Internal Medicine and Diabetes Clinic, Paphos, Cyprus.
CDA College, Paphos, Cyprus.
Adv Clin Exp Med. 2022 Nov;31(11):1265-1274. doi: 10.17219/acem/151695.
Polycystic ovary syndrome (PCOS) is a disorder that involves several organ systems and cellular pathways. It is strongly influenced by environmental and epigenetic factors. The principal goal of all therapeutic approaches to individuals with reproductive abnormalities is the treatment of subfertility or the regulation of menstruation when pregnancy is not desired. Obesity is closely related to insulin resistance (IR) and subsequent hyperinsulinemia, which aggravate hyperandrogenism and impair early follicle development. Weight loss is of vital importance for overweight/obese individuals with anovulatory infertility. The GLP-1R agonists have achieved remarkable weight reduction and abdominal fat loss in patients with type 2 diabetes (T2D), as well as in overweight/obese individuals and individuals with prediabetes. They have also been shown to promote lower fasting insulin levels and insulin resistance markers. These beneficial effects have been suggested to be particularly helpful in women with PCOS, while their possible role in the hypothalamic-pituitary-gonadal axis is under intense research. This review analyzes the current evidence for GLP-1R agonists, focusing on their effects on ovarian morphology, menstrual dysfunction and fertility outcomes. It also discusses their future role in achieving targeted therapeutic approaches.
多囊卵巢综合征（PCOS）是一种涉及多个器官系统和细胞途径的疾病。它受到环境和表观遗传因素的强烈影响。所有针对生殖异常个体的治疗方法的主要目标都是治疗不孕或调节月经，当不希望怀孕时。肥胖与胰岛素抵抗（IR）和随后的高胰岛素血症密切相关，这会加重高雄激素血症并损害早期卵泡发育。对于患有排卵障碍性不孕的超重/肥胖个体，减轻体重至关重要。GLP-1R 激动剂在 2 型糖尿病（T2D）患者以及超重/肥胖个体和糖尿病前期患者中已实现显著的体重减轻和腹部脂肪减少。它们还显示出降低空腹胰岛素水平和胰岛素抵抗标志物的作用。这些有益的作用被认为在 PCOS 妇女中特别有帮助，而它们在下丘脑-垂体-性腺轴中的可能作用正在深入研究中。本综述分析了 GLP-1R 激动剂的现有证据，重点讨论了它们对卵巢形态、月经功能障碍和生育结局的影响。它还讨论了它们在实现靶向治疗方法中的未来作用。
