Синдром поликистозных яичников и кардиометаболический риск: современные подходы к междисциплинарной профилактике и динамическому наблюдению

Введение. Синдром поликистозных яичников (СПКЯ) – распространенная эндокринно-метаболическая патология репродуктивного возраста, ассоциированная с высоким кардиометаболическим риском.

Цель: проанализировать современные данные о распространенности, механизмах развития и клиническом значении кардиометаболических нарушений при СПКЯ, а также обосновать подходы к междисциплинарной профилактике и динамическому наблюдению.

Материалы и методы. Проведен нарративный обзор публикаций за 2017–2026 гг. в базах PubMed/MEDLINE, ScienceDirect, Google Scholar и eLibrary. Приоритет отдавался международным рекомендациям, систематическим обзорам, метаанализам, рандомизированным исследованиям и клинически значимым когортным данным.

Результаты. Кардиометаболический риск при СПКЯ обусловлен высокой распространенностью инсулинорезистентности, дислипидемии, артериальной гипертензии и ожирения. В клинической практике приоритет должен отдаваться оценке гликемического статуса (предпочтительно с помощью орального глюкозотолерантного теста), липидного профиля, артериального давления и антропометрических показателей, а не рутинному расчету индексов инсулинорезистентности. Обоснована значимость комплексной немедикаментозной профилактики (диета, физические нагрузки, психотерапевтическая поддержка) и применения метформина или средств коррекции ожирения по показаниям.

Заключение. СПКЯ ассоциирован с высокой распространенностью кардиометаболических нарушений, обусловленных инсулинорезистентностью, висцеральным ожирением, гиперандрогенией и хроническим воспалением, что требует долгосрочной междисциплинарной модели наблюдения с непрерывной профилактикой и медикаментозной коррекцией по показаниям. 

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