endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.62751/2713-0177-2026-7-1-09endofocus-203Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSСиндром поликистозных яичников сквозь призму кардиометаболического риска: от патогенеза к новым терапевтическим стратегиямPolycystic ovary syndrome through the prism of cardiometabolic risk: From pathogenesis to new therapeutic strategieshttps://orcid.org/0000-0001-5512-6899УшановаФ. О.UshanovaF. O.

Фатима Омариевна Ушанова, к. м. н., доцент

ИКМ; кафедра эндокринологии

117513; ул. Островитянова, д. 1; Москва

Fatima O. Ushanova, C. Sci. (Med.), associate professor

Institute of Clinical Medicine; Department of Endocrinology

117513; 1 bldg. 6 Ostrovityanova st.; Moscow

fati_2526@mail.ruhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Татьяна Юльевна Демидова, д. м. н., профессор, зав. кафедрой, заслуженный врач РФ

ИКМ; кафедра эндокринологии 

Москва

Scopus Author ID: 7003771623

Tatiana Yu. Demidova, D. Sci. (Med.), Prof., Honored Doctor of the Russian Federation

Institute of Clinical Medicine; Department of Endocrinology

Moscow

Scopus Author ID: 7003771623

t.y.demidova@gmail.comРоссийский национальный исследовательский медицинский университет имени Н.И. Пирогова (Пироговский университет)Pirogov Russian National Research Medical University202603052026716675Copyright © Ушанова Ф.О., Демидова Т.Ю., 20262026Ушанова Ф.О., Демидова Т.Ю.Ushanova F.O., Demidova T.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/203

   Синдром поликистозных яичников (СПКЯ) в современной медицине рассматривается как сложное мультисистемное состояние с выраженным кардиометаболическим профилем. Традиционные терапевтические стратегии, базирующиеся на применении комбинированных оральных контрацептивов и метформина, зачастую оказываются недостаточно эффективными для долгосрочной коррекции метаболических рисков и профилактики сердечно-сосудистых осложнений. В статье обсуждается смена парадигмы лечения СПКЯ в пользу использования инкретиновых препаратов – агонистов рецепторов глюкагоноподобного пептида 1 (семаглутида) и двойных агонистов глюкагоноподобного пептида 1 / глюкозозависимого инсулинотропного полипептида (тирзепатида). Проанализирован многогранный механизм действия этих фармакологических агентов, включающий не только снижение массы тела и инсулинорезистентности, но и прямое влияние на патофизиологические звенья заболевания – гиперандрогению, системное воспаление и дисфункцию яичников. В работе представлены данные последних метаанализов, подтверждающие значимое улучшение антропометрических показателей и липидного профиля при СПКЯ под влиянием инкретинов. Интеграция инкретиновой терапии в алгоритмы ведения СПКЯ открывает новые возможности для комплексной метаболической и репродуктивной реабилитации пациенток, обеспечивая персонализированный подход к лечению этого гетерогенного заболевания.

   Polycystic ovary syndrome (PCOS) is considered a complex multisystem condition with a pronounced cardiometabolic profile in modern medicine. Traditional therapeutic strategies based on combined oral contraceptives and metformin are often insufficiently effective for long-term correction of metabolic risks and prevention of cardiovascular complications. This article discusses the paradigm shift in PCOS treatment, favoring the use of incretin agents – GLP-1 receptor agonists (semaglutide) and dual GLP-1/GIP agonists (tirzepatide). The multifaceted mechanism of action of these agents is analyzed, including not only weight loss and insulin resistance but also a direct impact on the pathophysiological components of the disease: hyperandrogenism, systemic inflammation, and ovarian dysfunction. The paper presents data from recent meta-analyses confirming significant improvements in anthropometric parameters and lipid profiles in PCOS under the influence of incretins. Integrating incretin therapy into PCOS management algorithms opens new possibilities for comprehensive metabolic and reproductive rehabilitation of patients, providing a personalized approach to the treatment of this heterogeneous disease.

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