多囊卵巢综合征(polycystic ovarian syndrome, PCOS)是一种和遗传背景密切相关的常见疾病,月经稀发、高雄激素 血症、卵巢多囊样变为其基本特征。 最新的遗传学研究揭示,与代谢综合征相关的 PCOS 可以被视为代谢综合征在女性生殖 系统中的特殊表现形式,这一疾病现被称为代谢相关性 PCOS。 在治疗 PCOS 的过程中,改善代谢综合征的状态至关重要。 当 前,生酮饮食已被认为是改善代谢综合征、控制体重和改善 PCOS 的有效手段。 作为一种新兴的治疗策略,生酮饮食在治疗 PCOS 方面展示出了显著的潜力,如调整月经周期,降低肝功能损害,提高维生素 D 水平等。 本文主要从遗传学的角度探讨 PCOS 作为代谢综合征在卵巢中的表现,并通过采用生酮饮食来改善全身代谢,从而改善 PCOS 的情况。 我们建议在医务人员 指导下实施优化的生酮饮食治疗方案,包括“柔性生酮”“达标退酮”和“均衡膳食终身维持”等阶段,并强调饮食方案应根据 个人情况进行个性化设计,以提高患者的依从性。

Polycystic ovary syndrome PCOS is a prevalent endocrine - metabolic disorder primarily affecting women of reproductive age. It is an autosomal dominant genetic disease characterized initially by metabolic abnormalities followed by reproductive anomalies. Current genetic studies suggest that PCOS associated with metabolic syndrome can be interpreted as a unique manifestation of metabolic syndrome within the female reproductive system now referred to as Metabolic Associated Polycystic Ovary Syndrome. The key to treating PCOS lies in the improvement of metabolic syndrome. Currently the ketogenic diet is recognized as an effective strategy for improving metabolic syndrome managing weight and ameliorating PCOS. Emerging as a novel therapeutic approach the ketogenic diet has demonstrated significant potential in PCOS management such as regulating menstrual cycles reducing hepatic damage and elevating Vitamin D levels among others. We recommend implementing an optimized ketogenic diet treatment plan under the guidance of a physician involving stages of "flexible ketosis" "targeted keto withdrawal" and "balanced diet lifelong maintenance". It is emphasized that dietary plans should be individualized to enhance patient compliance.