme li eketsa kutloisiso ea insulin. Adiponectin e ka ba le phello e tobileng mosebetsing oa ovari. Li-receptor tsa Adiponectin li fumanoa ka popelong ea mahe le endometrium. Lisele tsa Theca ho bakuli ba nang le PCOS li ne li na le polelo e tlase ea li-receptor tsa adiponectin ha li bapisoa le li-ovary tsa basali ba phetseng hantle. Lithutong, ho hlohlelletsoa ha adiponectin ho ne ho amana le ho fokotseha ha tlhahiso ea androgen le androgen. Liphetho tsena li tiisa kamano e bohlokoa lipakeng tsa botenya, adiponectin, le hyperandrogenism ho PCOS. Keketseho ea testosterone ho bakuli ba batenya le PCOS e kanna ea kopanngoa le ho fokotseha ha adiponectin.

Leptin ke adipokine oa pele ea hlalosoang mme o na le tšusumetso ea bohlokoa ho taolo ea phepelo ea lijo le ts'ebeliso ea matla. Leptin o hlahella

adipocytes, e thibela ho kenella ha lijo mme e khothalletsa tšebeliso ea matla. Leptin e ama tšoelesa ea "hypothalamus" le "pituitary" ebile ha e ame feela taolo ea hypothalamic ea takatso ea lijo, empa le ts'ebetso ea kutloelo-bohloko ea kutloelo-bohloko. Ho litoeba, liente tsa leptin li ntlafalitse nts'etsopele ea ovarian follicle hobane Li-receptors tsa leptin li fumanoe kahara mahe a bomme, ho bontšang hore leptin e ka ba ntho ea bohlokoa bakeng sa ts'ebetso ea gonad. Boithuto bo boetse bo bonts'itse likamano tse haufi pakeng tsa leptin le BMI, sekhahla sa letheka le maemo a hanyetsang insulin.

Bakeng sa li-macrophages ho monya LDL (li-density lipoprotein tse tlase), li tlameha ho fuoa oxidised, li etse oxPLL e le sebopeho sa atherogenic sa LDL. Maemo a OxLDL a ile a eketseha ho bakuli ba nang le PCOS ha ba bapisoa le basali ba phetseng hantle. Ho feta moo, maemo a OxLDL a ne a bapisoa le ho bakuli ba nang le PCOS ba tloaelehileng le ba boima haholo, kahoo ho na le kamano e nyane pakeng tsa boima ba 'mele le oxPLL ea 25.26. CD36 e hlahisoa ka holim'a li-monocytes le macrophages. Ho thehwa ha lisele tsa foam ho qalisoa le ho matlafatsoa ke ho tlangoa ha li-receptor tsa oxLDL ho CD36, e leng ho etsang hore ts'ebetso ea CD36 e be sesosa sa lefu la pelo. Soluble CD36 (sCD36) e ka lekanngoa ho plasma mme e hokahane le ho hanyetsa insulin le glucose. Kamano e ntle e fumanoe pakeng tsa sCD36 le insulin le BMI. Bakuli ba PCOS ba ne ba e-na le maemo a phahameng a sCD36 ho feta basali ba phetseng hantle ba boima bo lekanang.

HsCRP e tsejoa hore e patiloe ho araba li-cytokines, ho kenyelletsa le IL-6. HsCRP e phahamisitsoeng e ne e le 'momori oa matla oa ntlha ea kotsi ea pelo le kotsi. HsCRP e ke ke ea ba letšoao la mafu a tšoaetsanoang feela, empa e ka ntlafatsa le ts'ebetso ea ho ruruha ka ho kenya tšebetsong limolek'hule le lisele tsa endothelial. Bakuli ba PCOS ba ne ba e-na le maemo a phahameng haholo a hsCRP ha a bapisoa le basali ba phetseng hantle. Litekong tsa morao-rao tsa meta, maemo a CRP a ne a le keketseho ea 96% ho PCOS khahlanong le sehlopha sa taolo mme a tsoela pele ho eketseha kamora ho khalemeloa BMI. Ho fumanoe hore hsCRP e hokahana hantle le matšoao a scXA a fumaneng mafura

boima, le ha ho se na proflation ea bohlokoa e fumanoeng ha ho lekanya testosterone kapa metabolism ea glucose.

Prolactin ha e pateloe ke tšoelesa ea pituitary feela, empa hape le macrophages ea lithane tsa adipose ha e arabela ho tsitsipana le ho tsepame ho phahameng ha tsoekere. Lithutong, prolactin e phahameng e ne e amahanngoa le keketseho ea palo ea lisele tse tšoeu tsa mali le mafu a autoimmune. Hypothesis ea hore prolactin e ka sebetsa e le adipokine e tšehetsoa ke lithuto ho bakuli ba nang le prolactinomas. Bakuli ba nang le prolactinoma ba ne ba loants'oa insulin, maikutlo a insulin a eketseha nakong ea kalafo ka dopamine agonist. Mefuta ea Prolactin e fumanoe e amana hantle le estradiol, testosterone e felletseng, DHEAS, 17-hydroxyprogesterone le cortisol maemong a bakuli ba PCOS. Litlhahlobisong tse 'maloa tsa khatello ea kelello, prolactin e ne e amahanngoa hantle le estradiol, 17OHP, le cortisol kamora ho tloaela lilemo, BMI le boemo ba ho tsuba. Boithuto mabapi le lisele tsa liphoofolo, prolactin e bile le phello e khothatsang e tobileng ho eketseheng ha lisele tsa adrenocortical, tse tlatselitseng ho adrenal hyperplasia 31.6.

