MECANISMOS FISIOPATOLÓGICOS E CONDUTAS TERAPÊUTICAS NA SÍNDROME DO OVÁRIO POLICÍSTICO: UMA REVISÃO BIBLIOGRÁFICA

DOI

https://doi.org/10.47820/recima21.v5i4.5094

Downloads

PDF

Resumo

Introdução: A Síndrome do Ovário Policístico (SOP) é uma condição endócrina complexa que afeta mulheres em idade reprodutiva, apresentando uma ampla gama de manifestações clínicas e metabólicas. Objetivo: analisar os mecanismos fisiopatológicos e condutas terapêuticas da SOP, fornecendo uma síntese atualizada da literatura científica. Metodologia: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e SciELO Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2013 e 2024, que abordassem sobre mecanismos fisiopatológicos e condutas terapêuticas da SOP. Após a análise, foram selecionados 37 artigos para a confecção dessa revisão bibliográfica.  Resultados e Discussão: A SOP é uma doença heterogênea caracterizada por hiperandrogenismo, ovulação disfuncional e morfologia dos ovários policísticos, acompanhada de anormalidades metabólicas, como resistência à insulina e obesidade. As abordagens terapêuticas para a SOP variam desde intervenções farmacológicas até modificações no estilo de vida. Os tratamentos farmacológicos visam normalizar os níveis hormonais, restaurar a ovulação e melhorar os sintomas clínicos, incluindo contraceptivos orais combinados, antiandrogênios e sensibilizadores de insulina, como a metformina.. Conclusão: A SOP continua sendo uma condição desafiadora para pacientes e profissionais de saúde, dada a sua complexidade fisiopatológica e as diversas manifestações clínicas.

Biografia do Autor

Zarife Azevedo Fialho

Instituto de Educação Superior do Vale do Parnaíba-IESVAP.

Mariana de Arruda Frazão

Centro Universitário do Maranhão - Uniceuma.

Thayna Peres Costa

Instituto de Educação Superior do Vale do Parnaíba-IESVAP.

Swelen Thaisi da Costa Silva

Centro Universitário do Maranhão - Uniceuma.

Miguel Ângelo Ibiapina Brito Filho

Centro Universitário Uninovafapi.

Ana Heloisa de Castro Macedo Paes

Centro Universitário Uninovafapi.

Igor de Oliveira Silva

Instituto de Educação Superior do Vale do Parnaíba-IESVAP.

Giovana Sardi de Freitas Alvarez Lopes

Acadêmica de Medicina.

Gabriela Ruiz Prestes

Acadêmica de Medicina.

Cleidyara de Jesus Brito Bacelar Viana Andrade

Acadêmica de Medicina.

Referências

ABBOTT, David H.; DUMESIC, Daniel A.; LEVINE, Jon E. Hyperandrogenic origins of polycystic ovary syndrome–implications for pathophysiology and therapy. Expert review of endocrinology & metabolismo, v. 14, n. 2, p. 131-143, 2019.

AL KHALIFAH, Reem A. et al. Metformin or oral contraceptives for adolescents with polycystic ovarian syndrome: a meta-analysis. Pediatrics, v. 137, n. 5, 2016.

AL WATTAR, Bassel H. et al. Clinical practice guidelines on the diagnosis and management of polycystic ovary syndrome: a systematic review and quality assessment study. The Journal of Clinical Endocrinology & Metabolism, v. 106, n. 8, p. 2436-2446, 2021.

ALESI, Simon et al. Nutritional supplements and complementary therapies in polycystic ovary syndrome. Advances in Nutrition, v. 13, n. 4, p. 1243-1266, 2022.

BANNIGIDA, Doddappa M.; NAYAK, B. Shivananda; VIJAYARAGHAVAN, R. Insulin resistance and oxidative marker in women with PCOS. Archives of physiology and biochemistry, v. 126, n. 2, p. 183-186, 2020.

BASKIND, N. Ellissa; BALEN, Adam H. Hypothalamic–pituitary, ovarian and adrenal contributions to polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 37, p. 80-97, 2016.

BRENNAN, Leah et al. Lifestyle and behavioral management of polycystic ovary syndrome. Journal of women's health, v. 26, n. 8, p. 836-848, 2017.

COYLE, Christopher; CAMPBELL, Rebecca E. Pathological pulses in PCOS. Molecular and cellular endocrinology, v. 498, p. 110561, 2019.

CREE-GREEN, Melanie et al. Insulin resistance, hyperinsulinemia, and mitochondria dysfunction in nonobese girls with polycystic ovarian syndrome. Journal of the Endocrine Society, v. 1, n. 7, p. 931-944, 2017.

DOMECQ, Juan Pablo et al. Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism, v. 98, n. 12, p. 4655-4663, 2013.

FENICHEL, Patrick et al. Which origin for polycystic ovaries syndrome: genetic, environmental or both?. Annales d'endocrinologie, p. 176-185, 2017.

FRANKS, S.; HARDY, K. Androgen action in the ovary. Front. Endocrinol., v. 9, p. 452, 2018.

GANIE, Mohammad Ashraf et al. Epidemiology, pathogenesis, genetics & management of polycystic ovary syndrome in India. Indian Journal of Medical Research, v. 150, n. 4, p. 333-344, 2019.

