POLYCYSTOSIS COV KEV UA NTEJ (PCOS) THIAB INSULIN RESISTANCE

Lub tswv yim ntawm insulin tsis kam txhais tau tias qhov kev poob qis hauv lub hlwb mus rau kev tsim cov tshuaj insulin. Qhov anomaly no feem ntau pom nyob rau hauv cov neeg mob ntshav qab zib mellitus, tab sis qee kis, muaj peev xwm tiv thaiv insulin kuj tseem ua rau cov neeg muaj kev noj qab haus huv zoo.

Tus kab mob xws li polycystic ovary syndrome (PCOS) tshwm sim hauv feem ntau ntawm cov poj niam uas muaj kab mob endocrine. Nws yog qhov txawv txav los ntawm kev hloov ntawm zes qe menyuam muaj nuj nqi (nce ovulation lossis tsis tuaj, ncua sij hawm poj niam coj khaub ncaws). Hauv 70% ntawm cov neeg mob, PCa qhia tias muaj hom 2 mob ntshav qab zib mellitus.

Cov neeg soj xyuas thiab insulin tsis kam yog cov ntsiab lus muaj txiaj ntsig zoo thiab lub sijhawm, cov kws tshawb fawb tab tom siv sijhawm ntau los kawm lawv qhov kev sib raug zoo. Hauv qab no, tus kab mob nws tus kheej, kev kho mob rau cov kab mob polycystic, kev kuaj mob thiab kev muaj peev xwm xeeb tub hauv lub cev xeeb tub, kev sib txheeb ntawm polycystic thiab cov tshuaj hormones insulin, thiab kev noj zaub mov noj rau tus kab mob no yuav piav qhia kom meej.

Polycystic

Tus kab mob no tau pom thaum pib ntawm lub xyoo pua xeem los ntawm ob tus kws tshawb fawb Asmeskas - Stein thiab Leventhal, yog li ntawd tus mob polycystic tseem hu ua Stein-Leventhal syndrome. Lub etiology ntawm tus kab mob no tseem tsis tau muaj kev kawm txaus. Ib qho ntawm cov tsos mob tseem ceeb yog nce zais txiv neej cov txiv neej cov tshuaj hormones hauv lub cev ntawm tus poj niam (hyperandrogenism). Qhov no yog vim qhov tsis zoo adrenal lossis zes qe menyuam muaj nuj nqi.

Hauv PCOS, lub zes qe menyuam muaj cov yam ntxwv zoo - polycystic, yam tsis muaj neoplasm. Hauv cov zes qe menyuam, kev sib txuas ntawm kev tsim cov corpus luteum yog qhov tsis zoo, progesterone ntau lawm txhaws, thiab ovulation thiab poj niam coj khaub ncaws cuam tshuam.

Cov tsos mob thawj zaug qhia tias Stein-Leventhal syndrome:

• Qhaj ntawv lossis ncua sijhawm ntev ntawm kev coj khaub ncaws,
• Tshaj cov plaub hau hauv qhov chaw tsis muaj ntsej muag (ntsej muag, nraub qaum, hauv siab, ncej puab sab hauv),
• Pob txuv, oily tawv, roj plaub hau,
• Qhov hnyav hnyav nce txog li 10 kg hauv lub sijhawm luv luv,
• Cov plaub hau poob lawm
• Kev rub me ntsis mob hauv qab plab hauv lub cev thaum coj khaub ncaws (mob mob ceev tsis zoo ib yam).

Lub cev ovulation ib txwm nyob hauv cov poj niam yog tswj hwm los ntawm kev hloov pauv ntawm theem ntawm cov tshuaj hormones uas ua rau lub pituitary thiab zes qe menyuam ua. Thaum coj khaub ncaws, ovulation tshwm sim kwv yees ob lub lis piam ua ntej nws pib. Zes qe menyuam tsim tawm cov tshuaj hormone estrogen, ntxiv rau progesterone, uas npaj lub tsev menyuam rau kev txais yuav lub qe chiv xeeb menyuam. Txhawm rau qis dua me ntsis, lawv tsim cov txiv neej hormone testosterone. Yog tias kev xeeb tub tsis tshwm sim, tom qab ntawd cov qib hormone yog txo qis.

Nrog polycystosis, zes qe menyuam secrete nce tus nqi ntawm testosterone. Txhua yam no tuaj yeem ua rau muaj menyuam tsis taus thiab cov tsos mob saum toj no. Nws yog tsim nyog kom paub tias cov poj niam txiv neej cov tshuaj hormones tshwm sim hauv lub cev tsuas yog vim muaj cov txiv neej cov tshuaj hormones, hloov ua lawv. Nws hloov tawm tias tsis muaj cov txiv neej cov tshuaj hormones, poj niam kuj tsis tuaj yeem tsim hauv lub cev ntawm poj niam.

Qhov no yuav tsum to taub, txij li thaum ua tsis tiav hauv qhov txuas no ua rau polycystic ovary.

PCOS THIAB INSULIN RESISTANCE

Tshaj tawm 20 xyoo dhau los, nws tau tsim tau hais tias hyperinsulinemia yog qhov tseem ceeb ntawm polycystic ovary syndrome (PCOS) hauv kev sib piv tseem ceeb ntawm poj niam. Cov neeg mob no muaj "PCOS metabolic," uas tuaj yeem suav ua lub xeev uas muaj mob ntshav qab zib. Feem ntau, cov menyuam ntxhais no muaj kev rog dhau, poj niam coj khaub ncaws tsis xwm yeem, thiab tseem muaj cov txheeb ze uas muaj ntshav qab zib.

Feem ntau ntawm cov poj niam mob polycystic ovary syndrome (PCOS) yog cov tshuaj insulin tiv thaiv thiab rog dhau. Tshaj dhau qhov hnyav hauv nws tus kheej yog qhov ua rau kev cuam tshuam ntawm metabolic. Tab sis insulin kuj tseem raug kuaj pom hauv cov poj niam nrog PCOS uas tsis rog dhau los. Qhov no feem ntau vim yog qib LH thiab ntshav testosterone dawb.

Lub ntsiab hauv lub hauv paus rau cov poj niam nrog polycystic zes qe menyuam yog tias qee hom cell hauv lub cev - feem ntau feem ntau cov leeg nqaij thiab cov rog - tej zaum yuav muaj cov tshuaj insulin, thaum lwm lub hlwb thiab cov kabmob muaj. Raws li qhov tshwm sim, lub qog pituitary, zes qe menyuam thiab qog adrenal ua haujlwm rau tus poj niam muaj insulin tsis kam tsuas yog muaj feem ntau ntawm insulin (thiab tsis teb zoo rau ib txwm), uas ua rau muaj luteinizing hormone thiab androgens. Qhov tshwm sim no yog hu ua "kev xaiv tiv taus."

Vim li cas

Nws ntseeg tau tias ib qho ntawm cov yam tseem ceeb ntawm kev tiv thaiv insulin yog qhov nce ntawm cov rog. Ntau cov kev tshawb fawb qhia tau tias cov ntsiab lus siab ntawm cov roj ntsha dawb hauv cov ntshav ua rau qhov tseeb tias cov hlwb, nrog rau cov leeg hlwb, nres tsis teb txhua zaus rau insulin. Qhov no tuaj yeem qee vim los ntawm cov rog thiab cov metabolites ntawm fatty acids uas loj hlob hauv cov leeg nqaij (rog intramuscular). Qhov laj thawj tseem ceeb rau kev nce rog dawb yog noj ntau calories thiab rog dhau. Kev rog, lub cev hnyav thiab rog yog qhov cuam tshuam nrog insulin tsis kam. Visceral rog ntawm lub plab (ib puag ncig cov plab hnyuv siab raum) yog qhov txaus ntshai heev. Nws tuaj yeem tso tawm ntau cov fatty acids dawb rau hauv cov ntshav thiab txawm tias tso cov tshuaj hormones uas ua rau insulin tsis kam.

Cov poj niam muaj lub cev nyhav (thiab txawm yuag) yuav muaj PCOS thiab insulin tsis kam, tab sis qhov kev tsis zoo no muaj ntau dua ntawm cov neeg rog dhau.

Nws muaj ob peb lwm yam ua rau muaj qhov cuam tshuam:

Kev noj haus fructose ntau heev (los ntawm qab zib ntau dua li cov txiv hmab txiv ntoo) tau cuam tshuam rau cov kua dej tsis haum tshuaj.

Ua rau oxidative kev ntxhov siab thiab mob hauv lub cev tuaj yeem ua rau cov tshuaj insulin tsis kam.

Kev tawm dag zog lub cev ua rau cov kua dej tsis txaus siab, thaum lub zog tsis ua haujlwm, ntawm qhov tsis sib thooj, poob qis.

Muaj pov thawj qhia tias kev ua txhaum ntawm cov kab mob nyob hauv txoj hnyuv tuaj yeem ua rau mob o, uas ua rau cov kab mob insulin ntau dua thiab lwm cov teeb meem metabolic.

Tsis tas li ntawd, muaj caj ces thiab yam tseem ceeb. Khwv yees tias tej zaum 50% ntawm cov tib neeg muaj txoj kev cia siab rau qhov kev tsis zoo no. Tus poj niam yuav nyob hauv pab pawg no yog tias nws muaj keeb kwm tsev neeg muaj ntshav qab zib, mob plawv, tawg, lossis PCOS. Hauv lwm tus, 50% kev tiv thaiv insulin yog muaj txiaj ntsig vim kev noj zaub mov tsis zoo, rog thiab tsis muaj kev tawm dag zog.

Kev kuaj mob

Yog tias xav tias polycystic zes qe menyuam, cov kws kho mob ib txwm sau ntawv tshuaj insulin kuj rau cov poj niam.

Kev yoo cov insulin siab yog qhov qhia tias kam tiv taus.

Kev kuaj HOMA-IR suav laij cov insulin resistance index, rau qhov cov piam thaj thiab yoo insulin sai sai. Qhov siab tshaj nws yog, qhov zuj zus.

Kev kuaj ntshav qabzib ntsuas kev yoo qab zib thiab ob teev tom qab noj qee yam qab zib.

Glycated hemoglobin (A1C) ntsuas txog qib ntawm glycemia hauv peb lub hlis dhau los. Tus nqi zoo tagnrho yuav tsum qis dua 5.7%.