Hape, haufinyane tjena, ka li-polycystic ovary syndrome, ho na le matšoao a mangata a tšoaetso le a metabolic. Tse ling tsa matšoao ana li kenyelletsa chemokine migration inhibition factor (MIF), protheine ea monocytic chemoattractant (MCP) -1 le protheine ea maqhubu a macrophage (MIP), visfatin le resitin, joalo-joalo. Lintlha tse mabapi le matšoao ana a kotsi lia hanyetsana, le bohlokoa ba tsona ho PCOS e ntse e lokela ho thehwa.

Kahoo, litholoana tsa lipatlisiso tse ngata li bonts'itse hore ho na le likamano tse itseng lipakeng tsa mats'oao a fapaneng a tšoaetso, ho hanyetsa insulin, le polycystic ovary syndrome (Tafole ea 1).

Ho hlokahala liphuputso tse ling ho fumana hore na ke matšoao afe a lokelang ho hlahlojoa liketsong tsa letsatsi le letsatsi e le ba boletsoeng esale pele ba kotsing ea metabolic le pelo le bakuli ba PCOS.

Likamano tse ka bang teng lipakeng tsa mats'oao a ho choachoasela le matšoao a palo ea mafura

boima, insulin le maemo a testosterone.

Matšoao a nang le tšoaetso ho PCOS.

Matšoao a bophahamo ba ho ruruha ho PCOS im / fat boima Insulin sensitivity Testosterone

Adiponectin Fokotsa (0 i ,.

Grepn Fokotsoe i t- (0

Prolactin Fokotsitsoe (V) 0) +

SCD36, oh-LDL Eketsehile (0 + + che

CRP Eketsetse + Che

Leptin Ka har'a meeli e tloaelehileng + + (+) che

IL-6 Tloaelehileng + N / A

t t "Kamano e matla e arohaneng, kamano e fapaneng, (t) (t) kamano e fokolang e fokolang

+ + kamano e fokolang e kopaneng, + li-inter-modulus (t) kamano e ntle: ha ho kamano

DANISH MEDICAL JOURNAL. Litšoaneleho tsa endocrine le metabolic ho polycystic ovary syndrome. Dan med j

BUKA KHAOLO. Physiology le Pathology ea Reproduction ea Basali

Jeniki ea bongaka ba endocrinology le metabolism. Tian, ​​Ye, Zhao, Han, Chen, Haitao, Peng, Yingqian, Cui, Linlin, Du, Yanzhi, Wang, Zhao, Xu, Jianfeng, Chen, Zi-Jiang. E phatlalalitsoe ka la 1 Mmesa 2016

Glintborg D., Andersen M. Tlatsetso mabapi le pathogeneis, ho ruruha, le metabolism ho hirsutism le polycystic ovary syndrome. Gynecol Endocrinol 2010.4: 281-96

DANISH MEDICAL JOURNAL. Litšoaneleho tsa endocrine le metabolic ho polycystic ovary syndrome. Dan Med J 2016.63 (4): B5232

Eriksen M. B., Minet A. D., Glintborg D. et al. Mosebetsi o ka sehloohong oa mitochondrial ho myotubes e thehiloeng ho basali ba nang le PCOS. J Clin Endocrinol Metab 2011, 8: E1298-E1302.

Buka ea Journal of endocrinology le metabolism. Broskey, Nicholas T., Klempel, Monica C., Gilmore, L.

Anne, Sutton, Elizabeth F., Altazan, Abby D., Burton, Jeffrey H., Ravussin, Eric, Redman, Leanne M. E phatlalalitsoe ka la 1 Phuptjane 2017

Eriksen M., Porneki A.D., Skov V. et al. Khanyetso ea insulin ha e bolokiloe ho myotubes e thehiloeng ho basali ba nang le PCOS. PLOS ONE 2010, 12: e14469.

Cibula D., Skrha J., Hill M. et al. Phatlalatso ea kutloisiso ea insulin ho basali ba nonobese ba nang le ovary ea polycystic. Phuptjane 2016

Corbould A. Liphello tsa androgens liketsong tsa insulin ho basali: na androgen e fetela karolo ea basali metabolic syndrome? Diabetes Metab Res Rev 2008, 7: 520-32.

Ramatiki ea K'holera ea Polycystic (Stein-Leventhal Syndrome) Lorena I. Rasquin Leon, Jane V. Mayrin. Setsi sa Bongaka sa Einstein. Ntlafatso ea ho qetela: la 6 Mphalane 2017

Molao oa Neuroendocrine oa ho ja lijo ka bongata ho Polycystic Ovary Syndrome. Daniela R., Valentina I., Simona C., Valeria T., Antonio L. Reprod Sci. 2017 Jan 1: 1933719117728803. Doi: 10.1177 / 1933719117728803.

