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Желчнокаменная болезнь как коморбидное синдрому поликистозных яичников заболевание*
Успенская Ю.Б., Кузнецова И.В. Желчнокаменная болезнь как коморбидное синдрому поликистозных яичников заболевание. Consilium Medicum. 2015; 17 (6): 45–48. DOI: 10.26442/2075-1753_2015.6.45-48
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Uspenskaya Yu.B., Kuznetsova I.V. Cholelithiasis ascomorbidity polycystic ovary syndrome disease. Consilium Medicum. 2015; 17 (6): 45–48. DOI: 10.26442/2075-1753_2015.6.45-48
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Аннотация
Синдром поликистозных яичников (СПКЯ) – сложная междисциплинарная проблема в связи с вовлечением в патогенез не только нарушений репродуктивной системы, но и многоплановых расстройств метаболизма, многие из которых патогномоничны для желчнокаменной болезни (ЖКБ). Представленные в статье данные литературы и собственные результаты свидетельствуют о предрасполагающей роли СПКЯ в развитии ЖКБ. Гормональные контрацептивы значительно повышают риск ЖКБ и могут явиться триггером камнеобразования. Индивидуализированный подход в назначении комбинированных оральных контрацептивов пациенткам с СПКЯ с учетом дополнительных рисков ЖКБ и их динамическое наблюдение позволят предотвращать возникновение или прогрессирование ЖКБ.
Ключевые слова: желчнокаменная болезнь, синдром поликистозных яичников, коморбидность.
Ключевые слова: желчнокаменная болезнь, синдром поликистозных яичников, коморбидность.
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Polycystic ovary syndrome (PCOS) is a complex interdisciplinary problem in connection with the involvement in the pathogenesis not only of reproductive system, but also multifaceted metabolic disorders, many of which are pathognomonic for cholelithiasis. Presented in the article the literature and their own clinical observation suggest predisposing role in the development of PCOS cholelithiasis. Hormonal contraceptives greatly increase the risk of gallstone disease, and may be the trigger of stone formation. The individualized approach to the appointment of COC patients with PCOS with the additional risk of cholelithiasis, and dynamic monitoring would prevent the onset and progression of cholelithiasis.
Key words: gallstone disease, polycystic ovary syndrome, comorbidity.
Key words: gallstone disease, polycystic ovary syndrome, comorbidity.
Полный текст
Список литературы
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5. Руководство по амбулаторно-поликлинической помощи в акушерстве и гинекологии. Под ред. В.Е.Радзинского. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2014. / Rukovodstvo po ambulatorno-poliklinicheskoi pomoshchi v akusherstve i ginekologii. Pod red. V.E.Radzinskogo. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2014. [in Russian]
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8. Acién P, Quereda F, Matallín P et al. Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders. Fertil Steril 1999; 72: 32–40.
9. Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2006; 65 (2): 137–45.
10. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2007; 66 (4): 513–7.
11. Basdevant A. Steroids and lipid metabolism: Mechanism of action. Int J Fertil 1992; 37 (Suppl. 2): 93–7.
12. Bennion, LJ, Grundy SM. Effects of diabetes mellitus on cholesterol metabolism in man. N Eng J Med 1977; 296: 1365–71.
13. Coviello AD, Legro RS, Dunaif A: Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. J Clin Endocrinol Metab 2006; 91: 492–7.
14. Cryer A. Comparative biochemistry and physiology of lipoprotein lipase. In: Borensztajn J (ed.) Lipoprotein lipase Evener: Chicago, IL, 1987; p. 277–327.
15. Diehl AK. Cholelithiasis and the insulin resistance syndrome. Hepatology 2000; 31: 528–30.
16. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta- analysis. JAMA 2006; 295: 1288–99.
17. Duan LP, Wang HH, Ohashi A, Wang DQ-H. Role of intestinal sterol transporters Abcg5, Abcg8, and Npc1l1 in cholesterol absorption in mice: gender and age effects. Am J Physiol Gastrointest Liver Physiol 2006; 290: G269–G276.