Yog tias tus poj niam muaj rog dhau, rog dhau thiab muaj rog ntau nyob ib ncig ntawm nws lub duav, ces qhov uas yuav muaj cov tshuaj insulin no heev. Tus kws kho mob yuav tsum tau them sai sai rau qhov no.

1. Dub (Negroid) Acanthosis

Nov yog lub npe ntawm daim tawv nqaij uas qhov chaw tsaus tsaus pom nyob rau qee qhov chaw, suav nrog cov quav (caj dab, caj dab, thaj chaw hauv siab). Nws lub xub ntiag ntxiv qhia tias cov tshuaj insulin tsis kam.

Cov Roj HDL uas tsis muaj roj ("zoo") thiab triglycerides siab yog ob qho ntxiv lwm qhov cim uas muaj feem cuam tshuam nrog insulin tsis kam.

Siab insulin thiab qab zib yog cov tsos mob tseem ceeb ntawm insulin tsis kam hauv polycystic ovaries. Lwm cov phiajcim suav nrog kev muaj roj ntau hauv plab, nce triglycerides, thiab HDL tsawg.

Li cas los tshawb nrhiav txog kev tiv thaiv insulin

Tus poj niam muaj qhov teeb meem no yog tias nws muaj peb lossis ntau tshaj ntawm cov tsos mob hauv qab no:

• Mob ntshav Hlwb (tshaj 140/90),
• qhov hnyav nyhav tshaj qhov tsim nyog 7 kg lossis ntau dua,
• triglycerides yog txhawb,
• tag nrho cov roj (cholesterol) siab dua qhov ib txwm muaj
• Cov roj ("Zoo") (HDL) yog qis dua li 1/4 ntawm tag nrho,
• kom uric acid thiab piam thaj ntau ntau,
• muaj glycated hemoglobin,
• txhawb daim siab enzymes (qee zaum)
• qis ntshav ntshav magnesium.

Qhov tshwm sim ntawm kev muaj zog insulin ntxiv:

• polycystic zes qe menyuam syndrome,
• pob txuv
• hirsutism
• ntxiv lawm tshob
• mob ntshav qab zib
• kev xav rau cov suab thaj thiab carbohydrates,
• Kua-hom rog thiab teeb meem poob phaus
• ntshav siab
• kev mob plawv
• o
• mob cancer
• lwm qhov kev cuam tshuam tsis zoo
• txo lub neej siab luv.

Sab Hauv, Kev POS PCOS THIAB METABOLIC SYNDROME

Insulin tsis kam yog qhov pom tseeb ntawm ob qhov xwm txheej tshwm sim ntau - mob ntshav qab zib thiab hom ntshav qab zib hom 2. Kev mob ntshav siab yog teeb meem kev pheej hmoo cuam tshuam nrog hom 2 mob ntshav qab zib, kab mob plawv, thiab lwm yam kev cuam tshuam. Cov tsos mob xam nrog rau cov triglycerides siab, HDL qis, ntshav siab, lub cev rog nruab nrab (rog nyob ib ncig ntawm lub duav), thiab ntshav qab zib siab. Cov tshuaj Insulin kuj tseem yog qhov tseem ceeb hauv kev txhim kho ntshav qab zib hom 2.

Los ntawm kev tiv thaiv qhov kev vam meej ntawm cov tshuaj insulin, feem ntau ntawm kev mob metabolic thiab mob ntshav qab zib hom 2 tuaj yeem tiv thaiv.

Insulin tsis kam yog lub plawv ntawm lub cev metabolic syndrome, mob plawv, thiab ntshav qab zib hom 2, uas tam sim no yog cov teeb meem kev noj qab haus huv feem ntau hauv ntiaj teb. Ntau lwm yam kab mob tseem muaj feem cuam nrog insulin kuj. Cov no suav nrog cov kab mob rog tsis muaj cawv, polycystic ovary syndrome (PCOS), Kab mob Alzheimer thiab mob cancer.

YUAV UA LI CAS YUAV TSUM TAU KEV CAI RAU INSULIN IN POLYCYSTOSIS LOS NTAWM KHW

Txawm hais tias insulin tsis kam yog qhov txhaum loj uas ua rau muaj kev rau txim loj, nws tuaj yeem sib txuas. Cov tshuaj noj nrog metformin yog kev kho mob tseem ceeb uas kws kho mob sau tseg. Txawm li cas los xij, cov poj niam muaj hom insulin-resistant ntawm PCOS tuaj yeem kho tau los ntawm kev hloov pauv lawv txoj kev ua neej.

Tej zaum qhov no yog qhov yooj yim tshaj los txhim kho cov tshuaj insulin. Cov nyhuv yuav pom tseeb yuav luag tam sim ntawd. Xaiv cov kev tawm dag zog uas koj nyiam tshaj plaws: khiav, taug kev, ua luam dej, caij tsheb kauj vab. Nws yog qhov zoo los ua ke nrog cov kis las nrog yoga.

Nws yog ib qho tseem ceeb kom plam visceral rog, uas nyob hauv thaj tsam plab thiab daim siab.

Cov luam yeeb tuaj yeem ua rau cov tshuaj insulin tsis kam thiab ua rau mob hnyav rau cov poj niam nrog ovary polycystic.

1. Txiav ntawm qab zib

Sim txo koj cov piam thaj kom tsawg, tshwj xeeb los ntawm cov piam thaj ntau zoo li dej qab zib.

1. Noj Ntsis Noj Qab Nyob Zoo

Kev noj haus rau polycystic ovary yuav tsum tau ua raws cov zaub mov tsis tseem ceeb. Kuj suav cov txiv ntoo thiab roj ntses nyob hauv koj cov zaub mov.

Noj omega-3 fatty acids tuaj yeem txo ntshav triglycerides, uas feem ntau txhawb nrog polycystic ovary kab mob thiab insulin tsis kam.

Noj tshuaj pab kom insulin rhiab heev thiab txo cov ntshav qab zib. Cov no suav nrog, piv txwv li, magnesium, berberine, inositol, vitamin D thiab cov kev kho mob hauv zej zog xws li cinnamon.

Muaj cov ntaub ntawv pov thawj hais tias tsis zoo, pw luv luv kuj tseem ua rau cov tshuaj insulin tsis kam.

Nws yog qhov tseem ceeb rau cov menyuam ntxhais uas muaj polycystic ovary kawm paub tswj kev ntxhov siab, nro thiab ntxhov siab. Yoga thiab pabcuam ntxiv nrog cov vitamins B thiab magnesium tseem tuaj yeem pab nyob ntawm no.

Muaj cov qe hlau siab yog cuam tshuam nrog insulin tsis kam. Hauv qhov no, tus neeg pub ntshav pub dawb, hloov pauv los ntawm nqaij mus rau zaub mov zaub mov, thiab suav nrog cov khoom noj muaj roj ntau hauv cov khoom noj muaj txiaj ntsig tuaj yeem pab cov poj niam postmenopausal.

Insulin tsis kam nyob rau hauv cov poj niam nrog polycystic ovary tuaj yeem txo qis thiab txawm tias kho tau yooj yim nrog kev hloov pauv ntawm kev ua neej yooj yim, uas suav nrog kev noj zaub mov zoo, txhawb ntxiv, kev tawm dag zog, poob phaus, pw tsaug zog zoo, thiab txo kev ntxhov siab.

Abstract ntawm cov ntawv xov xwm hauv kev kho mob thiab kev noj qab haus huv, tus sau phau ntawv kev tshawb fawb yog Matsneva I.A., Bakhtiyarov K.R., Bogacheva N.A., Golubenko E.O., Pereverzina N.O.

Polycystic ovary syndrome (PCOS) yog ib qho ntawm cov tshuaj feem ntau ntawm endocrinopathies. Txawm hais tias muaj qhov tshwm sim ntawm PCOS thiab muaj keeb kwm ntev ntawm kev tshawb fawb, kev qhia txog kab mob, pathogenesis, kev kuaj mob thiab kho tus mob tseem yog qhov muaj peev xwm tshaj plaws. Nyob rau hauv xyoo tas los, qhov kev nce zuj zus ntawm cov kws tshawb fawb tau nyiam los ntawm cov lus nug ntawm kev koom tes ntawm hyperinsulinemia mus rau kev tsim kho PCOS. Nws paub tias nyob rau hauv 50-70% ntawm cov neeg mob, PCOS koom nrog kev rog, hyperinsulinemia, thiab kev hloov pauv hauv cov ntshav lipid spectrum, uas ua rau muaj kev pheej hmoo ntawm kev tsim kab mob plawv, hom ntshav qab zib 2 thiab ua rau muaj kev txo qis hauv lub neej nruab nrab. Ntau tus kws tshawb fawb taw rau qhov kev txiav txim siab caj ceg ntawm cov metabolism hauv kev tsis sib haum xeeb hauv PCOS, qhov kev cia siab uas ua rau hnyav dua qhov ua rau lub cev nyhav dhau los. Cov theem tam sim no hauv txoj kev kawm txog pathogenesis ntawm PCOS yog tus cwj pwm los ntawm kev kawm txog cov teeb meem hauv lub cev: insulin tsis kam, hyperinsulinemia, rog rog, hyperglycemia, dyslipidemia, mob rau lub cev, txoj kev kawm txog lawv qhov kev cuam tshuam ntawm cov txheej txheem pathological hauv zes qe menyuam, thiab cov kab mob ntsig txog xws li ntshav tsis muaj ntshav qab zib-mob ntshav qab zib mellitus thiab mob plawv. kab mob. Qhov no tuaj yeem piav qhia txog kev tshawb nrhiav rau qee yam kev kuaj mob tshiab los txiav txim siab seb lub cim twg yuav siv tau rau hauv kev coj ua txhua hnub raws li kev twv ua ntej ntawm metabolic thiab kev mob plawv hauv cov neeg mob PCOS.