Morgan J., Scholtz S., Lacey H. et al. Ho ata ha mathata a ho ja ho basali ba nang le hirsutism ea sefahleho: thuto ea maiketsetso ea epide-miological cohort. Int J Ja Disord 2008, 5: 427-31.

BIOMECHANICS, TLHAKISO, LE OSTEOARTHRITIS. MOLEMO OA LITLHAKISO: HA MOSA OA LEBELE OA BONTSA. Francisco V., Pérez T., Pino J., López V., Franco E., Alonso A., Gonzalez-Gay M.A., Mera A., Lago F., Gómez R., Gualillo O. J. Orthop Res. 2017 Oct 28.

Karolo ea adipocyte mitochondria ho ruruheng, lipemia le kutloisiso ea insulin ho batho: litlamorao tsa pioglitazone

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Chen X., Jia X., Qiao J. et al. Adipokines ts'ebetsong ea ho ikatisa: khokahano pakeng tsa botena le lefu la polycystic ovary. J Mol Endocrinol 2013, 2: R21-R37.

Li S., Shin H. J., Ding E. L., van Dam R. M. Maemo a Adiponectin le kotsi ea lefu la tsoekere la mofuta oa 2: tlhahlobo e hlophisitsoeng le tlhahlobo ea meta. JAMA 2009, 2: 179-88.

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Comim F.V., Hardy K., Franks S. Adiponectin le li-receptor tsa eona ka ovary: bopaki bo bong ba khokahano pakeng tsa botenya le hyperandrogenism ho polycystic ovary syndrome. PLOS ONE 2013, 11: e80416.

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HO SIRELETSA SYSTEM LE HO FIHLELA INSULIN IN POLYCYSTIC

Matsneva I.A., Bakhtiyarov K.R., Bogacheva N.A., Golubenko E.O., Pereverzina N.O.

Yunivesithi ea pele ea bongaka ea 'muso ea Moscow e reheletsoe ka I.M. Sechenov, Moscow, Russia Federation

Tsebiso. Polycystic ovarian syndrome (PCOS) ke e 'ngoe ea mefuta ea endocrinopathies hangata. Leha ho na le khaello e phahameng ea PCOS le pale e telele ea boithuto, litaba tsa etiology, pathogeneis, ho hlahloba lefu lena le kalafo ea lefu lena e ntse e le tseko e kholo. Lilemong tsa morao tjena, tlhokomelo e ntseng e eketseha ea bo-ramahlale e hapiloe ke potso ea tlatsetso ea hyperinsulinemia ho nts'etsopele ea PCOS. Hoa tsebahala hore ho 50-70% ea linyeoe PCOS e kopantsoe le botena, hyperinsulinemia le liphetoho ho lipid spectrum ea mali, e leng se eketsang kotsi ea ho ba le mafu a pelo, mofuta oa lefu la tsoekere la II mme se lebisa ho fokotseha hoa nako e tloaelehileng ea bophelo . Bafuputsi ba bangata ba supa boikemelong ba liphatsa tsa lefutso tsa metabolic ho PCOS, ponahatso ea eona e eketsoa le ho feta ha boima ba 'mele bo feteletseng. Karolo ea sejoale-joale thutong ea pathogeneis ea PCOS e bontšoa ke tlhahlobo e tebileng ea mafu a metabolic: ho hanyetsa insulin, hyperinsulinemia, botena, hyperglycemia, dyslipidemia, ts'oaetso ea methapo, boithuto ba phello e sa tobang ea ts'ebetso ea methapo ea mahe kahara mae a bomme. , le mafu a amanang le lefu lena a amanang le lefu la tsoekere le ikemetseng le lefu la pelo.

Sena se ka hlalosa ho batloa ha tlhahlobo e ncha ea tlhahlobo ho tseba hore na ke matšoao afe a ka sebelisoang ts'ebetsong ea letsatsi le letsatsi e le ba boletsoeng esale pele ba kotsi ea metabolic le pelo le bakuli ba PCOS.

Mantsoe a bohlokoa: ho hanyetsa insulin, ho ruruha hoa systemic, polycystic ovary syndrome, hyperinsulinemia, hyperandrogenia.

BUKA KHAOLO. Physiology le Pathology ea Reproduction ea Basali

Buka ea Journal of endocrinology le metabolism. Tian, ​​Ye, Zhao, Han, Chen, Haitao, Peng, Yingqian, Cui, Linlin, Du, Yanzhi, Wang, Zhao, Xu, Jianfeng, Chen, Zi-Jiang. E phatlalalitsoe ka la 1 Mmesa 2016

Glintborg D., Andersen M. Tlatsetso mabapi le pathogeneis, ho ruruha, le metabolism ho hirsutism le polycystic ovary syndrome. Gynecol Endocrinol 2010.4: 281-96

DANISH MEDICAL JOURNAL. Litšoaneleho tsa endocrine le metabolic ho polycystic ovary syndrome. Dan Med J 2016.63 (4): B5232

Eriksen M. B., Minet A. D., Glintborg D. et al. Mosebetsi o ka sehloohong oa mitochondrial ho myotubes e thehiloeng ho basali ba nang le PCOS. J Clin Endocrinol Metab 2011, 8: E1298-E1302.