18. El-Mazny A, Abou-Salem N, El-Sherbiny W. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010; 109: 239–41.
19. Freeman R, Pollack R, Rosenbloom E. Assessing impaired glucose tolerance and insulin resistance in Polycystic Ovarian Syndrome with a muffin test: alternative to glucose tolerance test. Endocr Pract 2010; 16 (5): 810–7.
20. Gielkens HA, Lam WF, Coenraad M et al. Effect of insulin on basal and cholecystokinin-stimulated gallbladder motility in humans. J Hepatology 1998; 28: 595–602.
21. Gilat T, Konikoff F. Pregnancy and the biliary tract. Can J Gastroenterol 2000; 14–37.
22. Hahm JS, Park JY, Park KG et al. Gallbladder motility in diabetes mellitus using real time ultrasonography. Am J Gastroenterol 1996; 91: 2391–4.
23. Isik S, Ozcan HN, Ozuguz U et al. Impaired gallbladder motility and the effect of metformin therapy in patients with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2012; 76 (3): 373–8; doi: 10.1111/j.1365-2265.2011.04210.x
24. Kline LW, Karpinski E. Progesterone inhibits gallbladder motility through multiple signaling pathways. Steroids 2005; 70 (9): 673–9.
25. Kline LW, Karpinski E. Testosterone and dihydrotestosterone inhibit gallbladder motility through multiple signaling pathways. Steroids 2008; 73: 1174–80.
26. Ko CW, Beresford SA, Schulte SJ. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology 2005; 41 (2): 359–65.
27. Lundholm L, Zang H, Hirschberg AL et al. Key lipogenic gene expression can be decreased by estrogen in human adipose tissue. Fertil Steril 2008; 90: 44–8.
28. Luque-Ramírez M, Alpañés M, Escobar-Morreale HF. The determinants of insulin sensitivity, b-cell function, and glucose tolerance are different in patients with polycystic ovary syndrome than in women who do not have hyperandrogenism. Fertil Steril 2010; 94: 2214–21.
29. Mendez-Sanchez N, Vega, H, Uribe M et al. Risk factors for gallstone disease in Mexicans are similar to those found in Mexican-Americans. Digest Dis Sci 1998; 43: 935–9.
30. Nakeeb A, Comuzzie AG, Al-Azzawi H et al. Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg 2006; 10: 940–8.
31. Ness GC, Chambers CM. Feedback and hormonalregulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase: the concept of cholesterol buffering capacity. Proc Soc Exp Biol Med 2000; 224 (1): 8–19.
32. Ness GC, Zhao Z, Wiggins L. Insulin and glucagon modulate hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity by affecting immunoreactive protein levels. J Biol Chem 1994; 269: 29168–72.
33. Pesant MH, Baillargeon JP: Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome. Fertil Steril 2011; 95: 210–5.
34. Philipp BW, Shapiro DJ. Estrogen regulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase and acetyl-CoA carboxylase in xenopus laevis. J Biol Chem 1981; 256 (6): 2922–7.
35. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology 2000; 31: 299–303.
36. Sacks FM, Walsh BW. The effects of reproductive hormones on serum lipoproteins: Unresolved issues in biology and clinical practice. Multidisciplinary perspectives on menopause. Ann N Y Acad Sci 1990; 592: 272–85.
37. Simon JA, Donald B, Hunninghake MD et al. Effect of Estrogen plus Progestin on Risk for Biliary Tract Surgery in Postmenopausal Women with Coronary Artery Disease: The Heart and Estrogen/progestin Replacement Study. Ann Intern Med 2001; 135 (7): 493–501.
38. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2013; 6: 1–13; doi: 10.2147/CLEP.S37559
39. Strom BL, Tamragouri RN, Morse ML et al. Oral contraceptives and other risk factors for gallbladder disease. Clin Pharmacol Ther 1986; 39: 335–41.