TXUJ CI KOOM TES THIAB INSULIN RESISTANCE HAUV LUB POLYCYSTIC OVARIAN SYNDROME

Polycystic ovarian syndrome (PCOS) yog ib qho ntawm feem ntau cov lus ntawm endocrinopathies. Txawm hais tias muaj qhov loj ntawm PCOS thiab keeb kwm ntev ntawm txoj kev tshawb no, cov teeb meem ntawm txoj kev kho mob, kab mob pathogenesis, kev kuaj mob thiab kho tus mob syndrome yeej tseem muaj kev sib cav ntau dua. Nyob rau hauv xyoo tas los, qhov kev nce zuj zus ntawm cov kws tshawb fawb tau nyiam los ntawm cov lus nug ntawm kev koom tes ntawm hyperinsulinemia mus rau kev tsim kho PCOS. Nws tau paub tias nyob rau hauv 50-70% ntawm cov kis PCOS tau ua ke nrog kev rog, hyperinsulinemia thiab kev hloov ntawm daim di ncauj> insulin tsis kam, hyperinsulinemia, rog rog, hyperglycemia, dyslip> kev mob cuam tshuam, kev kawm txog lawv qhov kev cuam tshuam ntawm cov txheej txheem pathological hauv zes qe menyuam, thiab cov kab mob cuam tshuam xws li insulin-mob ntshav qab zib mellitus thiab kab mob plawv. Qhov no tuaj yeem piav qhia qhov kev tshawb nrhiav rau qee yam kev kuaj mob tshiab los txiav txim siab seb lub cim twg tuaj yeem siv rau hauv kev coj ua txhua hnub raws li kev twv ua ntej ntawm metabolic thiab hlab plawv txaus ntshai rau cov neeg mob PCOS.

Cov ntawv sau ntawm kev tshawb fawb tau ua haujlwm ntawm lub ncauj lus "Raug mob thiab insulin tsis kam hauv polycystic ovary syndrome"

TXUJ CI KOOM TXOOS THIAB UA RAWS LI INSULIN RESISTANCE IN SYNDROME

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

FGAOU VO Thawj Lub Tsev Kawm Ntawv Kho Mob Hauv Lub Xeev Moscow hauv nroog muaj npe tom qab I.M. Sechenov (Sechenov University), Moscow, Lavxias Federation

Ceeb Toom. Polycystic Ovary Syndrome (PCOS) yog ib qho ntawm cov tshuaj feem ntau ntawm endocrinopathies. Txawm hais tias muaj qhov tshwm sim ntawm PCOS thiab muaj keeb kwm ntev ntawm kev tshawb fawb, kev qhia txog kab mob, pathogenesis, kev kuaj mob thiab kho tus mob tseem yog qhov muaj peev xwm tshaj plaws. Nyob rau hauv xyoo tas los, qhov kev nce zuj zus ntawm cov kws tshawb fawb tau nyiam los ntawm cov lus nug ntawm kev koom tes ntawm hyperinsulinemia mus rau kev tsim kho PCOS. Nws paub tias nyob rau hauv 50-70% ntawm cov neeg mob, PCOS koom nrog kev rog, hyperinsulinemia, thiab kev hloov pauv hauv cov ntshav lipid spectrum, uas ua rau muaj kev pheej hmoo ntawm kev tsim kab mob plawv, hom ntshav qab zib 2 thiab ua rau muaj kev txo qis hauv lub neej nruab nrab. Ntau tus kws tshawb fawb taw rau qhov kev txiav txim siab caj ceg ntawm cov metabolism hauv kev tsis sib haum xeeb hauv PCOS, qhov kev cia siab uas ua rau hnyav dua qhov ua rau lub cev nyhav dhau los. Cov theem tam sim no hauv txoj kev kawm txog pathogenesis ntawm PCOS yog tus cwj pwm los ntawm kev kawm txog cov teeb meem hauv lub cev: insulin tsis kam, hyperinsulinemia, rog rog, hyperglycemia, dyslipidemia, mob rau lub cev, txoj kev kawm txog lawv qhov kev cuam tshuam ntawm cov txheej txheem pathological hauv zes qe menyuam, thiab cov kab mob ntsig txog xws li ntshav tsis muaj ntshav qab zib-mob ntshav qab zib mellitus thiab mob plawv. kab mob.

Qhov no tuaj yeem piav qhia txog kev tshawb nrhiav rau qee yam kev kuaj mob tshiab los txiav txim seb lub cim twg tuaj yeem siv rau hauv kev coj ua txhua hnub raws li kev twv ua ntej ntawm metabolic thiab kev mob plawv hauv cov neeg mob PCOS.

Cov ntsiab lus: insulin tsis kam, mob voos, mob polycystic ovary syndrome, hyperinsulinemia, hyperandrogenism.

Cov teeb meem ntawm kev kuaj mob polycystic ovary syndrome cuam tshuam rau tam sim no, txawm hais tias PCOS tau piav qhia los ntawm Stein thiab Leventhal xyoo 1935. Cov lus teev meej meej rau kev kuaj mob tsis muaj txog 2003, thaum Rotterdam cov qauv tau npaj tseg. Cov qauv no suav nrog:

1. Kev tsis xwm yeem / ua lub cev khiav ceev.

2. Cov chaw soj ntsuam / kuaj hyperandrogenism.

3. Polycystic cov zes qe menyuam.

Tab sis txawm tam sim no, kev kuaj mob ntawm PCOS ua rau muaj qee qhov nyuaj, qhov kev kuaj mob tseeb yog feem ntau tsim tsa tom qab ntev thiab, feem ntau, kev kuaj mob tsis xwm yeem thiab kev kho mob. Txog hnub no tuaj yeem piav qhia cov kev txaus siab ntawm cov kws tshawb nrhiav hauv qhov teeb meem no.

Polycystic zes qe menyuam mob tshwm sim hauv 2% -20% ntawm cov poj niam, thiab yog cov feem ntau muaj endocrinopathy rau cov poj niam uas muaj hnub nyoog deev. Tag nrho cov xwm txheej hauv lub ntiaj teb yog 3.5%.

Nyob rau hauv xyoo tas los, qhov kev nce zuj zus ntawm cov kws tshawb fawb tau nyiam los ntawm cov lus nug ntawm kev koom tes ntawm hyperinsulinemia mus rau kev tsim kho PCOS. Nws paub tias feem ntau cov neeg mob PCOS tiv thaiv insulin, thiab kwv yees li 50% ntawm cov neeg mob ua tau raws li cov txheej txheem ntawm kev puas siab puas ntsws 2,3. PCOS feem ntau cuam tshuam nrog B-cell ua haujlwm tsis zoo, uas ua rau muaj kev pheej hmoo ntawm ntshav qab zib hom 2. Hauv cov poj niam nrog PCOS, qhov kev pheej hmoo no tau ntau dua piv rau cov poj niam noj qab haus huv zoo tib yam nyhav thiab hnub nyoog. Cov Insulin txhawb cov kev ua p450c17 hauv cov zes qe menyuam thiab cov qog ua qog, uas ua rau kev nce hauv androgen ntau lawm.

Lub pathogenesis ntawm PCOS suav nrog hyperandrogenism, nruab nrab kev rog, thiab insulin tsis kam (hyperinsulinemia). Qib testosterone siab heev pab txhawb kev rog plab, uas nyeg tuaj yeem ua rau insulin tsis kam. Insulin tsis kam ua rau hyperinsulinemia thiab tom qab ntawd ua rau muaj kev nce siab hauv cov keeb kwm ntau ntau ntawm cov zes qe menyuam thiab cov qog adrenal, txwv kev tsim cov poj niam txiv neej kev sib deev globulin (SHBG), thiab thiaj li ua rau muaj kev ua si testosterone. Tsis tas li ntawd cov tshuaj insulin kuj

thiab kev rog nyob hauv nruab nrab hauv qhov tshwm sim ntawm hyperandrogenism hauv PCOS cuam tshuam nrog cov kev mob tshwm sim thiab muaj kev zais ntau ntxiv ntawm adipokines, interleukins thiab chemokines, uas yuav ua rau muaj kev pheej hmoo ntxiv

kev txhim kho mob ntshav qab zib thiab mob plawv.

Muaj lwm yam mob muaj keeb thiab tsis paub txog

Daim duab 1. Phaj siab heev hauv PCOS.

KHAWV KOOB KHO SIAB. Endocrine thiab metabolic cov yam ntxwv hauv polycystic ovary syndrome. Dan med j

Insulin kuj. Insulin tsis kam yog qhov zoo sib xws nrog lub cev qhov ua cim (BMI), tab sis kuj tseem muaj nyob hauv cov neeg mob uas muaj qhov hnyav hauv PCOS. Qhov tseeb ntawm kev ua haujlwm ntawm cov insulin tsis kam hauv PCOS tseem tsis tau paub. Cov neeg mob PCOS muaj qhov sib npaug thiab zoo sib xws rau cov insulin receptor piv rau cov poj niam muaj kev noj qab haus huv, thiab yog li, insulin tsis kam yog tej zaum kev kho kom haum los ntawm cov kev hloov pauv ntawm cov teeb liab sib kis los ntawm lub teeb liab insulin. Ntxiv rau, oxidative thiab tsis-oxidative qabzib metabolism tau yog qhov tsis txaus rau cov neeg mob PCOS hauv kev tshawb fawb siv cov kev qhia ncaj qha rau cov calorimetry. Hauv cov kev tshawb fawb no, insulin-stimulated non-oxidative glucose metabolism tau cuam tshuam ntau dua li oxidative glucose metabolism, uas txhawb nqa qis ntawm glycogen synthase kev ua hauv PCOS. Cov kev ua haujlwm tsis muaj zog ntawm glycogen synthase yog kev paub tseeb los ntawm kev tshawb fawb cov leeg nqaij ntawm cov neeg mob. Cov kev tshawb fawb no tau qhia tias cov neeg mob PCOS tau muaj lub zog insulin los ntawm Akt thiab AS160, nrog rau muaj kev cuam tshuam cov kab mob insulin-induced glycogen synthetase piv nrog pawg tswj hwm. Hauv qee cov neeg mob PCOS, serine phosphoryl tau nce.

insulin receptor b, tab sis cov chaw deb ntawm insulin receptor cas 6.7 kuj tseem cuam tshuam.

Cov tshuaj Insulin tsis kam rau cov poj niam nrog PCOS tuaj yeem yog vim muaj caj ces yug lossis yoog raws li kev rog thiab hyperandrogenism. Cov txheej txheem no tau raug soj ntsuam ntxiv hauv cov kev coj ua rau cov leeg nqaij tau txais los ntawm cov neeg mob tiv thaiv insulin hauv PCOS thiab poj niam noj qab haus huv 8.9. Kev tsis ncaj ncees hauv kev ua ntawm cov tshuaj insulin, uas tawm tsam hauv cov hlwb raug tshem tawm ntawm qhov nruab nrab hauv vivo, qhia tias cov kev hloov pauv no yog los ntawm kev hloov pauv hauv cov noob uas tswj kev teeb liab kis. Cov kws tshawb fawb tau pom tias cov piam thaj kev txhim kho thiab oxidation, glycogen synthesis, thiab lipid uptake yog sib piv ntawm cov neeg mob PCOS thiab poj niam noj qab haus huv, thiab lawv kuj muaj qhov ua tau zoo ntawm cov haujlwm ntawm 6.7. Cov txiaj ntsig no tau qhia tias cov tshuaj insulin tsis kam hauv PCOS kuj yog qhov txiaj ntsig ntawm kev yoog. Pancreatic beta cell insulin secretion yog nce ntxiv los txhawb rau kev tiv thaiv cov tshuaj insulin. Yog li, hyperinsulinemia hauv PCOS kuj tseem tuaj yeem ua kev hloov kho ntawm cov tshuaj tiv thaiv insulin.