HOMER, Michael V. et al. Individual 17-hydroxyprogesterone responses to hCG are not correlated with follicle size in polycystic ovary syndrome. Journal of the Endocrine Society, v. 3, n. 4, p. 687-698, 2019.

IBÁÑEZ, Lourdes et al. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Hormone research in paediatrics, v. 88, n. 6, p. 371-395, 2017.

ILIE, Ioana R.; GEORGESCU, Carmen E. Polycystic ovary syndrome-epigenetic mechanisms and aberrant microRNA. Advances in clinical chemistry, v. 71, p. 25-45, 2015.

KIM, Joon Young et al. Impaired lipolysis, diminished fat oxidation, and metabolic inflexibility in obese girls with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, v. 103, n. 2, p. 546-554, 2018.

LI, Yan et al. Multi-system reproductive metabolic disorder: significance for the pathogenesis and therapy of polycystic ovary syndrome (PCOS). Life sciences, v. 228, p. 167-175, 2019.

LI, Yujing et al. Comparing the individual effects of metformin and rosiglitazone and their combination in obese women with polycystic ovary syndrome: a randomized controlled trial. Fertility and sterility, v. 113, n. 1, p. 197-204, 2020.

LIM, S. S. et al. Metabolic syndrome in polycystic ovary syndrome: a systematic review, meta‐analysis and meta‐regression. Obesity reviews, v. 20, n. 2, p. 339-352, 2019.

LIU, Yishan et al. The release of peripheral immune inflammatory cytokines promote an inflammatory cascade in PCOS patients via altering the follicular microenvironment. Frontiers in immunology, v. 12, p. 685724, 2021.

MANCINI, Antonio et al. Oxidative stress and low-grade inflammation in polycystic ovary syndrome: controversies and new insights. International Journal of Molecular Sciences, v. 22, n. 4, p. 1667, 2021.

MIZGIER, Małgorzata et al. Relation between inflammation, oxidative stress, and macronutrient intakes in normal and excessive body weight adolescent girls with clinical features of polycystic ovary syndrome. Nutrients, v. 13, n. 3, p. 896, 2021.

O’REILLY, Michael W. et al. AKR1C3-mediated adipose androgen generation drives lipotoxicity in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism, v. 102, n. 9, p. 3327-3339, 2017.

RUDDENKLAU, Amy; CAMPBELL, Rebecca E. Neuroendocrine impairments of polycystic ovary syndrome. Endocrinology, v. 160, n. 10, p. 2230-2242, 2019.

SADEGHI, Hosna Mohammad et al. Polycystic ovary syndrome: a comprehensive review of pathogenesis, management, and drug repurposing. International journal of molecular sciences, v. 23, n. 2, p. 583, 2022.

SAMUEL, Varman T. et al. The pathogenesis of insulin resistance: integrating signaling pathways and substrate flux. The Journal of clinical investigation, v. 126, n. 1, p. 12-22, 2016.

STEPTO, Nigel K. et al. Molecular mechanisms of insulin resistance in polycystic ovary syndrome: unraveling the conundrum in skeletal muscle?. The Journal of Clinical Endocrinology & Metabolism, v. 104, n. 11, p. 5372-5381, 2019.

SZCZUKO, Małgorzata et al. Nutrition strategy and life style in polycystic ovary syndrome—Narrative review. Nutrients, v. 13, n. 7, p. 2452, 2021.

TEEDE, Helena J. et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Human reproduction, v. 33, n. 9, p. 1602-1618, 2018.

WANG, Juan et al. Hyperandrogenemia and insulin resistance: The chief culprit of polycystic ovary syndrome. Life sciences, v. 236, p. 116940, 2019.

Witchel, Selma Feldman et al. “Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls.” Journal of the Endocrine Society, v. 3, n. 8, p. 1545-1573, 14 jun. 2019.

ZEIND, Caroline S. et al. Applied therapeutics: the clinical use of drugs. [S. l.]: Lippincott Williams & Wilkins, 2023.

ZHANG, Renjiao et al. Oxidative stress status in Chinese women with different clinical phenotypes of polycystic ovary syndrome. Clinical Endocrinology, v. 86, n. 1, p. 88-96, 2017.

ZHAO, Han et al. Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. Journal of Ovarian Research, v. 16, n. 1, p. 9, 2023.

ZHU, Daiyu et al. Effects of metformin on pregnancy outcome, metabolic profile, and sex hormone levels in women with polycystic ovary syndrome and their offspring: a systematic review and meta-analysis. Annals of Translational Medicine, v. 10, n. 7, 2022.

ZHU, Jing-ling et al. Sex hormone-binding globulin and polycystic ovary syndrome. Clinica chimica acta, v. 499, p. 142-148, 2019.

Como Citar

Azevedo Fialho, Z., de Arruda Frazão, M., Peres Costa, T., Thaisi da Costa Silva, S., Ângelo Ibiapina Brito Filho, M., Heloisa de Castro Macedo Paes, A., de Oliveira Silva, I., Sardi de Freitas Alvarez Lopes, G., Ruiz Prestes , G., & Brito Bacelar Viana Andrade , C. de J. (2024). MECANISMOS FISIOPATOLÓGICOS E CONDUTAS TERAPÊUTICAS NA SÍNDROME DO OVÁRIO POLICÍSTICO: UMA REVISÃO BIBLIOGRÁFICA. RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218, 5(4), e545094. https://doi.org/10.47820/recima21.v5i4.5094