40. Wild RA. The PCO paradigm: sex steroids, lipoprotein lipids, clotting, and the arterial wall. In The Ovary: Regulation, Dysfunction and Treatment. M Filicori and C Flamigni, eds. Elsevier Science B.V., 1996; p. 201–9.
2. Иванченкова Р.А. Хронические заболевания желчевыводящих путей. М.: Атмосфера, 2006. / Ivanchenkova R.A. Khronicheskie zabolevaniia zhelchevyvodiashchikh putei. M.: Atmosfera, 2006. [in Russian]
3. Ильченко А.А. Классификация желчнокаменной болезни. Тер. архив. 2004; 2: 75–9. / Il'chenko A.A. Klassifikatsiia zhelchnokamennoi bolezni. Ter. arkhiv. 2004; 2: 75–9. [in Russian]
4. Лейшнер У. Практическое руководство по заболеваниям желчных путей. М.: ГЭОТАР-МЕД, 2001. / Leishner U. Prakticheskoe rukovodstvo po zabolevaniiam zhelchnykh putei. M.: GEOTAR-MED, 2001. [in Russian]
5. Руководство по амбулаторно-поликлинической помощи в акушерстве и гинекологии. Под ред. В.Е.Радзинского. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа, 2014. / Rukovodstvo po ambulatorno-poliklinicheskoi pomoshchi v akusherstve i ginekologii. Pod red. V.E.Radzinskogo. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2014. [in Russian]
6. Руководство по репродуктивной медицине. Под ред. Б.Карра, Р.Блэкуэлла, Р.Азиза. Пер. с англ. М.: Практика, 2015. / Rukovodstvo po reproduktivnoi meditsine. Pod red. B.Karra, R.Blekuella, R.Aziza. Per. s angl. M.: Praktika, 2015. [in Russian]
7. Acalovschi M. Cholesterol gallstones: from epidemiology to prevention. Postgrad Med J 2001; 77: 221–9.
8. Acién P, Quereda F, Matallín P et al. Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders. Fertil Steril 1999; 72: 32–40.
9. Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2006; 65 (2): 137–45.
10. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2007; 66 (4): 513–7.
11. Basdevant A. Steroids and lipid metabolism: Mechanism of action. Int J Fertil 1992; 37 (Suppl. 2): 93–7.
12. Bennion, LJ, Grundy SM. Effects of diabetes mellitus on cholesterol metabolism in man. N Eng J Med 1977; 296: 1365–71.
13. Coviello AD, Legro RS, Dunaif A: Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. J Clin Endocrinol Metab 2006; 91: 492–7.
14. Cryer A. Comparative biochemistry and physiology of lipoprotein lipase. In: Borensztajn J (ed.) Lipoprotein lipase Evener: Chicago, IL, 1987; p. 277–327.
15. Diehl AK. Cholelithiasis and the insulin resistance syndrome. Hepatology 2000; 31: 528–30.
16. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta- analysis. JAMA 2006; 295: 1288–99.
17. Duan LP, Wang HH, Ohashi A, Wang DQ-H. Role of intestinal sterol transporters Abcg5, Abcg8, and Npc1l1 in cholesterol absorption in mice: gender and age effects. Am J Physiol Gastrointest Liver Physiol 2006; 290: G269–G276.
18. El-Mazny A, Abou-Salem N, El-Sherbiny W. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010; 109: 239–41.
19. Freeman R, Pollack R, Rosenbloom E. Assessing impaired glucose tolerance and insulin resistance in Polycystic Ovarian Syndrome with a muffin test: alternative to glucose tolerance test. Endocr Pract 2010; 16 (5): 810–7.
20. Gielkens HA, Lam WF, Coenraad M et al. Effect of insulin on basal and cholecystokinin-stimulated gallbladder motility in humans. J Hepatology 1998; 28: 595–602.
