Metabolički sindrom predstavlja kompleksan klinički entitet koji značajno utiče na reproduktivno zdravlje žena kroz sve životne faze. Metabolički sindrom predstavlja skup međusobno povezanih poremećaja koji značajno povećavaju rizik od aterosklerotskih kardiovaskularnih bolesti, uključujući infarkt miokarda, cerebrovaskularne incidente, perifernu vaskularnu bolest, kao i razvoj insulinske rezistencije i dijabetesa tipa 2. Insulinska rezistencija, kao njegova centralna komponenta, ima ključnu ulogu u patogenezi sindroma policističnih jajnika, poremećaja fertiliteta, gestacijskog dijabetesa i brojnih komplikacija u trudnoći. Sama menopauza je povezana saredistribucijom masnog tkiva - povećava se abdominalno i visceralno masno tkivo, studije sugerišu da starenje, a ne menopauza, ima veću ulogu u povećanju telesne mase. Međutim, pad koncentracije estrogena, bez odgovarajuće fizičke aktivnosti i promene u ishrani, uzrokuje promenu telesnog sastava - prelazak iz ginoidnog ka androidnom tipu distribucije masti, što povećava rizik od insulinske rezistencije, koja je ključni faktor u razvoju metaboličkih bolesti, pre svega dijabetesa tipa 2 i kardiovaskularnih komplikacija. Uzimajući u obzir visoku prevalencu metaboličkog sindroma i njegov rastući uticaj na žensko zdravlje, neophodna je dalja edukacija, rana dijagnostika i individualizovan terapijski pristup, kako bi se unapredio kvalitet i dužina života žena širom životnog ciklusa. Ključne reči: metabolički sindrom, reproduktivno zdravlje, insulinska rezistencija, gojaznost
Lo J, Cresswell B, Wolf N. Impact of insulin resistance during pregnancy. BMC Pregnancy Childbirth. 2015;15:50.
2.
Dunaif A, Scoccia B, Fonseca V. Insulin resistance and the ovarian hyperandrogenic state. J Clin Endocrinol Metab. 1993;77(1):315–21.
3.
Robinson S, Leunbach A, Sabow M. Insulin resistance and ovarian function. Obstet Gynecol Clin North Am. 2002;29(1):51–63.
4.
Fisher SJ, Primakoff P, Myatt L. Endothelial dysfunction and insulin resistance in pregnancy. Metabolism. 2008;57(5):626–33.
5.
Hsieh C. Polycystic ovary syndrome and metabolic syndrome: A review. Biol Reprod. 2007;76(3):478–85.
6.
Metcalf M, Malaske M. Insulin resistance and reproductive dysfunction. Rev Diabet Stud. 2012;9(4):279–86.
7.
Crowther CA, Hiller JE, Moss. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352(24):2477–86.
8.
Donovan L, Letourneau K, Carver T. Glucose intolerance during pregnancy and its relation to insulin resistance. Am J Obstet Gynecol. 2005;192(2):563–70.
9.
Smith M, K W, C. Metabolic changes in pregnancy: Physiology, effects and complications. Obstet Gynecol Clin North Am. 2012;39(2):257–68.
10.
Aiken CE, Ozanne SE. The impact of maternal obesity on the long-term health of the offspring. Acta Physiologica. 2013;208(1):13–21.
11.
Hovanes P, Duffy N, Welch A. Lipid metabolism and obesity in pregnancy. J Clin Endocrinol Metab. 2013;98(2):487–96.
12.
Casserly IP, Topol EJ. Obesity and cardiovascular disease. Lancet. 2004;364(9438):1787–99.
13.
Hsu R, Schorr M, Williams E. Pregnancy and metabolic syndrome. Semin Perinatol. 2012;36(5):283–9.
14.
Navarrete MV, Meza B, Garcia T. Menopause and metabolic syndrome: A review of associated risks. Menopause Review. 2019;18(1):25–30.
15.
Dennerstein L, Dudley EC, Hopper JL. A prospective population-based study of menopause in Australian women. Maturitas. 2000;34(2):179–85.