Cov kev tshawb fawb pom tau tias cov tshuaj insulin muaj nyob rau ob qho tib si ib txwm thiab polycystic zes qe menyuam. Hauv kev sib xyaw nrog LH, insulin txhawb cov kev ua ntawm p450c17 hauv cov zes qe menyuam thiab cov qog ua qog thiab ua rau nce ntawm kev tsim tawm androgens. Cov kev tshawb fawb paub tseeb tias theca cell hauv cov neeg mob PCOS yog nkag siab ntau dua li cov androgen txhawb cov teebmeem ntawm cov insulin dua li ntawm zes qe menyuam. Yog li, insulin tuaj yeem ua gonadotropin, pab txhawb kev nce siab ntawm androgens los ntawm cov thev naus laus zis. Ntxiv rau, hyperinsulinemia txo qis tsim SHBG hauv lub siab. Ua tsaug rau cov tshuab no, qib testosterone dawb nce ntxiv. Tsis tas li, qib qis SHBG tau siv rau hauv kev kuaj mob ntawm PCOS thiab cuam tshuam nrog qis insulin rhiab heev hauv euglycemic hyperinsulinemic test.

Testosterone tuaj yeem txhim kho insulin tsis kam ncaj qha lossis tsis ncaj. Testosterone tshuaj nyob rau hauv cov koob tshuaj supraphysiological nyob rau hauv cov poj niam tau ncaj qha nrog insulin tsis kam, soj ntsuam siv euglycemic test. Tsis tas li ntawd, muaj testosterone ntau ntau tuaj yeem pab txhawb kev rog plab, uas tuaj yeem ua rau insulin tsis kam. PCOS phenotypes nrog hyperandrogenism tau tiv thaiv cov tshuaj tiv thaiv kab mob ntau dua li cov phenotypes tsis muaj hyperandrogenism, uas tseem tau lees tias qhov tseem ceeb ntawm hyperandrogenism hauv insulin tsis kam hauv PCOS.

Cov kab mob o tag thiab o. Raws li kev tshawb fawb, kwv yees li 75% ntawm cov neeg mob PCOS yog cov rog dhau, thiab qhov nruab nrab lub cev rog yog pom nyob hauv cov neeg mob uas muaj ob qho tib si ib txwm thiab hnyav dhau. Qhov ntau ntawm kev noj zaub mov kom yuag tau yuav luag 40% ntawm cov poj niam mob hirsutism, thiab sib hloov, hauv cov poj niam nrog PCOS, bulimia tau muaj ntau heev. Tus nqi metabolic tsis txo qis hauv cov neeg mob PCOS, thiab hauv kev sim kho tsis muaj qhov sib txawv hauv qhov muaj peev xwm los txo qhov hnyav ntawm cov neeg mob PCOS thiab cov poj niam noj qab nyob zoo nyob hauv kev noj zaub mov zoo ib yam. Txawm li cas los xij, ghrelin kev noj qab haus huv tom qab noj mov tsawg dua nyob rau hauv PCOS piv nrog cov poj niam noj qab haus huv, tawm tswv yim tsis txaus siab raws li txoj cai. Grelin tsuas yog ua kom zais los ntawm cov keeb ntawm endocrine ntawm lub plab. Cov qib Ghrelin nce ntxiv thaum kev tshaib plab thiab txo qis thaum noj mov. Kev zais zais Grecin txo qis thaum lub zog tshuav zoo, xws li kev rog dhau los. Ghrelin yog qhia nyob rau hauv pancreatic beta hlwb thiab tuaj yeem tiv thaiv insulin secretion. Tsawg ghrelin yog txuam nrog kev tiv thaiv insulin thiab ntshav qab zib. Ghrelin zoo sib txheeb ze nrog

adiponectin thiab rov qab nrog leptin. Cov kev tshawb fawb yav dhau los tshaj tawm tias cov ghrelin tsawg hauv cov neeg mob PCOS piv nrog cov poj niam noj qab haus huv.

Cov kev tshawb fawb pom tau tias qhov kev txo qis hauv lub neej zoo hauv PCOS tau cuam tshuam nrog kev nce hauv lub cev nyhav. Visceral rog yog txuam nrog insulin tsis kam thiab nce siab ntau yam, tuaj yeem tuaj yeem kho tau ib qho los ntawm lub xeev uas maj mam txhim kho mob. Adipose cov nqaij mos ua tawm thiab tso tawm ntau cov protein ua ke, hu ua adipokins. Nrog rau kev zam ntawm leptin thiab adiponectin, adipokines tsis tsim tshwj xeeb los ntawm adipocytes, lawv tsuas yog zais cia los ntawm cov rog macrophages. Nrog kev rog dhau, tus naj npawb ntawm cov roj macrophages nce ntau dua hauv cov nqaij subcutaneous thiab visceral adipose cov nqaij mos, thiab cov roj ntsha mus rau lub cev mononuclear ntau dua. Kev ua kom ntau ntxiv tso rau ntawm adipokines kwv yees metabolic syndrome thiab nce kev pheej hmoo ntawm kev tsim muaj ntshav qab zib.

Adiponectin yog cov protein ntau muaj sib luag thiab muaj zais zais tshwj xeeb ntawm cov ntaub so ntswg adipose. Adiponectin secretion txo qis nrog cov rog. Kev noj tshuaj adiponectin tsawg kawg tau cuam tshuam nrog kev pheej hmoo ntawm cov tshuaj insulin thiab kev txhim kho ntshav qab zib hom 2. Cov kev ua haujlwm los ntawm qhov uas adiponectin cuam tshuam rau insulin rhiab heev tsis tau to taub. Kev tshawb nrhiav tsiaj thiab hauv vitro tau pom tias recombinant adiponectin stimulates cov leeg thiab hepatic nqus ntawm cov piam thaj, txo qis dua ntawm gluconeogenesis hauv daim siab, thiab txhawb txoj kev oxidation ntawm cov roj dawb hauv cov leeg pob txha. Yog li, adiponectin txo qis triglyceride ntau ntau thiab ua rau cov kua dej tsis txaus siab. Adiponectin kuj tseem tuaj yeem muaj kev cuam tshuam ncaj qha rau zes qe menyuam muaj nuj nqi. Adiponectin receptors muaj nyob hauv zes qe menyuam thiab endometrium. Theca hlwb hauv cov neeg mob PCOS tau qis qis ntawm adiponectin receptors piv nrog zes qe menyuam cov poj niam noj qab nyob zoo. Hauv kev tshawb fawb, adiponectin stimulation tau txuam nrog kev txo qis ntawm zes qe menyuam thiab androgen ntau lawm. Cov txiaj ntsig no pom tseeb txoj kev sib raug zoo ntawm kev rog, adiponectin, thiab hyperandrogenism hauv PCOS. Kev nce hauv testosterone hauv cov neeg mob rog thiab PCOS tuaj yeem sib kho los ntawm qhov txo qis hauv adiponectin.

Leptin yog thawj zaug adipokine tau piav qhia thiab muaj kev cuam tshuam tseem ceeb rau kev tswj hwm kev noj zaub mov thiab kev siv lub zog. Leptin sawv ntawm

adipocytes, inhibits kev noj haus thiab txhawb kev siv zog. Leptin cuam tshuam rau hypothalamus thiab lub caj pas pituitary thiab tuaj yeem cuam tshuam tsis yog hypothalamic kev cai ntawm kev qab los noj mov, tab sis kuj tseem cuam tshuam ntawm cov leeg hlwb. Hauv cov nas, leptin hno txhim kho ovarian follicle kev loj hlob vim yog leptin receptors tau pom nyob rau hauv zes qe menyuam, qhia tias leptin yuav yog qhov tseem ceeb rau kev ua haujlwm gonad. Cov kev tshawb fawb kuj qhia txog kev sib raug zoo ntawm leptin thiab BMI, duav ib ncig ntawm lub duav thiab theem ntawm cov tshuaj tiv thaiv insulin.

Rau macrophages kom nqus cov LDL (cov lipoproteins uas tsis muaj hnyav), lawv yuav tsum tau oxidized, ua oxLDL ib qho qauv atherogenic ntawm LDL. Qib OxLDL tau nce ntxiv hauv cov neeg mob PCOS piv nrog poj niam noj qab haus huv. Ntxiv mus, OxLDL qib tau sib piv hauv cov neeg mob PCOS uas muaj ob qho tib si ib txwm thiab hnyav dua, yog li kev sib koom tes me me ntawm lub cev nyhav thiab oxLDL ntawm 25.26 tau xav tias. CD36 yog qhia nyob rau saum npoo ntawm monocytes thiab macrophages. Kev tsim cov ua npuas ua npuas yog pib thiab txhim kho los ntawm txoj kev khi ntawm oxLDL receptors rau CD36, uas ua rau CD36 cov haujlwm ua rau muaj kev pheej hmoo rau cov kab mob plawv. Soluble CD36 (sCD36) tuaj yeem ntsuas cov ntshav thiab kho cov kua dej tsis haum tshuaj thiab ntshav qabzib. Cov koom haum zoo tau pom ntawm sCD36 thiab insulin thiab BMI. Cov neeg mob PCOS tau muaj sCD36 siab dua cov poj niam muaj txiaj ntsig zoo ntawm lub cev nyhav.