21. Gilat T, Konikoff F. Pregnancy and the biliary tract. Can J Gastroenterol 2000; 14–37.
22. Hahm JS, Park JY, Park KG et al. Gallbladder motility in diabetes mellitus using real time ultrasonography. Am J Gastroenterol 1996; 91: 2391–4.
23. Isik S, Ozcan HN, Ozuguz U et al. Impaired gallbladder motility and the effect of metformin therapy in patients with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2012; 76 (3): 373–8; doi: 10.1111/j.1365-2265.2011.04210.x
24. Kline LW, Karpinski E. Progesterone inhibits gallbladder motility through multiple signaling pathways. Steroids 2005; 70 (9): 673–9.
25. Kline LW, Karpinski E. Testosterone and dihydrotestosterone inhibit gallbladder motility through multiple signaling pathways. Steroids 2008; 73: 1174–80.
26. Ko CW, Beresford SA, Schulte SJ. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology 2005; 41 (2): 359–65.
27. Lundholm L, Zang H, Hirschberg AL et al. Key lipogenic gene expression can be decreased by estrogen in human adipose tissue. Fertil Steril 2008; 90: 44–8.
28. Luque-Ramírez M, Alpañés M, Escobar-Morreale HF. The determinants of insulin sensitivity, b-cell function, and glucose tolerance are different in patients with polycystic ovary syndrome than in women who do not have hyperandrogenism. Fertil Steril 2010; 94: 2214–21.
29. Mendez-Sanchez N, Vega, H, Uribe M et al. Risk factors for gallstone disease in Mexicans are similar to those found in Mexican-Americans. Digest Dis Sci 1998; 43: 935–9.
30. Nakeeb A, Comuzzie AG, Al-Azzawi H et al. Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg 2006; 10: 940–8.
31. Ness GC, Chambers CM. Feedback and hormonalregulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase: the concept of cholesterol buffering capacity. Proc Soc Exp Biol Med 2000; 224 (1): 8–19.
32. Ness GC, Zhao Z, Wiggins L. Insulin and glucagon modulate hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity by affecting immunoreactive protein levels. J Biol Chem 1994; 269: 29168–72.
33. Pesant MH, Baillargeon JP: Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome. Fertil Steril 2011; 95: 210–5.
34. Philipp BW, Shapiro DJ. Estrogen regulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase and acetyl-CoA carboxylase in xenopus laevis. J Biol Chem 1981; 256 (6): 2922–7.
35. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology 2000; 31: 299–303.
36. Sacks FM, Walsh BW. The effects of reproductive hormones on serum lipoproteins: Unresolved issues in biology and clinical practice. Multidisciplinary perspectives on menopause. Ann N Y Acad Sci 1990; 592: 272–85.
37. Simon JA, Donald B, Hunninghake MD et al. Effect of Estrogen plus Progestin on Risk for Biliary Tract Surgery in Postmenopausal Women with Coronary Artery Disease: The Heart and Estrogen/progestin Replacement Study. Ann Intern Med 2001; 135 (7): 493–501.
38. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2013; 6: 1–13; doi: 10.2147/CLEP.S37559
39. Strom BL, Tamragouri RN, Morse ML et al. Oral contraceptives and other risk factors for gallbladder disease. Clin Pharmacol Ther 1986; 39: 335–41.
40. Wild RA. The PCO paradigm: sex steroids, lipoprotein lipids, clotting, and the arterial wall. In The Ovary: Regulation, Dysfunction and Treatment. M Filicori and C Flamigni, eds. Elsevier Science B.V., 1996; p. 201–9.