Buka ea Journal of endocrinology le metabolism. Broskey, Nicholas T., Klempel, Monica C., Gilmore, L. Anne, Sutton, Elizabeth F., Altazan, Abby D., Burton, Jeffrey H., Ravussin, Eric, Redman, Leanne M. E phatlalalitsoe ka la 1 Phuptjane 2017.

Eriksen M., Porneki A.D., Skov V. et al. Khanyetso ea insulin ha e bolokiloe ho myotubes e thehiloeng ho basali ba nang le PCOS. PLOS ONE 2010, 12: e14469.

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BIOMECHANICS, TLHAKISO, LE OSTEOARTHRITIS. MOLEMO OA LITLHAKISO: HA MOSA OA LEBELE OA BONTSA. Francisco V., Pérez T., Pino J., López V., Franco E., Alonso A., Gonzalez-Gay M.A., Mera A., Lago F., Gómez R., Gualillo O. J. Orthop Res. 2017 Oct 28.

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Chen X., Jia X., Qiao J. et al. Adipokines ts'ebetsong ea ho ikatisa: khokahano pakeng tsa botena le lefu la polycystic ovary. J Mol Endocrinol 2013, 2: R21-R37.

Li S., Shin H. J., Ding E. L., van Dam R. M. Maemo a Adiponectin le kotsi ea lefu la tsoekere la mofuta oa 2: tlhahlobo e hlophisitsoeng le tlhahlobo ea meta. JAMA 2009, 2: 179-88.

Chen M.B., McAinch A.J., Macaulay S.L. et al. Ts'ebetso e senyehileng ea AMP-kinase le mafura acid oxidation ke adiponectin ea lefats'e ea lihlahisoa tsa mesifa ea lesapo la sethoathoa sa lefu la tsoekere la 2. J Clin Endocrinol Metab 2005, 6: 3665-72.

Comim F.V., Hardy K., Franks S. Adiponectin le li-receptor tsa eona ka ovary: bopaki bo bong ba khokahano pakeng tsa botenya le hyperandrogenism ho polycystic ovary syndrome. PLOS ONE 2013, 11: e80416.

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Ho ikoetlisa le ho theola boima ba 'mele hangata hase lenyalo le thabisang: Liteko tse fapaneng tsa boikoetliso ba basali ba nang le BMI e fapaneng. Jackson M., Fatahi F., Alabduljader K., Jelleyman C., Moore J.P., Kubis H.P. Appl Physiol Nutr Metab. 2017 Nov 2.

Barkan D., Hurgin V., Dekel N. et al. Leptin e kenya ovulation ho litoeba tse haellang tsa GnRH. FASEB J 2005, 1: 133-5.

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Nakhjavani M., Morteza A., Asgarani F. et al. Metformin e khutlisetsa khokahano lipakeng tsa serum-oxidized LDL le leptin maemong a bakuli ba lefu la tsoekere. Redox Rep 2011, 5: 193-200.

Mekhatlo ea Endotoxemia E nang le Tsamaiso ea Ts'ebetso, Ts'ebetso ea Endothelial, le Phello ea Cardiovascular ho Phihlello ea fig. Chan W., Bosch J.A., Phillips A.C., Chin S.H., Antonysunil A., Inston N., Moore S., Kaur O., McTernan P.G., Borrows R.J. Len Nutr. 2017 Oct 28.

Diamanti-Kandarakis E., Paterakis T., Alexandraki K. et al. Matšoao a ts'oaetso ea maemo a tlase a tlase ho polycystic ovary syndrome le phello e molemo ea metformin. Hum Reprod 2006, 6: 1426-31.

Bouckenooghe T., Sisino G., Aurientis S. et al. Adipose Tissue Macrophages (ATM) ea bakuli ba batenya haholo ba lokolla litekanyetso tse eketsehang tsa prolactin nakong ea phephetso ea ho ruruha: Karolo ea prolactin ho diabesity? Biochim Biophys Acta 2013, 4: 584-93.

Mofuta o thibelang insulin ea PCOS

Ho joalo mofuta oa khale oa PCOS Ebile ke tse tloaelehileng haholo. E phahameng insulin le leptin inhibit ovulation le ho susumetsa mae a bomme hore ba hlophise testosterone e matla. Ho hanyetsa insulin ho bakoa ke tsoekere, ho tsuba, lithibela-pelehi tsa li-hormone, mafura le chefo ea tikoloho.

E tloaelehileng haholo Sesosa sa PCOS ke bothata bo ka sehloohong ba insulin le leptin.Insulin e lokollotsoe makhophong a hao. Leptin e lokollotsoe mafura a hau. Ka bobeli, lihormone tsena tse peli li laola tsoekere ea mali le takatso ea lijo. Li boetse li laola lihormone tsa hau tsa basali.

Insulin e phahama haufinyane kamora ho ja, e thusang lisele tsa hau ho monya tsoekere e tsoang maling a hau le ho e fetola matla. Eaba oa oa. Sena se tloaelehile ha o "na le insulin".

Leptin ke hormone ea hau ea satiety. E phahama ka mor'a ho ja, hammoho le ha o na le mafura a lekaneng. Leptin o bua le hypothalamus ea hau mme o bua ka ho fokotsa takatso ea hau ea lijo le ho eketsa tekanyo ea metabolism ea hau. Leptin o boetse o bolella tšoelesa ea hau ea pituitary ho lokolla FSH le LH. Sena se tloaelehile ha o "leketsetse leptin."

