PAPEL DE LAS CITOQUINAS EN LA PATOG\uc9NESIS DEL S\ucdNDROME DE OVARIO POLIQU\ucdSTICO Y FACTORES METAB 3LICOS ASOCIADOS.

En la actualidad, el s\uedndrome de ovario poliqu\uedstico (SOP) o hiperandrogenismo ov\ue1rico funcional, es una disfunci\uf3n endocrino-metab\uf3lica de alta prevalencia (5-10%) en la mujer premenop\ue1usica, tiene implicaciones significativas a corto y largo plazo como oligomenorrea, amenorrea, infertilidad, diabetes mellitus, enfermedades cardiovasculares, mayor riesgo de c\ue1ncer de endometrio y el vello corporal excesivo (hirsutismo). Esta alteraci\uf3n endocrinol\uf3gica se inicia poco despu\ue9s de la menarqu\ueda. Niveles cr\uf3nicamente elevados de la hormona luteinizante (LH) y la resistencia a la insulina son las dos alteraciones fisiopatol\uf3gicas m\ue1s comunes que se observan en pacientes con SOP, originando anovulaci\uf3n, hiperandrogenismo lo que explican las manifestaciones ginecol\uf3gicas de este s\uedndrome, y adem\ue1s un conjuntos de alteraciones metab\uf3licas como mayor incidencia de obesidad, diabetes mellitus tipo 2, dislipidemia, mayor riesgo de enfermedad arterial coronaria e hipertensi\uf3n arterial as\ued como, enfermedad de h\uedgado graso no alcoh\uf3lico. Dentro del ovario se producen un conjunto de citoquinas como factor de necrosis tumoral a(TNF-a), interleucina 1, el receptor2 del TNF-a, que parecen estar relacionada con la etiopatogenia de este s\uedndrome. La interleucina 6 y la interleucina 18 se elevan en SOP por el sustrato metab\uf3lico que lo acompa\uf1a donde el elemento fisiopatol\uf3gico com\ufan es la resistencia insulina. Futuras investigaciones se encargaran de dilucidar exactamente la interrelaci\uf3n entre la elevaci\uf3n de esta citoquinas proinflamatorias y las manifestaciones cl\uednicas del SOP, que permitan ejecutar medidas terap\ue9uticas precoces en estas pacientes para disminuir su morbimortalidad.(AU) ABSTRACT Currently, polycystic ovary syndrome (PCOS) or functional ovarian hyperandrogenism, is the endocrine-metabolic dysfunction are highly prevalent (5-10%) in premenopausal women, has significant implications in the short and long term as oligomenorrhea, amenorrhea, infertility, diabetes mellitus, cardiovascular disease, increased risk of endometrial cancer and excess body hair (hirsutism). This endocrine disruption starts shortly after menarche. Chronically elevated levels of luteinizing hormone (LH) and insulin resistance are the two most common pathophysiological changes seen in patients with PCOS, leading to anovulation, hyperandrogenism explain what gynecological manifestations of this syndrome, and also a joint metabolic abnormalities such as increased incidence of obesity, type 2 diabetes mellitus, dyslipidemia, increased risk of coronary artery disease and hypertension as well as fatty liver disease alcoholic. Within the ovary cause a combination of cytokines such as tumor necrosis factor a ( T N F-a), interleukin 1, receptor2 the F-T N a, which appear to be related to the pathogenesis of this syndrome. Interleukin 6 and interleukin-18 are elevated in PCOS by accompanying metabolic substrate where the element common pathophysiological insulin resistance. Future research will be commissioned to clarify the exact relationship between the elevation of the proinflammatory cytokines and clinical manifestations of PCOS, of which a early therapeutic measures in these patients to decrease morbidity and mortality.(AU