________________________________________________
1. Gerok V., Blium Kh.E. Zabolevaniia pecheni i zhelchevydelitel'noi sistemy. Per. s nem. Pod obshch. red. V.T.Ivashkina, A.A.Sheptulina. M.: MEDpress-inform, 2009. [in Russian]
2. Ivanchenkova R.A. Khronicheskie zabolevaniia zhelchevyvodiashchikh putei. M.: Atmosfera, 2006. [in Russian]
3. Il'chenko A.A. Klassifikatsiia zhelchnokamennoi bolezni. Ter. arkhiv. 2004; 2: 75–9. [in Russian]
4. Leishner U. Prakticheskoe rukovodstvo po zabolevaniiam zhelchnykh putei. M.: GEOTAR-MED, 2001. [in Russian]
5. Rukovodstvo po ambulatorno-poliklinicheskoi pomoshchi v akusherstve i ginekologii. Pod red. V.E.Radzinskogo. 2-e izd., pererab. i dop. M.: GEOTAR-Media, 2014. [in Russian]
6. Rukovodstvo po reproduktivnoi meditsine. Pod red. B.Karra, R.Blekuella, R.Aziza. Per. s angl. M.: Praktika, 2015. [in Russian]
7. Acalovschi M. Cholesterol gallstones: from epidemiology to prevention. Postgrad Med J 2001; 77: 221–9.
8. Acién P, Quereda F, Matallín P et al. Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders. Fertil Steril 1999; 72: 32–40.
9. Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clin Endocrinol (Oxf) 2006; 65 (2): 137–45.
10. Barber TM, Wass JA, McCarthy MI, Franks S. Metabolic characteristics of women with polycystic ovaries and oligo-amenorrhoea but normal androgen levels: implications for the management of polycystic ovary syndrome. Clin Endocrinol (Oxf) 2007; 66 (4): 513–7.
11. Basdevant A. Steroids and lipid metabolism: Mechanism of action. Int J Fertil 1992; 37 (Suppl. 2): 93–7.
12. Bennion, LJ, Grundy SM. Effects of diabetes mellitus on cholesterol metabolism in man. N Eng J Med 1977; 296: 1365–71.
13. Coviello AD, Legro RS, Dunaif A: Adolescent girls with polycystic ovary syndrome have an increased risk of the metabolic syndrome associated with increasing androgen levels independent of obesity and insulin resistance. J Clin Endocrinol Metab 2006; 91: 492–7.
14. Cryer A. Comparative biochemistry and physiology of lipoprotein lipase. In: Borensztajn J (ed.) Lipoprotein lipase Evener: Chicago, IL, 1987; p. 277–327.
15. Diehl AK. Cholelithiasis and the insulin resistance syndrome. Hepatology 2000; 31: 528–30.
16. Ding EL, Song Y, Malik VS, Liu S. Sex differences of endogenous sex hormones and risk of type 2 diabetes: a systematic review and meta- analysis. JAMA 2006; 295: 1288–99.
17. Duan LP, Wang HH, Ohashi A, Wang DQ-H. Role of intestinal sterol transporters Abcg5, Abcg8, and Npc1l1 in cholesterol absorption in mice: gender and age effects. Am J Physiol Gastrointest Liver Physiol 2006; 290: G269–G276.
18. El-Mazny A, Abou-Salem N, El-Sherbiny W. Insulin resistance, dyslipidemia, and metabolic syndrome in women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010; 109: 239–41.
19. Freeman R, Pollack R, Rosenbloom E. Assessing impaired glucose tolerance and insulin resistance in Polycystic Ovarian Syndrome with a muffin test: alternative to glucose tolerance test. Endocr Pract 2010; 16 (5): 810–7.
20. Gielkens HA, Lam WF, Coenraad M et al. Effect of insulin on basal and cholecystokinin-stimulated gallbladder motility in humans. J Hepatology 1998; 28: 595–602.
21. Gilat T, Konikoff F. Pregnancy and the biliary tract. Can J Gastroenterol 2000; 14–37.
22. Hahm JS, Park JY, Park KG et al. Gallbladder motility in diabetes mellitus using real time ultrasonography. Am J Gastroenterol 1996; 91: 2391–4.
23. Isik S, Ozcan HN, Ozuguz U et al. Impaired gallbladder motility and the effect of metformin therapy in patients with polycystic ovary syndrome. Clin Endocrinol (Oxf) 2012; 76 (3): 373–8; doi: 10.1111/j.1365-2265.2011.04210.x
24. Kline LW, Karpinski E. Progesterone inhibits gallbladder motility through multiple signaling pathways. Steroids 2005; 70 (9): 673–9.
