Access restricted to higher education institution's students and staff
master's thesis
Endokrinološki aspekti sindroma policističnih jajnika

Klara Pulić (2016)
Metadata
TitleEndokrinološki aspekti sindroma policističnih jajnika
AuthorKlara Pulić
Mentor(s)Sanja Klobučar Majanović (thesis advisor)
Abstract
Sindrom policističnih jajnika najčešći je endokrinološki poremećaj u žena generativne dobi. Pretpostavlja se kako je rezultat interakcije genetičkih svojstava jajnika i brojnih kongenitalnih i okolišnih faktora, a tipično se manifestira u razdoblju adolescencije. Najznačajniji postnatalni rizični čimbenik je debljina, no osnovni je poremećaj u intraovarijskoj regulaciji steroidogeneze u odgovoru na luteinizirajući hormon, obično udružen sa selektivnom inzulinskom rezistencijom: mišići su rezistentni na inzulin, dok jajnici, nadbubrežne žlijezde i masno tkivo zadržavaju relativnu osjetljivost, što potiče proizvodnju androgena i pretilost. Kliničke su karakteristike sindroma oligo-amenoreja i menstrualna disfunkcija, povezane s neplodnošću, hiperandrogenizam te često prisutni udruženi rizični čimbenici za kardiovaskularne bolesti i šećernu bolest tipa 2, uključujući pretilost, inzulinsku rezistenciju, hiperinzulinemiju, intoleranciju glukoze i dislipidemiju. Moguće manifestacije su i opstruktivna apneja tijekom spavanja, nealkoholna masna bolest jetre te psihijatrijski poremećaji. Dijagnostika započinje kliničkom procjenom hirzutizma i menstrualnih abnormalnosti, a nastavlja se laboratorijskom obradom te transvaginalnim ultrazvukom. Nakon postavljanja dijagnoze bitno je identificirati i redovito pratiti značajke metaboličkog sindroma te rizik razvoja komplikacija. Prvu terapijsku opciju kod većine žena predstavlja redukcija tjelesne težine koja je često dovoljna za uspostavu ovulatornih ciklusa uz povoljan utjecaj na metaboličke rizike. Za ublažavanje hiperandrogenizma i menstrualne disfunkcije koriste se oralni kontraceptivi, ponekad uz dodatak antiandrogena. Iako je metformin prvenstveno lijek za šećernu bolest tipa 2, često se koristi za terapiju ili prevenciju stanja povezanih sa sindromom policističnih jajnika, poput intolerancije glukoze, inzulinske rezistencije, pretilosti, ali i neplodnosti, oligomenoreje i hirzutizma
Keywordspolycystic ovary sindrome infertility hyperandrogenism insulin resistance metabolic syndrome obesity cardiovascular risk
Committee MembersToni Valković (committee chairperson)
Ivan Bubić (committee member)
Dijana Detel (committee member)
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za internu medicinu
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2016-07-15
Parallel abstract (English)
Polycystic ovary syndrome is the most common endocrine disorder among women of reproductive age, probably as a result of interaction between ovarian genetic traits and many congenital or environmental factors, which usually becomes manifest during adolescence. The most common postnatal contributor is obesity, but the fundamental defect seems to be an intrinsic disorder in the intraovarian regulation of steroidogenesis in response to luteinizing hormone, often accompanied by selective insulin resistance, in which muscle is insulinresistant, while the ovaries, adrenals and adipose tissue remain relatively sensitive, promoting androgen production and obesity. The syndrome is clinically characterized by oligoamenorrhea, menstrual dysfunction, infertility, hyperandrogenism, as well as the frequent presence of associated risk factors for cardiovascular disease and diabetes, including obesity, insulin resistance, glucose intolerance and dyslipidemia. Other possible clinical manifestations include obstructive sleep apnea, nonalcoholic fatty liver disease, mood or eating disorders. The evaluation begins with a clinical evaluation of hirsutism and menstrual abnormality, followed by laboratory testing and transvaginal ultrasonography. Once a diagnosis has been established, it is important to identify and monitor the main features of metabolic syndrome and the risk for complications. Weight loss can restore ovulatory cycles and improve metabolic risk, so it is the first-line intervention for most women. Oral contraceptives are the main pharmacologic therapy for managing hyperandrogenism and menstrual dysfunction, but sometimes antiandrogen has to be added. Although treatment of type 2 diabetes mellitus is the only approved indication for metformin, it has been used ''offlabel'' to treat or prevent several clinical problems associated with polycystic ovary syndrome, such as obesity, type 2 diabetes mellitus, infertility, oligomenorrhea, hirsutism.
Parallel keywords (Croatian)sindrom policističnih jajnika neplodnost hiperandrogenizam inzulinska rezistencija metabolički sindrom pretilost kardiovaskularni rizik
Resource typetext
Access conditionAccess restricted to higher education institution's students and staff
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:737023
CommitterBosa Licul