Der Einsatz oraler Antidiabetika in der Behandlung des Polyzystischen Ovarsyndroms

Zusammenfassung

Das Polyzystische Ovarsyndrom (PCOS) ist die häufigste endokrine Erkrankung der Frau in der reproduktiven Lebensphase. Es ist ein komplexes Krankheitsbild mit metabolischen Störungen und ihren Langzeitfolgen. Als gesundheitliche Spätfolge droht die Entwicklung eines Diabetes mellitus Typ 2, der gemeinsam mit der häufig vorkommenden Adipositas und Dyslipidämie zu einem erhöhten Risiko kardiovaskulärer Erkrankungen führt. Die Insulinresistenz mit konsekutiver Hyperinsulinämie spielt eine Schlüsselrolle in der Pathophysiologie des PCOS.
Vor diesem Hintergrund erscheint eine Behandlung des PCOS durch orale Antidiabetika sinnvoll. Die Mehrzahl der Studien zeigte, dass diese Medikamente zu einer Verbesserung der typischen Symptome wie dem Hyperandrogenismus und der Zyklusunregelmäßigkeiten führten. Die Ovulations- und Schwangerschaftsraten wurden gesteigert. Darüber hinaus konnten kardioprotektive Wirkungen und eine verbesserte Insulinsensitivität, die möglicherweise auch beim PCOS vor der Entwicklung eines Diabetes mellitus Typ 2 schützt, nachgewiesen werden. Die vorliegende Übersicht beleuchtet den Einsatz verschiedener oraler Antidiabetika beim PCOS und ihren Einfluss auf die Fertilität, die drohende Entwicklung eines Diabetes mellitus und das Risiko kardiovaskulärer Erkrankungen.

Abstract

The polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is a complex metabolic-endocrine disorder with severe long-term health consequences like type 2 diabetes. The increased risk for cardiovascular diseases in women with PCOS is due to diabetes, adipositas and dyslipidemia. Insulin resistance plays a key role in the pathophysiology of this syndrome.
This makes the use of oral antidiabetic drugs most compelling. The majority of studies have shown a melioration of the typical symptoms like hyperandrogenism and cycle irregularities. Ovulation and pregnancy rates increased. Furthermore these drugs might be cardioprotective by improving insulin sensitivity and reduce the risk for type 2 diabetes. This article reviews the use of different oral antidiabetic drugs in the treatment of PCOS and their influence on fertility, the risk for type 2 diabetes and cardiovascular diseases.

Schlüsselwörter

Polyzystische Ovarsyndrom (PCOS) - Hyperinsulinämie - orale Antidiabetika - Diabetes mellitus Typ 2

Key words

Polycystic ovary syndrome (PCOS) - hyperinsulinemia - oral antidiabetic drugs - type 2 diabetes

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