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Adipositas – Bedeutung bei verschiedenen gynäkologisch-endokrinologischen Fragestellungen

Obesity – Importance for various gynecological endocrinological problems

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Zusammenfassung

Innerhalb der vergangenen 2 Dekaden hat sich die Adipositasinzidenz von etwa 15 auf über 25 % erhöht. Besonders dramatische Folgen hat die Adipositas bei Frauen mit männlichem Fettverteilungsmuster, denn viszerales Fettgewebe übt erhebliche Einflüsse auf Glukose- und Fettstoffwechsel aus. Neben kardiovaskulären Risiken kann Adipositas auch eine ungünstige epigenetische Prägung des Feten verursachen und Probleme mit der Kontrazeption wie der Fertilität bedingen sowie – u. a. durch permanent erhöhte Insulinkonzentrationen – das Wachstum maligner Neoplasien fördern. Im Beitrag werden ätiologische Zusammenhänge, pathophysiologische Kausalketten und epidemiologische Entwicklungen dargelegt. Diskutiert werden mögliche therapeutische Ansätze und Interventionsoptionen, etwa bestimmte Komponenten bei der Auswahl einer Kontrazeption oder einer Hormonsubstitution.

Abstract

Over the past two decades the incidence of obesity has increased from approximately 15% to over 25%. Obesity has particularly dramatic consequences for women with a male distribution pattern of fat because visceral fatty tissue has a considerable influence on glucose and fat metabolism. In addition to cardiovascular risks obesity can also cause an unfavorable epigenetic impregnation of the fetus and problems with contraception as well as fertility and promote the growth of malignant neoplasms due to permanently increased insulin concentrations. This article presents the etiological associations, pathophysiological causal chains and epidemiological developments. Possible therapeutic approaches and interventional options, for example certain components in the selection of contraception and hormone substitution are discussed.

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  1. Klinik für Gynäkologische Endokrinologie und Reproduktionsmedizin, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    J. Neulen

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K. Schaudig, Hamburg

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O. Ortmann, Regensburg

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Neulen, J. Adipositas – Bedeutung bei verschiedenen gynäkologisch-endokrinologischen Fragestellungen. Gynäkologe 50, 120–124 (2017). https://doi.org/10.1007/s00129-016-4023-x

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