transmedТрансляционная медицинаTranslational Medicine2311-44952410-5155Almazov National Medical Research Centre, Saint Petersburg, Russia10.18705/2311-4495-2025-12-2-161-170FKVZNAtransmed-1033Research ArticleАКУШЕРСТВО И ГИНЕКОЛОГИЯСиндром поликистозных яичников: современные тренды в диагностике и леченииPolycystic ovary syndrome: new trends in diagnosis and treatmenthttps://orcid.org/0000-0002-7729-1606АбусуеваЗ. А.AbusuevaZ. A.

Абусуева Зухра Абусуевна - д.м.н., профессор кафедры акушерства и гинекологии.

Махачкала

Zukhra A. Abusueva - Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology, Dagestan State Medical University.

Makhachkala

zuhaabusueva@mail.ruhttps://orcid.org/0000-0002-4303-7546СейдалиеваК. Л.SeidalievaK. L.

Сейдалиева Кира Лукмановна - студент 6 курса лечебного факультета.

ул. Абдуразака Шахбанова, д. 13, Махачкала, 367014

Kira L. Seidalieva - 6th year student of the Faculty of Medicine of the Dagestan State Medical University.

Abdurazak Shakhbanov str., 13, Makhachkala, 367014

kira_se02@mail.ruhttps://orcid.org/0009-0002-1729-4781ЭфендиеваР. М.EfendievaR. M.

Эфендиева Рамина Мавлюдиновна - аспирант кафедры акушерства и гинекологии.

Махачкала

Ramina M. Efendieva - Postgraduate Student of the Department of Obstetrics and Gynecology, Dagestan State Medical University.

Makhachkala

romidok@mail.ruhttps://orcid.org/0000-0002-6418-5599СтефанянН. А.StefanyanN. A.

Стефанян Нателла Амлетовна - к.м.н., доцент кафедры акушерства и гинекологии.

Махачкала

Natella A. Stefanyan - PhD, Associate Professor of the Department of Obstetrics and Gynecology, Dagestan State Medical University.

Makhachkala

amu1972@mail.ruИбрагимовБ. Р.IbragimovB. R.

Ибрагимов Бахмуд Расулович - к.м.н., доцент кафедры акушерства и гинекологии.

Махачкала

Bakhmud R. Ibragimov - PhD, Associate Professor of the Department of Obstetrics and Gynecology, Dagestan State Medical University.

Makhachkala

Bahmud313@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Дагестанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияDagestan State Medical UniversityRussian Federation202517072025122161170Copyright © Абусуева З.А., Сейдалиева К.Л., Эфендиева Р.М., Стефанян Н.А., Ибрагимов Б.Р., 20252025Абусуева З.А., Сейдалиева К.Л., Эфендиева Р.М., Стефанян Н.А., Ибрагимов Б.Р.Abusueva Z.A., Seidalieva K.L., Efendieva R.M., Stefanyan N.A., Ibragimov B.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://transmed.almazovcentre.ru/jour/article/view/1033

Синдром поликистозных яичников (СПЯ) — частое эндокринное заболевание женщин репродуктивного периода, распространенность которого колеблется от 13 % до 25 %. СПЯ — это заболевание с репродуктивными и метаболическими нарушениями. В рамках данной статьи будут рассматриваться новшества в диагностике и лечении СПЯ.

Новшеством в диагностике является: определение уровня АМГ > 4,7 нг/мл (специфичность 92 %, чувствительность 89 %) при недоступности УЗИ, уточнение УЗИ-маркеров — ≥ 20 фолликулов или объем яичника ≥ 10 мл у взрослых и акцент на гиперандрогению с приоритетом определения свободного тестостерона с учетом этнических особенностей.

В лечении СПЯ сохраняется акцент на модификации образа жизни и на борьбе с ожирением. Рекомендуется 150–300 мин. физической активности в неделю. Среди фармакологических препаратов метформин, КОК и антиандрогены сохраняют свои позиции, однако появляется все больше упоминаний об изоформах инозитола, которые рекомендуются использовать в качестве экспериментальной терапии. Инозитолы (мио- и D-хиро-инозитол в соотношении 40:1) демонстрируют эффективность в улучшении овуляции (OR 1.8), снижении свободного тестостерона (15–20 %) и умеренном уменьшении инсулинорезистентности (HOMAI-R -0.8). Однако их применение требует дальнейших исследований для стандартизации.

Современная диагностика СПЯ стала более гибкой благодаря включению АМГ, а терапия сочетает традиционные (КОК, метформин) и перспективные методы (инозитолы, аГПП-1). Инозитолы, несмотря на ограниченную доказательную базу, занимают важное место в лечении, особенно при метаболических и репродуктивных нарушениях.

Polycystic Ovary Syndrome (PCOS) — frequent endocrine disease of women of the reproductive period, the prevalence of which ranges from 13 % to 25 %. PCOS is a disease with reproductive and metabolic disorders. This article will discuss innovations in the diagnosis and treatment of PCOS.

An innovation in diagnosis is the determination of AMH levels > 4.7 ng/ml (specificity 92 %, sensitivity 89 %) when ultrasound is unavailable, the refinement of ultrasound markers — ≥ 20 follicles or ovarian volume ≥ 10 ml in adults, and the focus on hyperandrogenism with priority for determining free testosterone, taking into account ethnic characteristics.

In the treatment of PCOS, the emphasis remains on lifestyle modification and on combating obesity. 150–300 minutes of physical activity per week is recommended. Among the pharmacological drugs, metformin, COCs and antiandrogens retain their positions, but there are more and more mentions of inositol isoforms that are recommended for use as experimental therapy. Inositols (myo- and D-chiroinositol in a ratio of 40:1) demonstrate effectiveness in improving ovulation (OR 1.8), reducing free testosterone (15–20 %), and moderately reducing insulin resistance (HOMA-IR -0.8). However, their application requires further research for standardization.

Modern diagnosis of PCOS has become more flexible due to the inclusion of AMH, and therapy combines traditional (COCs, metformin) and promising methods (inositols, aGPP-1). Inositols, despite the limited evidence base, occupy an important place in the treatment, especially for metabolic and reproductive disorders.

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The authors declare that there are no conflicts of interest present.