PDF(Pubmed)
Abstract：
Polycystic ovary syndrome is a common reproductive endocrine condition that affects women of fertile age and is characterized by three main features, including hyperandrogenism, chronic anovulation, and polycystic ovaries. In addition, half of women with polycystic ovary syndrome have insulin resistance, and obesity or overweight, type 2 diabetes, hypertension, and hyperlipidemia are the most common metabolic abnormalities affecting (30%) women with polycystic ovary syndrome. Weight loss is regarded as the first-line treatment as it can potentially improve polycystic ovary syndrome parameters (androgen levels, menstrual cyclicity, lipid and glucose metabolism). However, achieving and maintaining weight loss can be challenging, and pharmacological agents could be essential to achieve optimal glycemic control and improve the endocrine disturbance associated with polycystic ovary syndrome. Glucagon-like peptide-1 receptor agonist has been demonstrated as monotherapy or in combination with metformin for managing obesity and insulin resistance associated with polycystic ovary syndrome. Yet, its effect on endocrine and metabolic parameters remains elusive, and further research is needed to close the gap. The aim is to evaluate the efficacy of glucagon-like peptide-1 receptor agonist monotherapy and/or a combined treatment between glucagon-like peptide-1 receptor agonist and metformin for improving anthropometric measurements, endocrine and metabolic parameters in lean and obese women with polycystic ovary syndrome. A systematic review of longitudinal cohort studies was conducted across databases including Ovid Medline, PubMed Central, and Cochrane Library between 2015 and 2022. Eligible studies included participants with polycystic ovary syndrome diagnosed according to the 2003 Rotterdam or the 1990 National Institutes of Health criteria. A total of eight studies including 486 patients with polycystic ovary syndrome were analyzed. The mean age was between 18 and 45 years with mean follow-up period between 12 and 32 weeks. In all these studies, results were comparable for the reduction in body mass index, waist circumference, fat mass, and visceral fat mass; however, it was more in combination therapy versus comparator. In conclusion, glucagon-like peptide-1 receptor agonists effectively reduce body weight and improve some of the endocrine and metabolic parameters of polycystic ovary syndrome. A combined treatment with glucagon-like peptide-1 receptor agonist and metformin had significant effects on weight loss and favorable results on endocrine and metabolic parameters, yet further research is needed to discover the long-term safety of combined therapy in women diagnosed with polycystic ovary syndrome and obesity or overweight.
摘要：
多囊卵巢综合征是一种常见的生殖内分泌疾病，影响育龄妇女，其特征是三个主要特征，包括高雄激素血症,慢性无排卵,和多囊卵巢.此外,一半的多囊卵巢综合征患者有胰岛素抵抗,肥胖或超重，2型糖尿病,高血压,和高脂血症是影响（30％）多囊卵巢综合征妇女的最常见代谢异常。减肥被认为是一线治疗，因为它可以潜在地改善多囊卵巢综合征参数（雄激素水平，月经周期，脂质和葡萄糖代谢）。然而,实现和保持减肥可能是具有挑战性的，和药物可能是实现最佳血糖控制和改善多囊卵巢综合征相关内分泌紊乱所必需的。胰高血糖素样肽-1受体激动剂已被证明是单一疗法或与二甲双胍联合治疗与多囊卵巢综合征相关的肥胖和胰岛素抵抗。然而，它对内分泌和代谢参数的影响仍然难以捉摸，需要进一步的研究来缩小差距。目的是评估胰高血糖素样肽-1受体激动剂单一疗法和/或胰高血糖素样肽-1受体激动剂和二甲双胍之间的联合治疗对改善人体测量学测量的功效。患有多囊卵巢综合征的瘦和肥胖女性的内分泌和代谢参数。对纵向队列研究进行了系统评价，包括OvidMedline，PubMedCentral,和Cochrane图书馆在2015年至2022年之间。符合条件的研究包括根据2003年鹿特丹或1990年美国国立卫生研究院标准诊断的多囊卵巢综合征参与者。共分析了8项研究，包括486例多囊卵巢综合征患者。平均年龄在18至45岁之间，平均随访时间在12至32周之间。在所有这些研究中,体重指数降低的结果具有可比性，腰围,脂肪量,和内脏脂肪；然而，与比较剂相比，联合治疗更多。总之,胰高血糖素样肽-1受体激动剂可有效减轻多囊卵巢综合征的体重并改善其某些内分泌和代谢参数。胰高血糖素样肽-1受体激动剂和二甲双胍联合治疗对体重减轻有显著影响，对内分泌和代谢参数有良好的结果。然而，需要进一步的研究来发现联合治疗对诊断为多囊卵巢综合征和肥胖或超重的女性的长期安全性。