16.
Kessler M, Dobnig H, Ziegler M. Insulin resistance and the menopause transition. J Clin Endocrinol Metab. 2005;90(8):4309–14.
17.
You H, Lee E, Kim M. Abdominal obesity, metabolic syndrome, and cardiovascular disease in menopausal women. Endocrinol Metab. 2013;28(3):169–74.
18.
Després JP. Abdominal obesity and the metabolic syndrome. Nature. 2006;444(7121):881–7.
19.
Rogge L, Koca K. Hormonal changes and obesity in postmenopausal women. Maturitas. 2008;59(4):360–6.
20.
Santoro N, Skurnick J. Menopause and metabolic syndrome. Fertil Steril. 2009;92(6):2014–21.
21.
Griffin D, Pritchard J. Adiponectin in metabolic syndrome and cardiovascular risk. Heart Metab. 2005;23(2):12–9.
22.
Carmina E, Lobo RA. Polycystic ovary syndrome: A key to understanding the metabolic syndrome. J Clin Endocrinol Metab. 2004;89(6):2565–71.
23.
Choudhury I, A K, A. Impact of metabolic syndrome on reproductive h+ealth in women. J Pak Med Assoc. 2019;69(1):98–104.
24.
Mottillo S, Filion KB, Genest J, Joseph L, Rinfret S, EL. S, et al. The metabolic syndrome and cardiovascular risk: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;56(14):1113–32.
25.
Rojas J, Duran I, Varela C, Cortes P. Prevalence of metabolic syndrome in women: A systematic review. Rev Med Chil. 2018;146(2):182–90.
26.
Balen AH, Laven JSE, Tan SL. The management of anovulatory infertility. Hum Reprod Update. 2003;9(2):141–56.
27.
Lippi G, Sanchis-Gomar F, Furlanello F. Obesity and metabolic syndrome as cardiovascular risk factors: epidemiology and clinical practice. Adv Cardiol. 2012;48:35–50.
28.
Goodarzi MO, Dumesic DA. Polycystic ovary syndrome: etiology and implications for long-term health. J Clin Endocrinol Metab. 2010;95(3):1125–32.
29.
Fain JN. Release of inflammatory mediators by human adipose tissue. J Clin Endocrinol Metab. 2001;86(9):4534–8.
30.
Meigs JB, Wilson PW, Fox CS. The metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Curr Diabetes Rev. 2008;4(2):141–5.
31.
Rader DJ, Dufour R, Hutchison S. The role of visceral fat in the development of cardiovascular disease. Metabolism. 2009;58(3):306–9.
32.
Alswat K. Gender disparities in osteoporosis. Saudi Med J. 2017;38(1):1–8.
33.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention. Circulation. 2009;120(16):1640–5.
34.
Zawadzki JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. Blackwell Scientific. 1992:377–84.
35.
Dunaif A, Wu X, Lee A. The insulin resistance syndrome in polycystic ovary syndrome: Insulin secretion and action. Obstet Gynecol. 2001;97(3):450–8.
36.
Azziz R, Woods KS, Reyna R. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab. 2004;89(6):2745–9.
37.
Sharma A, Cho C, Patil N. Metabolic syndrome and cardiovascular disease in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2019;235:31–6.
38.
Das S, Muthukumar K, Rajkumar S. Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: An emerging clinical problem. Gynecol Endocrinol. 2018;34(1):10–6.
39.
Group RESHRE /A. SRMSPCOSCW. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS. Hum Reprod. 2004;19(1):41–7.
40.
Witchel SF. Polycystic ovary syndrome in adolescents. Pediatrics. 2016;137(3).
41.
E.S.H.R.E./A.S.R.M. Definitions of polycystic ovary syndrome. Fertil Steril. 2003;79(3):485–93.
42.
Gobin-Limballe S, Gauthier T, Rodier M. Insulin resistance and hyperinsulinemia in PCOS: role of adipokines. Diabetes Metab. 2006;32(5):430–6.
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