Ha o hlokomela insulin, o na le tsoekere e tlase le insulin e tlase ho palo ea hau ea mali e potlakileng. Ha u tsotella leptin, o na leptin e tloaelehileng e tlase.

Tabeng ea PCOS, ha u tsotelle insulin le leptin. Oa li hana, ho bolelang hore o ka se li arabe hantle. Insulin ha e khone ho bolela hore lisele tsa hau li sebelisa glucose ea matla, ka hona ho e-na le hoo e fetola tsoekere e le mafura. Leptin a ke ke a joala hypothalamus ea hau hore e hatisa takatso ea lijo, ka hona o lapa ka linako tsohle.

Ha u insulin ho hanyetsa, o na le insulin e ngata ea mali. Ho ja neng khanyetso ea leptin, o na le leino le phahameng maling. Le mofuta ona PCOS o na le insulin le ho hanyetsa leptin - e sa tsoa bitsoa khanyetso ea insulin.

Ho hanyetsa insulin ho baka ho fetang feela PCOS. Mosali a ka ba le boima ba ho ilela khoeli (menorrhagia), ho ruruha, makhopho, khaello ea progesterone le tšekamelo ea ho eketsa boima ba 'mele. Kotsi ea ho ba le lefu la tsoekere, mofets'e, lefu la masapo, dementia le lefu la pelo ea eketseha. Ke ka lebaka leo PCOS e eketsang kotsi ea maemo ana.

Lisosa tsa Resulin ea Insulin

Sesosa se atileng haholo sa ho hanyetsa insulin ke tsoekere, e buang ka fructose e kenelletseng lijong tsa tsoekere le lino tse tsoekere. Fructose e tsetselitsoeng (empa e se ka lethal dose e tlase) e fetola tsela eo boko ba hau bo arabang ka eona ho leptin. Sena se fetola tsela eo 'mele oa hau o sebetsang ka eona ho insulin. Pructose e kopaneng e boetse e etsa hore o je ho feta, e lebisang ho nona.
Ho na le mabaka a mang a ho hanyetsa insulin. Tse ka sehloohong ke: liphatsa tsa lefutso, ho tsuba, ho ja mafura, khatello ea maikutlo, lipilisi tsa thibelo ea bokhachane, ho hloka boroko, khaello ea magnesium (e tšohliloeng ka tlase) le chefo ea tikoloho. Lintho tsena li baka ho hanyetsoa ha insulin hobane li senya receptor ea hau ea insulin, ka lebaka leo, e ke ke ea arabela hantle.

Mohato oa ho fokotsa kutloisiso ea lithane ho insulin

Nakong ea ts'ebeliso ea lithibela-mafu tsa lihormone, lihormone tsa maiketsetso, tse fapaneng le likhakanyo tsa lihormone tsa bona, li lula li fanoa 'meleng oa mosali e monyane ka dosage e kholo. Kamora ho kenella ho joalo, lihormone tsa tsona li ke ke tsa ba le phello ho litšoelesa tsa endocrine. Boitaolo ba tsamaiso ea endocrine bo tla senyeha.
Hore 'mele o phele, ke lisele tsa litho tsohle se ke oa nahanela lihormone tsohle, ho kenyelletsa le insulin.

Hobaneng ha "insulin" e le bohloko?

Bohlokoa ba ho utloahala ha liente le litho ho insulin bo bohlokoa haholo. E khetha ho kenella ka seleng ea tsoekere le limatlafatsi tse ling. Ebile, ho bolaoa ke tlala ntle le insulin le glucose ho etsahala bakeng sa mmele. Sesebelisoa se ka sehloohong sa tsoekere ke boko, bo neng bo ke ke ba sebetsa ntle le eona.
Mohlala, ho bakuli ba nang le lefu la tsoekere mellitus, le phokotseho e matla ea tsoekere, cortex ea "cerebral" e ka shoa nthong ea metsotso e seng mekae (hypoglycemic state). Ho qoba boemo bo kotsi joalo, bakuli ba nang le lefu la tsoekere ba lula ba nkile ntho e monate le bona.
Makhopho a tla qala ho kopanya insulin ka mokhoa o tsoelang pele le maemong a indasteri.ho thibela lefu la boko. Joale e ka qala mofuta oa lefu la tsoekere - lefu lena le kotsi ebile le kotsi.

Joale, ha mosali a nka ho lokile, ho joalo mesifa le kutlo ea setho ho insulin ea fokotseha. Ona ke bo bong ba mathata a mantlha ha u sebelisa lihormone tsa maiketsetso. Tlhahiso ea "insulin" ea "insulin" e eketseha haholo. Insulin e ngata e baka mafu a mangata a metabolic le endocrine, ho fihlela nts'etsopele ea lefu la tsoekere la mofuta oa 2. Ho etsahala seo feela liphetoho li etsahala kahara mae a bomme - li fetoha li-insersensitive ho insulinebe litholoana li tla tšoana hantle - ntle le lefu la tsoekere.