HsCRP paub tau tias muaj kev tiv thaiv tsis pub leej twg paub nrog cytokines, suav nrog IL-6. Txhawb siab hsCRP yog qhov muaj zog tshaj plaws ib feem ntawm kev kwv yees ntawm kev pheej hmoo ntawm cov hlab plawv. HsCRP tuaj yeem tsis yog tsuas yog ua cim kev tiv thaiv kab mob, tab sis tseem tuaj yeem txhim kho cov txheej txheem ntawm cov mob los ntawm kev txuas ntxiv monocytes thiab hlwb endothelial. Cov neeg mob PCOS muaj qhov hsCRP ntau dua piv rau cov poj niam noj qab haus huv. Hauv kev ntsuas meta-tshuaj ntsuam tsis ntev los no, cov qib CRP tau nyob nruab nrab 96% nce hauv PCOS tiv thaiv pawg tswj hwm thiab txuas ntxiv nce tom qab kho rau BMI. Nws tau pom tias hsCRP zoo sib txheeb nrog qhov tsim muaj DEXA-scanned cov roj

huab hwm coj, thaum tsis muaj qhov sib txuam tseem ceeb tau pom thaum ntsuas testosterone lossis ntsuas metabolism hauv qabzib.

Prolactin yog zais tsis tsuas yog los ntawm lub qog pituitary, tab sis kuj yog los ntawm macrophages ntawm adipose nqaij hauv kev teb rau kev mob thiab cov ntshav qabzib ntau. Hauv cov kev tshawb fawb, prolactin siab tau cuam tshuam nrog kev nce ntshav ntawm cov ntshav dawb thiab cov kab mob autoimmune. Cov lus pov thawj uas prolactin tuaj yeem ua raws li adipokine tau txais kev txhawb nqa los ntawm kev tshawb fawb hauv cov neeg mob prolactinomas. Cov neeg mob nrog prolactinoma tau tiv thaiv insulin, tshuaj insulin ntau zog thaum kho nrog dopamine agonist. Cov qib Prolactin tau pom tias muaj feem cuam tshuam nrog estradiol, tag nrho testosterone, DHEAS, 17-hydroxyprogesterone thiab qib cortisol hauv cov neeg mob PCOS. Hauv ntau cov kev ntsuas kev ntsuas, prolactin tau cuam tshuam zoo nrog estradiol, 17OHP, thiab cortisol tom qab kho lub hnub nyoog, BMI, thiab haus luam yeeb xwm txheej. Hauv kev tshawb fawb txog cov tsiaj hlwb, prolactin muaj qhov tshwm sim ncaj qha rau lub zog loj hlob ntawm adrenocortical hlwb, uas ua rau adrenal hyperplasia 31.6.

Tsis tas li, tsis ntev los no, nrog polycystic ovary syndrome, ntau yam ntawm cov kiav txhab thiab cov zom zaub mov zom zaub mov tau raug ntsuas. Qee qhov ntawm cov cim no suav nrog chemokine migration inhibition factor (MIF), monocytic chemoattractant protein (MCP) -1 thiab macrophage inflammatory protein (MIP), visfatin thiab resitin, thiab lwm yam. Cov ntaub ntawv ntawm cov cim phom sij no yog qhov cuam tshuam, thiab lawv qhov tseem ceeb hauv PCOS. tseem raug tsim.

Yog li, cov txiaj ntsig ntawm ntau cov kev tshawb fawb tau pom tias muaj qee qhov kev sib raug zoo ntawm ntau cov cim tiv thaiv kab mob, tiv thaiv insulin, thiab polycystic ovary syndrome (Cov Lus 1).

Cov kev tshawb fawb txuas ntxiv yog xav tau los txiav txim rau lub cim ntawm leej twg yuav tsum tau tshuaj xyuas hauv kev coj ua txhua hnub raws li kev twv ua ntej ntawm metabolic thiab kev mob plawv hauv cov neeg mob PCOS.

Cov koom haum ua tau ntawm thaj ua rau mob cim thiab cov cim ntawm cov rog

huab hwm coj, insulin thiab testosterone theem.

Cov kab mob o hauv PCOS.

Cov cim ntawm kev mob Qib hauv PCOS im / rog huab hwm coj Insulin rhiab heev Testosterone

Adiponectin Txo (0 i ,?

Grepn Txo Kuv i-- 0

Prolactin Txo (V) 0) +

SCD36, oh-LDL Nce ntxiv (0 + + tsis muaj

CRP Nce + + Tsis Tau

Leptin Raws li kev txwv ib txwm + + (+) tsis muaj

IL-6 Li Qub + N / A

t t muaj kev sib raug zoo sib xyaw, t rov qab sib raug zoo, (t) (t) tsis muaj zog kev sib raug zoo

+ + inverse kev sib raug zoo txoj kev sib raug zoo, + qhov zoo sib cuam tshuam (t) qhov cuam tshuam zoo tsis muaj: tsis muaj kev sib raug zoo

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Nakhjavani M., Morteza A., Asgarani F. li al. Metformin txum kho cov kev sib txuam ntawm cov dej-oxidized LDL thiab leptin ntau ntau hauv cov neeg mob ntshav qab zib hom 2. Redox Rep 2011, 5: 193-200.

Lub Koom Haum Ua Si ntawm Endotoxemia Nrog Txheej Txheem Hluav Taws Xob, Kev Ua Kom Endothelial, thiab Lub Plab Hlawv txhaws nyob rau hauv lub raum ua tiav. 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. Los ntawm Nutr. 2017 Oct 28.

Diamanti-Kandarakis E., Paterakis T., Alexandraki K. li al. Qhov taw qhia ntawm cov qis qis mob ua mob hauv polycystic ovary syndrome thiab cov txiaj ntsig muaj txiaj ntsig ntawm metformin. Hum Reprod 2006, 6: 1426-31.

Bouckenooghe T., Sisino G., Aurientis S. li al. Adipose Tissue Macrophages (ATM) ntawm cov neeg mob rog yog nthuav tawm ntau ntxiv ntawm prolactin thaum muaj kev sib tw: Lub luag haujlwm rau prolactin hauv diabesity? Biochim Biophys Acta 2013, 4: 584-93.

Heterogenous keeb kwm ntawm hyperandrogenism hauv polycystic ovary syndrome nyob rau hauv kev sib raug zoo nrog lub cev qhov ntsuas thiab insulin tsis kam. Patlolla S., Vaikkakara S., Sachan A., Ven-katanarasu A., Bachimanchi B., Bitla A., Settipalli S., Pathiputturu S., Sugali R.N., Chiri S. Gynecol Endocrinol. 2017 Oct 25: 1-5

TXUJ CI KOOM TES THIAB KEV KOOM HAUV HAUV POLYCYSTIC

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

Thawj lub xeev Moscow lub tsev kawm ntawv kho mob lub npe tom qab I.M. Sechenov, Moscow, Lavxias teb sab Federation

Ceeb Toom. Polycystic ovarian syndrome (PCOS) yog ib qho ntawm feem ntau cov lus ntawm endocrinopathies. Txawm hais tias muaj qhov loj ntawm PCOS thiab keeb kwm ntev ntawm txoj kev tshawb no, cov teeb meem ntawm txoj kev kho mob, kab mob pathogenesis, kev kuaj mob thiab kho tus mob syndrome yeej tseem muaj kev sib cav ntau dua. Nyob rau hauv xyoo tas los, qhov kev nce zuj zus ntawm cov kws tshawb fawb tau nyiam los ntawm cov lus nug ntawm kev koom tes ntawm hyperinsulinemia mus rau kev tsim kho PCOS. Nws paub tias nyob rau hauv 50-70% ntawm cov kis PCOS tau ua ke nrog kev rog, hyperinsulinemia thiab hloov lipid spectrum ntawm cov ntshav, uas ua rau muaj kev pheej hmoo ntawm kev tsim kab mob plawv, ntshav qab zib hom II thiab ua rau txo qis hauv lub neej nruab nrab ntev. Cov. Ntau tus kws tshawb fawb taw rau qhov kev txiav txim siab caj ceg ntawm cov metabolism hauv kev tsis sib haum xeeb hauv PCOS, qhov kev cia siab uas ua rau hnyav dua lub cev nyhav dhau los. Cov qib tshiab niaj hnub nyob rau hauv kev kawm txog cov kab mob pathogenesis ntawm PCOS yog tus cwj pwm los ntawm qhov kev tshawb fawb tob hauv cov teeb meem hauv lub cev: insulin tsis kam, hyperinsulinemia, rog rog, hyperglycemia, dyslipidemia, muaj kab mob hauv lub cev, kawm txog lawv qhov kev cuam tshuam ntawm cov txheej txheem pathological hauv zes qe menyuam. , thiab cov kab mob cuam tshuam xws li insulin-ywj siab mob ntshav qab zib mellitus thiab kab mob plawv.

Qhov no tuaj yeem piav qhia qhov kev tshawb nrhiav rau qee yam kev kuaj mob tshiab los txiav txim siab seb lub cim twg tuaj yeem siv rau hauv kev coj ua txhua hnub raws li kev twv ua ntej ntawm metabolic thiab hlab plawv txaus ntshai rau cov neeg mob PCOS.

Cov ntsiab lus: insulin tsis kam, mob voos, mob polycystic ovary syndrome, hyperinsulinemia, hyperandrogenia.

PHAU NTAWV TSHOOJ. Lub cev tswv yim thiab kab mob ntawm poj niam deev

Cov Ntawv Xov Xwm ntawm kev kho mob endocrinology thiab metabolism. Tian, ​​Ye, Zhao, Han, Chen, Haitao, Peng, Yingqian, Cui, Linlin, Du, Yanzhi, Wang, Zhao, Xu, Jianfeng, Chen, Zi-Jiang. Luam tawm Tsib Hlis 1, 2016

Glintborg D., Andersen M. Kev hloov kho tshiab ntawm pathogenesis, o, thiab cov metabolism hauv hirsutism thiab polycystic syndrome ntawm zes qe menyuam mob. Gynecol Endocrinol 2010.4: 281-96

KHAWV KOOB KHO SIAB. Endocrine thiab metabolic cov yam ntxwv hauv polycystic ovary syndrome. Dan Med J 2016.63 (4): B5232

Eriksen M. B., Minet A. D., Glintborg D. li al. Intact primary mitochondrial muaj nuj nqi hauv myotubes tsim los ntawm cov poj niam nrog PCOS. J Clin Endocrinol Metab 2011, 8: E1298-E1302.

Cov Ntawv Xov Xwm ntawm kev kho mob endocrinology thiab metabolism. Broskey, Nicholas T., Klempel, Monica C., Gilmore, L. Anne, Sutton, Elizabeth F., Altazan, Abby D., Burton, Jeffrey H., Ravussin, Eric, Redman, Leanne M. Luam tawm Lub Rau Hli 1, 2017

Eriksen M., Porneki A.D., Skov V. li al. Cov tshuaj Insulin tsis kam ua haujlwm hauv myotubes tsim los ntawm cov poj niam nrog PCOS. PLOS IB XYOO 2010, 12: e14469.