25. Kline LW, Karpinski E. Testosterone and dihydrotestosterone inhibit gallbladder motility through multiple signaling pathways. Steroids 2008; 73: 1174–80.
26. Ko CW, Beresford SA, Schulte SJ. Incidence, natural history, and risk factors for biliary sludge and stones during pregnancy. Hepatology 2005; 41 (2): 359–65.
27. Lundholm L, Zang H, Hirschberg AL et al. Key lipogenic gene expression can be decreased by estrogen in human adipose tissue. Fertil Steril 2008; 90: 44–8.
28. Luque-Ramírez M, Alpañés M, Escobar-Morreale HF. The determinants of insulin sensitivity, b-cell function, and glucose tolerance are different in patients with polycystic ovary syndrome than in women who do not have hyperandrogenism. Fertil Steril 2010; 94: 2214–21.
29. Mendez-Sanchez N, Vega, H, Uribe M et al. Risk factors for gallstone disease in Mexicans are similar to those found in Mexican-Americans. Digest Dis Sci 1998; 43: 935–9.
30. Nakeeb A, Comuzzie AG, Al-Azzawi H et al. Insulin resistance causes human gallbladder dysmotility. J Gastrointest Surg 2006; 10: 940–8.
31. Ness GC, Chambers CM. Feedback and hormonalregulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase: the concept of cholesterol buffering capacity. Proc Soc Exp Biol Med 2000; 224 (1): 8–19.
32. Ness GC, Zhao Z, Wiggins L. Insulin and glucagon modulate hepatic 3-hydroxy-3-methylglutaryl-coenzyme A reductase activity by affecting immunoreactive protein levels. J Biol Chem 1994; 269: 29168–72.
33. Pesant MH, Baillargeon JP: Clinically useful predictors of conversion to abnormal glucose tolerance in women with polycystic ovary syndrome. Fertil Steril 2011; 95: 210–5.
34. Philipp BW, Shapiro DJ. Estrogen regulation of hepatic3-hydroxy-3-methylglutaryl coenzyme A reductase and acetyl-CoA carboxylase in xenopus laevis. J Biol Chem 1981; 256 (6): 2922–7.
35. Ruhl CE, Everhart JE. Association of diabetes, serum insulin, and C-peptide with gallbladder disease. Hepatology 2000; 31: 299–303.
36. Sacks FM, Walsh BW. The effects of reproductive hormones on serum lipoproteins: Unresolved issues in biology and clinical practice. Multidisciplinary perspectives on menopause. Ann N Y Acad Sci 1990; 592: 272–85.
37. Simon JA, Donald B, Hunninghake MD et al. Effect of Estrogen plus Progestin on Risk for Biliary Tract Surgery in Postmenopausal Women with Coronary Artery Disease: The Heart and Estrogen/progestin Replacement Study. Ann Intern Med 2001; 135 (7): 493–501.
38. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clin Epidemiol 2013; 6: 1–13; doi: 10.2147/CLEP.S37559
39. Strom BL, Tamragouri RN, Morse ML et al. Oral contraceptives and other risk factors for gallbladder disease. Clin Pharmacol Ther 1986; 39: 335–41.
40. Wild RA. The PCO paradigm: sex steroids, lipoprotein lipids, clotting, and the arterial wall. In The Ovary: Regulation, Dysfunction and Treatment. M Filicori and C Flamigni, eds. Elsevier Science B.V., 1996; p. 201–9.
Авторы
Ю.Б.Успенская*, И.В.Кузнецова
ГБОУ ВПО Первый Московский государственный университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*jusp@mail.ru
ГБОУ ВПО Первый Московский государственный университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*jusp@mail.ru
________________________________________________
Yu.B.Uspenskaya*, I.V.Kuznetsova
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*jusp@mail.ru
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