Tse ling Ho loka ho thibela phaello ea mesifa ho basali ba banyane. Sena se ka baka phaello ea boima ba 'mele le ho fokotseha hoa kutloisiso ea insulin lithibela-pelehi tsa li-hormone ke khetho e mpe haholo bakeng sa PCOS.

Insulin e ama lehe la mahe joang?

Ka mae a bomme, androgens li entsoe, ho tloha moo li-estrogen li thehoa ka nako eo. Ts'ebetso ka boeona e susumetsoa ke insulin. Haeba maemo a eona a phahame, joale lihormone tsohle tsa "ovari" li tla "hlahisoa" haholo ka mahetleng.
Li-estrogens ke sehlahisoa sa qetellong sa ketane eohle ea lik'hemik'hale. Lihlahisoa tse mahareng - li-progesterone le androgens tsa mefuta e fapaneng. Ba fana haholo matšoao a sa thabiseng ho PCOS.

Insulin e ngata - li-androgens tse ngata tse ka maeeng

Lenane le leholo la insulin le nolofalletsa mahe hore a kopanye li-androgens ka bongata. Mme moroetsana o feta ho fumana lintho tsohle tse thabisang tsa hyperandrogenism: makhopho, ho lahleheloa ke moriri, hirsutism.

Testosterone (hormone ea adrenal), e boetse e bitsoa li-hormone tsa "monna", 99% e le 'meleng oa mosali ka sebopeho se sa sebetseng, se tlameletsoeng protheine e khethehileng (SHBG, SHBG). Testosterone e fetoha sebopeho se sebetsang - dihydrotestosterone (DHT, DHT) ka thuso insulin le enzyme ea 5-alpha reductase. Ka tloaelo, DHT ha ea lokela ho ba 1%.
Dihydrotestosterone e sekamela ho bokelleng mefuteng ea moririe bakang mathata a mangata bakeng sa ponahalo ea mosali: moriri o fetoha oa mafura, oa brittle ebe o qala ho itiha, ka lebaka leo o ka lebisa ho bola.
Peresente e phahameng ea DHT maling le eona e ama letlalo: meroalo e eketsehileng ea makhopho. Mme potoloho e ea fela mme metabolism e fetoha.

Qetellong, insulin e ngata haholo e tsosa gland ea hau hore e kopanye lihormone tsa luteinizing le ho feta., e eketsang le ho phahamisa androgens le ho thibela ovulation.

Kahoo, karolo e phahameng ea "insulin" maling e eketsa litaba tsa li-androgens tse sebetsang. Androgens ha e entsoe eseng feela ka maeeng, empa le litšoeleng tsa adrenal, sebete, liphio le lithane tsa adipose. Empa li-ovari ke sehokelo sa bohloka ho nts'etsopele ea PCOS.

Botenya bo bopehileng joaloka Apple

Ela hloko sesupo sa mmele sa ho nona ka sebopeho sa apole (e jereng boima bo feteletseng bo letile thekeng).
Sebelisa tekanyo ea theipi ho lekanya letheka la hau mokhubung. Haeba sebaka sa hau sa letheka se feta 89 cm, joale o na le kotsi ea ho hanyetsa insulin. Sena se ka baloa ka mokhoa o nepahetseng haholoanyane ka mokhoa oa tekanyo ea thekeng ho ea holimo: Sekeke sa hau se lokela ho ba tlase ho halofo ea bophahamo ba hau.
Ho ba motenya oa Apple ke letšoao le hlalosang la ho hanyetsa insulin. Ha o ntse o potoloha letheka, o tla eketsa monyetla oa hore PCOS ea hau e sirelle insulin.

Insulin e phahameng e etsa hore boima ba 'mele bo be boimamme sena e ka ba potoloho e mpe: botenya bo baka ho hanyetsa insulin, ho baka botenya, bo mpefatsang ho hanyetsa insulin. Mokhoa o motle ka ho fetisisa oa ho fokotsa boima ba 'mele ke ho lokisa ho hanyetsa ha insulin.

Bohlokoa! Khanyetso ea insulin e ka hlaha le ho batho ba mosesane. Teko ea mali e ea hlokahala ho fumana hore na.

Teko ea mali bakeng sa ho hanyetsa insulin

Botsa ngaka ea hau bakeng sa litlhahiso ho e 'ngoe ea likhetho tsa liteko.

• Teko ea mamello ea tsoekere ka insulin.
  Ka tlhahlobo ena, u fana ka lisampole tse 'maloa tsa mali (pele le kamora ho noa seno se monate). Teko e lekanya hore na o tlosa tsoekere e maling kapele hakae (e bonts'a hore na o arabela hantle ho insulin joang. U ka leka leptin, empa lilaboratori tse ngata ha li etse joalo.
• Teko ea mali tlasa index HOMA-IR.
  Ke tekanyo lipakeng tsa insulin e potlakileng ea lijo le glucose e potlakileng. Insulin e phahameng e bolela ho hanyetsa insulin.

Haeba o hana insulin, o hloka kalafo tseo re tla bua ka tsona hamorao.