Cibula D., Skrha J., Hill M. li al. Kev twv ua ntej ntawm insulin rhiab heev nyob rau hauv cov poj niam tsis tuaj yeem nrog ovary polycystic. Lub Rau Hli 2016

Corbould A. Qhov cuam tshuam ntawm androgens ntawm insulin kev txiav txim siab hauv cov poj niam: yog androgen dhau los ua ib qho kev cuam tshuam ntawm poj niam kev mob ntshav siab? Ntshav Qab Zib Metab Res Rev 2008, 7: 520-32.

Polycystic Ovarian Disease (Stein-Leventhal Syndrome) Lorena I. Rasquin Leon, Jane V. Mayrin. Einstein Lub Tsev Kho Mob. Xeem hloov tshiab: Kaum Hli 6, 2017

Neuroendocrine Kev Cai ntawm Cov Khoom Noj Kom Muaj Zog hauv Polycystic Ovary Syndrome. Daniela R., Valentina I., Simona C., Valeria T., Antonio L. Reprod Sci. 2017 Lub Ib Hlis 1: 1933719117728803. doi: 10.1177 / 1933719117728803.

Morgan J., Scholtz S., Lacey H. et al. Qhov dav dav ntawm kev noj kev tsis haum rau cov poj niam uas muaj lub ntsej muag hirsutism: kev tshawb pom epide-miological cohort. Int J Noj Ncuav Tsis Xyeej 2008, 5: 427-31.

KEV LOM ZEM, OBESITY, THIAB OSTEOARTHRITIS. LUB DAIM NTAWV POV THAWJ: THAUM THEEM THEEM. 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.

Lub luag hauj lwm ntawm adipocyte mitochondria hauv kev mob o, lipemia thiab insulin rhiab heev hauv tib neeg: cuam tshuam los ntawm kev kho pioglitazone. Xie X., Sinha S., Yi Z., Langlais P.R., Madan M., Bowen B.P., Willis W., Meyer C. Int J Obes (Lond). 2017 Lub Yim Hli 14. doi: 10.1038 / ijo.2017.192

Chen X., Jia X., Qiao J. li al. Adipokines hauv kev ua me nyuam: qhov txuas ntawm kev rog thiab polycystic syndrome ntawm zes qe menyuam. J Mol Endocrinol 2013, 2: R21-R37.

Li S., Shin H. J., Ding E. L., van Dam R. M. Adiponectin qib thiab kev pheej hmoo ntawm hom ntshav qab zib 2: kev soj ntsuam ib puag ncig thiab tshuaj tsom-meta. JAMA 2009, 2: 179-88.

Chen M.B., McAinch A.J., Macaulay S.L. li al. Txhim kho tsis ua haujlwm ntawm AMP-kinase thiab fatty acid oxidation los ntawm globular adiponectin hauv kab lis kev cai tib neeg cov leeg pob txha ntawm cov rog hom 2 mob ntshav qab zib. J Clin Endocrinol Metab 2005, 6: 3665-72.

Comim F.V., Hardy K., Franks S. Adiponectin thiab nws cov receptors hauv zes qe menyuam: cov pov thawj ntxiv rau kev sib txuas ntawm kev rog thiab hyperandrogenism hauv polycystic ovary syndrome. PLOS IB XYOO 2013, 11: e80416.

Otto B., Spranger J., Benoit S.C. li al. Ntau lub ntsej muag ntawm ghrelin: cov kev xav tshiab rau kev tshawb nrhiav khoom noj khoom haus? Br J Nutr 2005, 6: 765-71.

Kev tawm dag zog ua kev tawm dag zog thiab kev poob phaus, tsis yog ib txwm muaj kev sib yuav zoo siab: ib leeg qhov muag tsis pom kev tawm dag zog hauv cov poj niam uas muaj ntau hom BMI. Jackson M., Fatahi F., Alabduljader K., Jelleyman C., Moore J.P., Kubis H.P. Thov siv Physiol Nutr Metab. 2017 Nov 2.

Barkan D., Hurgin V., Dekel N. li al. Leptin induces ovulation hauv GnRH-cov nas tsis muaj zog. FASEB J 2005, 1: 133-5.

Jackson M., Fatahi F., Alabduljader K., Jelleyman C., Moore J.P., Kubis H.P. Thov siv Physiol Nutr Metab. 2017 Nov 2. doi: 10.1139 / apnm-2017-0577.

Gao S., Liu J. Chronic Dis Txhais Lus Med. 2017 Tsib Hlis 25, 3 (2): 89-94. doi: 10.1016 / j.cdtm.2017.02.02.008. eCollection 2017 Jun 25. Tshawb xyuas.

Onyango A.N. Oxid Med Cell Longev. 2017, 2017: 8765972. doi: 10.1155 / 2017/8765972. Epub 2017 Sep 7. Soj ntsuam.

Nakhjavani M., Morteza A., Asgarani F. li al. Metformin txum kho cov kev sib txuam ntawm cov dej-oxidized LDL thiab leptin ntau ntau hauv cov neeg mob ntshav qab zib hom 2. Redox Rep 2011, 5: 193-200.

Lub Koom Haum Ua Si ntawm Endotoxemia Nrog Txheej Txheem Hluav Taws Xob, Kev Ua Kom Endothelial, thiab Lub Plab Hlawv txhaws nyob rau hauv lub raum ua tiav. 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. Los ntawm Nutr. 2017 Oct 28.

Diamanti-Kandarakis E., Paterakis T., Alexandraki K. li al. Qhov taw qhia ntawm cov qis qis mob ua mob hauv polycystic ovary syndrome thiab cov txiaj ntsig muaj txiaj ntsig ntawm metformin. Hum Reprod 2006, 6: 1426-31.

Bouckenooghe T., Sisino G., Aurientis S. li al. Adipose Tissue Macrophages (ATM) ntawm cov neeg mob rog yog nthuav tawm ntau ntxiv ntawm prolactin thaum muaj kev sib tw: Lub luag haujlwm rau prolactin hauv diabesity? Biochim Biophys Acta 2013, 4: 584-93.

Cov tshuaj insulin-resistant hom PCOS

Nws yog classic hom PCOS thiab los ntawm kev deb tshaj. Siab tshuaj insulin thiab leptin inhibit ovulation thiab txhawb kev zes qe menyuam kom sib zog ua ke testosterone. Insulin tsis kam yog tshwm sim los ntawm qab zib, haus luam yeeb, tshuaj tiv thaiv hormonal, trans nqaijrog thiab ib puag ncig co toxins.

Feem ntau cov Qhov ua rau PCOS yog qhov teeb meem tseem ceeb nrog insulin thiab leptin.Cov tshuaj insulin tawm ntawm koj lub txiav. Leptin tso tawm ntawm koj cov rog. Ua ke, ob qhov tshuaj hormones no tswj cov ntshav qab zib thiab qab los. Lawv kuj tswj koj tus poj niam cov tshuaj hormones.

Cov tshuaj Insulin nce sai tom qab noj mov, uas ua rau koj lub hlwb kom nqus cov piam thaj ntawm koj cov ntshav thiab tig mus rau lub zog. Tom qab ntawd nws ntog. Qhov no ib txwm muaj thaum koj "insulin rhiab."

Leptin yog koj qhov kev xav ntawm lub cev. Nws sawv tom qab noj mov, nrog rau thaum koj muaj roj txaus. Leptin hais lus rau koj cov hypothalamus thiab hais txog kev txo qis koj lub siab thiab ua kom koj cov metabolism hauv lub siab. Leptin tseem qhia koj lub caj pas pituitary tso FSH thiab LH. Qhov no ib txwm muaj thaum koj "rhiab rau leptin."

Thaum koj nkag siab txog insulin, koj muaj piam thaj tsawg thiab muaj cov insulin tsawg hauv koj cov ntshav yoo mov. Thaum koj nkag siab rau leptin, koj muaj tsawg leptin.

Hauv PCOS, koj yuav tsis nkag siab insulin thiab leptin. Koj tawm tsam lawv, uas txhais tau tias koj tsis tuaj yeem teb lawv zoo. Cov tshuaj insulin tsis tuaj yeem hais tias koj lub hlwb noj cov piam thaj rau lub zog, yog li hloov nws hloov cov piam thaj rau cov rog. Leptin tsis tuaj yeem qhia koj lub hypothalamus tias nws suppresses tsis qab los, yog li koj tshaib plab txhua lub sijhawm.

Thaum twg koj insulin tsis kam, koj muaj ntshav siab insulin ntau ntau. Thaum yuav noj tsis kam rau leptin, koj muaj leptin siab hauv cov ntshav. Nrog hom no PCOS koj muaj insulin thiab leptin tsis kam - nws tsuas yog hu ua insulin kuj.

Cov tshuaj Insulin ua rau ntau dua li PCOS nkaus xwb. Ib tus poj niam tuaj yeem mob hnyav (ua rau muaj leeg), mob, mob ntxau, progesterone tsis txaus thiab ib txwm yuag kom yuag. Txoj kev pheej hmoo ntawm kev tsim muaj ntshav qab zib, mob cancer, txha, mob dementia, thiab mob plawv yog nce. Yog vim li cas PCOS tsub kom muaj kev pheej hmoo ntawm cov mob no.

Qhov ua rau muaj peev xwm tiv thaiv Insulin

Qhov teeb meem feem ntau ntawm insulin tsis kam yog qab zib, uas yog hais txog cov fructose ntau hauv cov khoom qab zib thiab cov dej qab zib. Concentrated fructose (tab sis tsis qis qis koob fructose) hloov qhov uas koj lub hlwb cuam tshuam rau leptin. Qhov no hloov pauv qhov uas koj lub cev cuam tshuam rau insulin. Concentrated fructose kuj ua rau koj noj ntau, uas ua rau koj qhov hnyav nce.
Muaj lwm cov laj thawj rau kev tawm tsam insulin. Lub ntsiab yog: kev mob caj ces, kev haus luam yeeb, pauv rog, kev ntxhov siab, tshuaj noj kom txhob muaj me nyuam, pw tsis tsaug zog, cov tsis muaj zog magnesium (sib tham hauv qab no) thiab ib puag ncig co toxins. Cov no ua rau cov insulin tsis kam vim tias lawv ua rau koj cov insulin puas tsuaj, thiab vim li ntawd, nws tsis tuaj yeem teb tsis tau zoo.

