Niafar Mitra, Pourafkari Leili, Porhomayon Jahan, Nader Nader
Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, IRAN.
Deptartment of Anesthesiology, University at Buffalo, Buffalo, NY, 14214, USA.
Arch Gynecol Obstet. 2016 Mar;293(3):509-15. doi: 10.1007/s00404-015-3976-7. Epub 2015 Dec 10.
Glucagon-like peptides receptor agonists are currently approved as anti-obesity agents, yet the experience with their use in polycystic ovarian syndromes (PCOS)-related obesity and insulin resistance is still limited.
We examined the effects of liraglutide on obesity, insulin resistance, and androgen levels in PCOS through a meta-analysis.
Seven RCTs where women with PCOS were treated with liraglutide were identified. The variables that were examined before and after a 90-day treatment included waist circumference, body mass index (BMI), fasting insulin concentrations, insulin resistance using homeostatic model (HOMA-IR), serum testosterone, and sex hormone-binding globulin (SHBG). The analysis included 178 women. Only 172 patients had post-treatment measurements. While BMI significantly dropped by -1.65 (0.72-2.58) Kg/m(2) after 3 months treatment with liraglutide, waist circumference did not change significantly. Similarly, fasting insulin levels, insulin sensitivity, and SHBG did not change significantly. However, serum testosterone decreased by 0.29 nmol/L in 88 women (P = 0.0003).
In a limited number of the women with PCOS, BMI and serum testosterone are only variables that significantly decrease after 3 months of treatment with GLP-1 receptor agonists. Larger sample size studies with longer durations of treatment may be required to examine potential benefits of these medications in improving insulin sensitivity.
胰高血糖素样肽受体激动剂目前已被批准作为抗肥胖药物,但它们在多囊卵巢综合征(PCOS)相关肥胖和胰岛素抵抗中的应用经验仍然有限。
我们通过荟萃分析研究了利拉鲁肽对PCOS患者肥胖、胰岛素抵抗和雄激素水平的影响。
确定了7项用利拉鲁肽治疗PCOS女性的随机对照试验(RCT)。在90天治疗前后检测的变量包括腰围、体重指数(BMI)、空腹胰岛素浓度、使用稳态模型评估的胰岛素抵抗(HOMA-IR)、血清睾酮和性激素结合球蛋白(SHBG)。分析纳入了178名女性。只有172名患者有治疗后的测量数据。在用利拉鲁肽治疗3个月后,BMI显著下降了-1.65(0.72-2.58)kg/m²,而腰围没有显著变化。同样,空腹胰岛素水平、胰岛素敏感性和SHBG也没有显著变化。然而,88名女性的血清睾酮下降了0.29 nmol/L(P = 0.0003)。
在有限数量的PCOS女性中,BMI和血清睾酮是仅有的在使用GLP-1受体激动剂治疗3个月后显著下降的变量。可能需要进行更大样本量、更长治疗时间的研究,以检验这些药物在改善胰岛素敏感性方面的潜在益处。