Ho hana tsoekere

Ntho ea pele eo u lokelang ho e etsa ke ho khaotsa ho ja lino tse tsoekere le lino tse tsoekere. Ke masoabi ho ba mojari oa litaba tse mpe, empa ke bolela hore ke khaotse ka botlalo. Ha ke bolele hore ka linako tse ling ke khutlela pie feela. Haeba u na le insulin, ha u na "lihlahisoa tsa lihormone" ho monya lijo tse theolelang. Nako le nako ha u ja sopho, e u sututsa le ho tebela ho hanyetsa insulin (le ho kenella ka hare ho PCOS).
Kea tseba hore ho thata ho tlohela tsoekere, haholo-holo haeba u lekhoba la eona. Ho fana ka tsoekere ho ka ba thata kapa hona ho ba boima ho feta ho tlohela. Ho tlosa tsoekere 'meleng ho hloka moralo o hlokolosi.

Mokhoa oa ho tsamaisa mokhoa oa ho hana tsoekere:

• Robala ka ho lekaneng (hobane ho hloka boroko ho baka litakatso tsa tsoekere).
• - Ja lijo tse felletseng tse kenyelletsang macronutrients ohle a mararo: protheine, starch, le mafura.
• Se ke oa leka ho fokotsa lijo tsa hau feela ka mefuta e meng ea lijo ha u ntse u tšela tsoekere.
• Qala lijo nakong ea khatello ea maikutlo bophelong ba hau.
• Hlokomela hore litakatso tse matla tsa liswiti li tla nyamela ka metsotso e 20.
• Hlokomela hore hangata litakatso li tla fela kamora libeke tse peli.
• Kenya magnesium hobane e fokotsa litabatabelo tsa tsoekere.
• Ithate. Itšoarele. Hopola hore u iketsetsa eona!

Ho hana tsoekere ho fapane le sejo se tlase sa carb. Ebile, hangata ho bonolo ho tlohela tsoekere haeba u sa qobelle ho ja, joalo ka litapole le raese, hobane starch e fokotsa litakatso. Ka lehlakoreng le leng, ho thata ho tlohela tsoekere haeba u ja lijo tse nang le tšoaetso tse kang koro le lihlahisoa tsa lebese. Sena ke hobane litakatso tsa lijo ke letšoao le tloaelehileng la lijo tse nang le tšoaetso.
Nako e tla tla eo ka eona insulin ea hau e tloaelehileng ebe u thabela sopho e sa sebetseng. Ka seoelo, ke bolela hanngoe ka khoeli.

Ho ikoetlisa

Ho ikoetlisa ho matlafatsa mesifa ho fumana insulin. Ebile, ke libeke tse 'maloa feela tsa boikoetliso bo matla bo bontšitseng keketseho ea sensulin ea 24%. Ingolise bakeng sa boikoetliso, le haeba u ka etsa boiteko bo fokolang u ntse u tla bona ntlafatso. Tsamaea ka hohle. Hloa litepisi. Khetha mofuta oa boikoetliso boo u bo ratang.

DIAGRAM YA LITLHAKISO TSA HO PHETHA BOTSOANG

Regimen e etselitsoe eseng feela ho eketsa maikutlo a insulin ho basali ba nang le PCOS, empa ho batho bohle ba kotsing e kholo ea lefu la tsoekere.

Magnesium taurate

Berberine *

Inositol Powder, 227 g

GTF Chrome ***

Lintlha tsa tafole

* Berberine se ke oa kopanya le litlhare tse ling tse fanoang ke lingaka: li-antidepressants, beta blockers, kapa li-immunosuppressants (hobane li ka fetola maemo a mali a meriana ea hau). Contraindred nakong ea bokhachane le pelehi.
Se ke oa sebelisa khafetsa ho feta likhoeli tse tharo hobane ke antimicrobial mme e ka fetola sebopeho sa libaktheria tsa mala. Likhoeli tse ling tse 3 le Berberine le curcumin.

** Alpha Lipoic Acid ka kakaretso e sireletsehile, empa ka litekanyetso tse phahameng (tse fetang 1000 mg) e ka fokotsa lihormone tsa qoqotho.
Alpha-lipoic acid, ha e le thiol, ha e kopane le vithamine B12, hobane mmoho ba ba le phello ea antitumor, empa e ba chefo ho 'mele oa motho ea phetseng hantle. Ka hona, re e noella ka thoko ho lithethefatsi moo B12 e leng teng, lithuto tsa alternating (re ke ke ra li tlisa ka letsatsi).
Nka ka thoko ho magnesium, tšepe le calcium, joalo ka kena ka karabelo le bona, lijong tse ling, o seke oa li kopanya le joala.

*** Chrome se ke oa kopanya le li-antidepressants, beta-blockers, H2 blockers, proton pump inhibitors, corticosteroids, NSAIDs.

Progesterone

Ho hanyetsa insulin ho boetse ho baka khaello ea progesterone le mejaro e boima.
Bothata ba mantlha ba PCOS ke ho haella ha progesterone bakeng sa libeke tse peli ka potoloho e 'ngoe le e' ngoe. Ho haella ha progesterone ho lebisa ho se leka-lekanang maeeng, ho tsose li-androgen, 'me ho lebisa ho potoloha e sa khaotseng. Hoa utloahala ho lokisa ho se leka-lekane hona ka ho pheta progesterone (sebakeng sa duphaston), ke fana ka likhetho tse peli tseo u ka khethang ho tsona:

Hona joale Lijo, Cream ea Progesterone ea Tlhaho

• ka ho ilela khoeli khafetsa - qala ho tloha matsatsing a 14 ho isa ho a 25 a MC (letsatsi la pele la ho itlotsa tranelate le lokela ho tsamaisana le letsatsi la ovulation.)
• kamora potoloho - etsa kopo matsatsi a 25 ka phomolo ea matsatsi a 5.
• ka progesterone e tlase haholo kapa testosterone e phahameng haholo - sebelisa khoeling ea pele khafetsa, 'me ho tloha karolong e latelang - ho ea karolong ea bobeli.