Cov txheej txheem ntawm kev txo cov ntaub so ntswg rhiab rau insulin

Thaum lub sijhawm siv cov tshuaj tiv thaiv kev xeeb menyuam, cov tshuaj hormones hluavtaws, qhov txawv ntawm qhov ntau ntawm lawv tus kheej cov tshuaj hormones, yog ib txwm muab rau lub cev ntawm tus ntxhais hluas hauv qhov ntau npaum li cas. Tom qab kev cuam tshuam li no, lawv cov tshuaj hormones yuav tsis muaj dab tsi cuam tshuam rau cov qog endocrine. Kev tswj tus kheej ntawm endocrine system yuav kho tsis tau.
Kom lub cev muaj peev xwm nyob taus, txhua hom kab mob hauv lub cev ua qhov tsis txaus rau txhua cov tshuaj hormones, suav nrog tshuaj insulin.

Vim li cas cov ntaub so ntswg insulin rhiab?

Qhov rhiab ntawm cov ntaub so ntswg thiab kabmob mus rau insulin yog qhov tseem ceeb heev. Nws txiav txim siab nkag mus rau hauv lub cell ntawm piam thaj thiab lwm yam khoom noj muaj txiaj ntsig. Qhov tseeb, kev tshaib plab tsis muaj insulin thiab piam thaj tshwm sim rau lub cev. Cov neeg tseem ceeb ntawm cov piam thaj yog lub hlwb, uas yuav tsis ua haujlwm tsis muaj nws.
Piv txwv, hauv cov neeg mob ntshav qab zib mellitus, muaj qhov txo qis hauv qabzib, lub hlwb cortex tuaj yeem tuag nyob rau ob peb feeb (hypoglycemic lub xeev). Yuav kom zam dhau qhov xwm txheej txaus ntshai, cov neeg mob ntshav qab zib tas li nqa cov khoom qab zib nrog lawv.
Tus txiav yuav pib coj los ua ke cov tshuaj insulin nyob hauv hom nruam thiab kev ntsuas ntawm kev lag luam.los tiv thaiv lub hlwb tuag. Yog li nws tuaj yeem pib ntshav qab zib hom 2 - tus kabmob yog qhov txaus ntshai thiab loj heev.

Yog li, thaum tus poj niam siv sijhawm OK, tom qab ntawd nqaij thiab lub cev rhiab rau insulin txo qisCov. Qhov no yog ib qho ntawm cov teeb meem loj thaum siv cov tshuaj hormones hluavtaws. Kev txiav txim siab ua rau lub cev insulin nce ntau. Insulin ntau dhau ua rau muaj ntau yam ntawm cov metabolism thiab endocrine ntshawv siab, txhawm rau txhim kho hom ntshav qab zib hom 2. Nws tshwm sim ntawd nkaus xwb hloov tshwm sim hauv lub zes qe menyuam - lawv ua hypersensitive rau insulinces qhov tshwm sim yuav zoo li qub - tsuas yog tsis muaj ntshav qab zib.

Ntau OK tiv thaiv kom tsis txhob nce leeg nyob ntawm poj niam me nyuam. Qhov no tuaj yeem ua rau qhov hnyav nce thiab txo qis hauv insulin rhiab heev, yog li ntawd Cov tshuaj tiv thaiv hormonal yog qhov kev xaiv tsis zoo tshwj xeeb rau PCOS.

Cov tshuaj insulin cuam tshuam li cas rau lub zes qe menyuam li cas?

Hauv cov zes qe menyuam, androgens raug muab coj los ua ke, los ntawm qhov twg estrogens yog tom qab tsim. Tus txheej txheem nws tus kheej yog kho los ntawm insulin. Yog tias nws qib nce siab, tom qab ntawd txhua lub qe ntawm zes qe menyuam yuav raug siv "tsim" hauv zes qe menyuam.
Estrogens yog qhov kawg ntawm cov khoom siv tshuaj. Cov khoom lag luam nrab - progesterone thiab androgens ntawm ntau hom. Lawv muab ntau cov tsos mob tsis zoo nyob hauv PCOS.

Ntau cov tshuaj insulin - ntau ntawm androgens hauv zes qe menyuam

Qhov loj npaum li cas ntawm cov insulin stimulates lub zes qe menyuam mus coj los ua androgens hauv kev dhau. Thiab cov tub ntxhais hluas ntxhais hluas ntau dua li tau txais txhua yam kev lom zem ntawm hyperandrogenism: pob txuv, plaub hau poob, hirsutism.

Testosterone (adrenal hormone), nws tseem hu ua "txiv neej" hormone, 99% yog nyob hauv poj niam lub cev hauv daim ntawv tsis muaj zog, khi los ntawm cov protein tshwj xeeb (SHBG, SHBG). Testosterone hloov mus rau hauv ib daim ntawv nquag - dihydrotestosterone (DHT, DHT) nrog kev pab insulin thiab 5-alpha reductase enzymeCov. Nquag, DHT yuav tsum tsis pub ntau tshaj 1%.
Dihydrotestosterone feem ntau yuav ntxiv rau cov hauv paus plaub hauua rau muaj teeb meem ntau rau tus poj niam lub ntsej muag: cov plaub hau ua oily, nkig thiab pib poob tawm, vim tias nws tuaj yeem ua rau do hau.
Qhov feem pua ​​ntawm DHT hauv cov ntshav kuj tseem cuam tshuam rau daim tawv nqaij: cov ntsiab lus ntawm cov rog, mob ntxau. Thiab tseem muaj lub voj voog tawm mus thiab cov metabolism hloov pauv.

Thaum kawg, ntau cov insulin nkim koj lub caj pas pituitary los ua ke ntau tshaj luteinizing hormone (LH), uas ntxiv ntxiv stimulates androgens thiab thaiv ovulation.

Yog li, theem siab ntawm insulin hauv cov ntshav nce cov ntsiab lus ntawm active androgens. Androgens tseem ua ke tsis yog hauv cov zes qe menyuam, tab sis kuj tseem nyob hauv cov qog adrenal, nplooj siab, raum, thiab cov ntaub so ntswg adipose. Tab sis cov zes qe menyuam yog qhov txuas tseem ceeb tshaj plaws hauv kev txhim kho PCOS.

Kua rog zoo li rog

Xyuam xim rau lub cev kos npe ntawm kev rog nyob rau hauv cov duab ntawm lub txiv av (nqa ib qho hnyav dhau ntawm koj lub duav).
Siv daim kab xev ntsuas los ntsuas koj lub duav ntawm txoj hlab ntaws. Yog tias koj lub duav ncig siab tshaj li ntawm 89 cm, tom qab ntawd koj muaj kev pheej hmoo ntawm cov tshuaj insulin. Qhov no tuaj yeem xam tau ntau dua qhov tseeb ntawm cov qauv ntawm qhov sib piv ntawm lub duav mus rau qhov siab: Koj lub duav yuav tsum qis dua li ib nrab ntawm koj qhov siab.
Kua rog yog qhov qhia txog cov tsos mob ntawm insulin kuj. Qhov loj dua ntawm koj lub duav ncig, qhov ntau dua koj PCOS yuav yog hom tshuaj insulin.

Insulin siab ua rau lub cev poob hnyavthiab qhov no tuaj yeem dhau mus ua lub voj voos: kev rog dhau los ua cov insulin tsis kam, ua rau cov rog, uas ntxiv rau kev ua haujlwm insulin tsis zoo. Lub tswv yim ua kom yuag poob zoo tshaj plaws yog kho cov tshuaj tiv thaiv insulin.

Tseem Ceeb! Insulin kuj tseem tuaj yeem tshwm sim hauv cov neeg nyias. Yuav tsum tau kuaj ntshav ntxiv thiaj paub.

Kuaj ntshav rau insulin tsis kam

Nug koj tus kws kho mob kom qhia rau ib qho ntawm cov kev xaiv ua:

• Kev ntsuam xyuas rau kev tso ntshav qabzib nrog insulin.
  Nrog rau qhov kev sim no, koj muab ntau qhov kuaj ntshav (ua ntej thiab tom qab haus cov dej qab zib). Kev ntsuam xyuas ntsuas sai npaum li cas koj tshem tawm cov piam thaj hauv cov ntshav (uas qhia tau hais tias koj teb tau insulin zoo npaum li cas). Koj tseem tuaj yeem kuaj tau leptin, tab sis feem ntau cov chaw sim tsis pom.
• Kuaj ntshav hauv qab qhov ntsuas HOMA-IR.
  Nws yog qhov sib piv ntawm kev yoo insulin thiab ceev cov piam thaj. Siab insulin txhais tau tias cov tshuaj insulin ua hauj.

Yog tias koj muaj insulin tsis kam, koj xav tau kev kho mob uas peb yuav tham txog tom qab.

Qab zib tsis kam

Thawj yam kom ua yog nres kev ua khoom qab zib thiab dej qab zib. Kuv thov txim yog cov neeg uas mloog cov xov xwm phem, tab sis kuv txhais tau tias nres txhua qhov. Kuv tsis txhais tau tias qee lub sijhawm rov qab tsuas yog noj cov ncuav qab zib. Yog tias koj muaj peev xwm tiv thaiv cov tshuaj insulin, koj tsis muaj "cov khoom hauv keeb kwm" los nqus cov khoom qab zib. Txhua lub sijhawm koj noj khoom noj qab zib, nws thawb koj ntxaum thiab ntxaum mus rau insulin kuj (thiab ntxaum mus rau hauv PCOS).
Kuv paub nws nyuaj rau txiav luam yeeb qab zib, tshwj xeeb yog tias koj quav rau nws. Kev muab piam thaj rau kom qab zib tuaj yeem ua nyuaj lossis nyuaj dua li kev txiav luam yeeb. Tshem cov piam thaj hauv lub cev yuav tsum muaj kev npaj ua zoo.

Yuav ua li cas pab txoj kev ua ntawm tsis lees qab qab zib:

• Pw kom txaus (vim tias kev pw tsis tsaug zog ua rau qab zib nqhis).
• Noj cov zaub mov kom ntau nrog rau tag nrho peb macronutrients: protein, starch, thiab rog.
• Tsis txhob sim txwv koj txoj kev noj zaub mov rau lwm yam zaub mov thaum koj pov cov qab zib.
• Pib noj haus thaum muaj kev ntxhov siab me me hauv koj lub neej.
• Tsum paub tias txoj kev mob siab rau khoom qab zib yuav ploj mus hauv 20 feeb.
• Nco ntsoov tias kev nqhis dej feem ntau yuav ploj zuj zus hauv ob lub lis piam.
• Ntxiv cov magnesium vim tias nws txo cov khoom qab zib.
• Hlub koj tus kheej. Zam txim rau koj tus kheej. Nco ntsoov, koj ua nws rau koj tus kheej!

Tsis kam qab zib yog txawv ntawm kev noj cov zaub mov uas muaj carb tsawg. Qhov tseeb, feem ntau nws yuav yooj yim rau kev qab zib yog tias koj tsis zam rau cov hmoov txhuv nplej siab, xws li cov qos yaj ywm thiab mov, vim tias cov hmoov txhuv nplej txhawm rau txhawm. Ntawm qhov tod tes, nws nyuab dua rau kev txiav luam yeeb yog tias koj noj cov zaub mov mob xws li nplej thiab khoom noj siv mis. Qhov no vim tias cov zaub mov ntshaw nqhis yog cov tsos mob ntawm cov khoom noj tiv thaiv kab mob.
Lub sijhawm yuav los thaum koj cov tshuaj insulin ib txwm nyob thiab tom qab ntawv koj tuaj yeem txaus siab ntawm cov khoom qab zib uas koj nyiam. Tsis tshua, Kuv txhais tau tias ib hlis ib zaug.

Kev tawm dag zog

Kev qoj ib ce rov ua kom rov mob dua cov leeg nqaij mus rau insulin. Qhov tseeb, tsuas yog ob peb lub lis piam ntawm kev cob qhia lub zog pom tias muaj qhov nce ntawm insulin rhiab heev ntawm 24%. Tso npe rau qhov kev tawm dag zog, txawm tias muaj kev mob siab me me koj tseem yuav pom kev txhim kho. Taug kev ncig lub block. Nce ntaiv. Xaiv hom kev tawm dag zog uas koj nyiam.

DIAGRAM TSWV YIM RAU COV NYIAJ KHWV TAU LOS TXOJ CAI

Qhov kev tswj hwm no tsis yog tsim nyog txhawm rau txhim kho cov tshuaj insulin rau hauv cov poj niam nrog PCOS, tab sis rau txhua tus neeg muaj kev pheej hmoo loj rau kev mob ntshav qab zib.

Magnesium taurate

Berberine *

Inositol Hmoov, 227 g

GTF Chrome ***

Cov lus hauv rooj

* Berberine tsis txhob sib xyaw nrog lwm cov tshuaj: cov tshuaj tiv thaiv kev puas tsuaj, beta blockers, lossis immunosuppressants (vim tias nws tuaj yeem hloov ntshav hauv koj cov tshuaj). Contraindicated thaum cev xeeb tub thiab lactation.
Tsis txhob siv txuas ntxiv rau ntau tshaj li peb lub hlis vim tias nws yog antimicrobial thiab tuaj yeem hloov kho kom muaj pes tsawg leeg ntawm cov kab mob hauv plab hnyuv. Hloov 3 lub hlis nrog berberine nrog tshuaj curcumin.

** Alpha Lipoic Acid feem ntau muaj kev nyab xeeb, tab sis ntawm koob tshuaj ntau dua (ntau dua li 1000 mg) nws tuaj yeem txo qis cov thyroid hormones.
Alpha-lipoic acid, ua rau thiol, tsis txuas nrog vitamin B12, vim hais tias ua ke lawv tau txais txiaj ntsig antitumor, tab sis dhau los ua lom rau lub cev ntawm tus neeg noj qab haus huv. Yog li, peb haus nws cais los ntawm cov tshuaj qhov twg B12 yog tam sim no, hloov cov kev kawm (peb tsis tuaj yeem xa lawv los ntawm hnub).
Noj cais tawm ntawm magnesium, hlau thiab calcium, raws li nkag mus rau hauv cov tshuaj tiv thaiv nrog lawv, hauv lwm pluas noj, tsis txhob sib tov nrog cawv.

*** Huab Tais tsis sib xyaw nrog cov tshuaj tiv thaiv kab mob, beta-blockers, H2 blockers, proton twj tso kua mis inhibitors, corticosteroids, NSAIDs.

Progesterone

Cov tshuaj Insulin kuj tseem ua rau cov leeg progesterone tsis txaus thiab cov voj voog hnyav.
Ib qho teeb meem tseem ceeb nrog PCOS yog qhov tsis muaj kev sib sau ntawm progesterone rau ob lub lis piam hauv txhua lub hlis. Qhov tsis muaj progesterone ua rau kev tsis txaus ntseeg ntawm lub zes qe menyuam, txhawb kev xav androgens, thiab ua rau cov kev voj voog tsis xwm yeem. Nws ua rau kev txiav txim siab los kho qhov tsis txaus ntseeg no los ntawm kev rov ntsuam xyuas progesterone (hloov ntawm duphaston), Kuv muaj 2 txoj kev xaiv los xaiv:

Tam sim no Cov Khoom Noj, Natural progesterone Lee

• nrog kev coj khaub ncaws tsis tu ncua - pib txij li 14 txog 25 hnub ntawm MC (thawj hnub ntawm txhawm rau lub qab zib yuav tsum sib haum rau hnub ov ov.)
• Thaum tsis muaj lub voj voog - thov 25 hnub nrog so ntawm 5 hnub.
• nrog tsawg tus progesterone lossis qib siab testosterone - siv thawj lub hli txuas ntxiv, thiab tom ntej - mus rau theem ob.

GUNA, Tso Hluav Taws Xob Progesterone Ncos

Qhov kawg nkaus yuav pom zoo tom qab 1 lub hlis ntawm kev siv.
Txoj kev siv:
Los ntawm 20 poob 2 zaug hauv ib hnub ntawm cov pa khoob 20-30 feeb ua ntej noj mov lossis ib teev tom qab noj mov, siv cov tswv yim hauv qab no:

• nrog kev coj khaub ncaws tsis tu ncua - pib txij li 14 txog 25 hnub ntawm MC (thawj hnub ntawm kev nkag yuav tsum sib xws rau hnub ovulation.)
• Thaum tsis muaj lub voj voog - noj 25 hnub nrog kev cuam tshuam ntawm 5 hnub.
• nrog tsawg tus progesterone lossis qib siab testosterone - siv thawj lub hli txuas ntxiv, thiab tom ntej - mus rau theem ob

Potentiated progesterone yog kev pom zoo rau siv nrog progesterone hluavtaws inducer - GUNA REGUCICLE (G3)yog li ntawd lub cev nws tus kheej txuas ntxiv cov txheej txheem no.
Los ntawm 20 poob 2 zaug hauv ib hnub ntawm lub plab khoob 20-30 feeb ua ntej noj mov lossis ib teev tom qab, noj txuas ntxiv rau ib hlis. Ob qho tshuaj yeeb yuav sib xyaw rau hauv ib khob dej thiab haus kom maj mam.

• Yuav Guna progesterone ntawm eBay nrog kev xa khoom thoob ntiaj teb
• Yuav Guna Rugulcycle ntawm eBay nrog kev xa khoom thoob ntiaj teb

Kev npaj progesterone pib nrog kev kho tshuaj insulin rau 3-4 lub hlis.

Hyperandrogenism tuaj yeem ua rau hyperestrogenism lossis hloov mus rau estrogen tsis txaus.
Thaum poob qis hauv estrogen synthesis, peb ntxiv rau ntxiv phytoestrogens lossis estrogens muaj zog xaiv los ntawm.
Phytoestrogens yog cov yam ntxwv zoo ib yam li tib neeg cov tshuaj estrogen, tab sis, raws li txoj cai, nws yog ib nyuag qis dua. Cov tshuaj ntsuab Phytoestrogenic cov tshuaj sib txawv, muaj feem, cuam tshuam rau lub cev ntawm kev sib txawv. Lawv tseem tuaj yeem nqa cov txiaj ntsig ntxiv rau kev noj qab haus huv ntawm lub cev: tswj kev tiv thaiv kab mob, txhim kho cov ntshav ncig ntawm lub plab mog, txo qhov mob, thiab lwm yam.

Xwm kev, Liab Clover

• nrog kev coj khaub ncaws tsis tu ncua - pib los ntawm 5 mus rau 14 hnub ntawm MC
• Yog tias endometrium hlob tsis zoo, tom qab ntawd los ntawm 5 mus rau 25 hnub MC

GUNA, Muaj Hnyav Hnyav Estradiol Ncos

• nrog kev coj khaub ncaws tsis tu ncua - pib txij li 14 txog 25 hnub ntawm MC (thawj hnub ntawm kev nkag yuav tsum sib xws rau hnub ovulation.)
• Yog tias endometrium tsis loj hlob zoo - ntawm 5 txog 25 hnub ntawm MC

Potentiated estradiol raug pom zoo rau siv nrog estradiol hluavtaws inducer - GUNA FEM, uas tones tag nrho endocrine system thiab lub cev nws tus kheej txuas ntxiv cov txheej txheem no.
Los ntawm 20 poob 2 zaug hauv ib hnub ntawm lub plab khoob 20-30 feeb ua ntej noj mov lossis ib teev tom qab, noj txuas ntxiv rau ib hlis. Ob qho tshuaj yeeb yuav sib xyaw rau hauv ib khob dej thiab haus kom maj mam.

Cov tshuaj hormones Homeopathic uas muaj zog tsuas muaj rau Ukraine nkaus xwb, hmoov tsis lawv tsis xa ncaj qha rau cov chaw tsim khoom los ntawm Russia. Qee yam tshuaj pib tshwm rau ntawm Amazon.

• Yuav Guna poj niam ntawm eBay nrog kev xa khoom thoob ntiaj teb.
• Yuav Guna estradiol ntawm eBay nrog kev xa khoom thoob ntiaj teb.

Txhawm rau tso ib qho khoom hauv khw ntawm Ukrainian faib ntawm Guna, koj xav tau daim ntawv pov thawj naj npawb ntawm cov kws tshaj lij uas tau kawm nrog lawv - 1781 (Lub npe tag nrho tuaj yeem raug rho tawm). Kev xa tawm yog nqa tawm thoob plaws hauv Ukraine los ntawm Xa ntawv tshiab, nyiaj ntsuab ntawm kev xa khoom.