GUNA, Potentiated Progesterone Drops

Phello e sa feleng e tla bonoa kamora khoeli ea ts'ebeliso.
Mokhoa oa ts'ebeliso:
Ka 20 o theoha makhetlo a 2 ka letsatsi ka mpeng e se nang letho metsotso e 20-30 pele u ja kapa hora e le 'ngoe ka mor'a ho ja, u sebelisa leano le latelang:

• ka ho ea matsatsing a ho ilela khoeli - qala ho tloha matsatsing a 14 ho isa ho a 25 a MC (letsatsi la pele la kamohelo le lokela ho lumellana le letsatsi la ovulation.)
• ka ho se potolohe - nka matsatsi a 25 nako ea matsatsi a 5.
• ka progesterone e tlase haholo kapa testosterone e phahameng haholo - sebelisa khoeling ea pele khafetsa, 'me ho tloha karolong e latelang - ho ea karolong ea bobeli

Progesterone e khothalletsoang e khothalletsoa hore e sebelisoe progesterone syntuchen GUNA REGUCICLE (G3)e le hore 'mele ka boeona o ka ntšetsa pele tšebetso ena.
Ka 20 o theoha makhetlo a 2 ka letsatsi ka mpeng e se nang letho metsotso e 20-30 pele ho lijo kapa hora e le 'ngoe ka mor'a moo, nka nako e telele khoeli e le ngoe. Lithethefatsi ka bobeli li ka tsoakoa ka khalase e le 'ngoe ea metsi ebe li nooa butle.

• Ho reka Guna progesterone ka eBay ka phano ea lits'oants'o tsa lefats'e
• Ho reka Guna Rugulcycle ka eBay ka phano ea lits'oants'o tsa lefats'e

Litokisetso tsa progesterone li qala ka kalafo ea insulin bakeng sa likhoeli tse 3-4.

Hyperandrogenism e ka lebisa ho hyperestrogenism kapa ka lehlakoreng le leng ho haella ha estrogen.
Haeba ho na le mofuta oa estrogen o fokotsehileng, eketsa tse ling phytoestrogens kapa estrogens tse ka bang teng ho khetha ho.
Phytoestrogens e tšoana le estrogen ea motho, empa, joalo ka molao, ha e na matla. Litlama tsa phytoestrogenic li na le metsoako e fapaneng, ka ho fapana, li ama 'mele ka litsela tse fapaneng. Li ka boela tsa tlisa melemo e meng ho bophelo bo botle ba 'mele: ho boloka ho se sireletsehe ha mmele, ho ntlafatsa phallo ea mali pelvis, ho fokotsa ho ruruha, jj.

Tsela ea tlhaho, Red Clover

• ka ho ilela khoeli khafetsa - qala ho tloha matsatsing a 5 ho isa ho a 14 a MC
• Haeba endometrium e hola hantle, joale ho tloha matsatsing a 5 ho isa ho a 25 MC

GUNA, Estradiol Drops

• ka ho ea matsatsing a ho ilela khoeli - qala ho tloha matsatsing a 14 ho isa ho a 25 a MC (letsatsi la pele la kamohelo le lokela ho lumellana le letsatsi la ovulation.)
• Haeba endometrium e sa hole hantle - ho tloha matsatsing a 5 ho isa ho a 25 a MC

Estradiol e nang le bokhoni e khothalletsoa hore e sebelisoe estradiol synthesis inducer - GUNA FEM, e emisang tsamaiso eohle ea endocrine le 'mele ka boeona o tsoela pele ka ts'ebetso ena.
Ka 20 o theoha makhetlo a 2 ka letsatsi ka mpeng e se nang letho metsotso e 20-30 pele ho lijo kapa hora e le 'ngoe ka mor'a moo, nka nako e telele khoeli e le ngoe. Lithethefatsi ka bobeli li ka tsoakoa ka khalase e le 'ngoe ea metsi ebe li nooa butle.

Lihormone tse nang le matla a homeopathic li fumaneha feela bakeng sa Ukraine, ka bomalimabe ha li sa tlisoa ka ho toba ho moetsi ho tsoa Russia. Lithethefatsi tse ling li ile tsa qala ho hlaha ho Amazon.

• Ho reka Guna fem ho eBay ka thomello ea lefats'e ka bophara.
• Ho reka Guna estradiol ho eBay ka thomello ea lefats'e ka bophara.

Ho beha odara ka lebenkeleng la sebui sa Guna sa Ukraine, o hloka palo ea setifikeiti ea setsebi se koetlisitsoeng le bona - 1781 (Lebitso le felletseng le ka siuoa). Ho tlisoa ho etsoa ho pholletsa le Ukraine ka poso e ncha, chelete ho phumants'o.