Carmina Enrico, Longo Rosa Alba
Endocrinology Unit, University of Palermo School of Medicine, 90144 Palermo, Italy.
J Clin Med. 2023 Sep 12;12(18):5921. doi: 10.3390/jcm12185921.
In spite of the widespread use of lifestyle modifications programs, many patients with PCOS are obese and prevalence of obesity in PCOS remains high. In this study, we present the data on the use of semaglutide, an incretin mimetic drug, in obese PCOS patients who were unresponsive to a lifestyle modification program. Twenty-seven obese patients with a diagnosis of PCOS, who did not reduce their body weight by a lifestyle modification program, were included in this study and treated by semaglutide, 0.5 mg subcutaneously once a week. After three months of treatment, an improvement in body weight with a mean decrease in body weight of 7.6 kg and a mean BMI loss of 3.1 was observed, while very few side effects were reported. Almost 80% of the studied obese PCOS patients obtained at least a 5% decrease in their body weight. Only a few patients (22%) obtained a decrease in body weight lower than 5% and were considered non-responsive to semaglutide, at least at the used doses. These patients presented a more severe obesity than responsive patients. Independently of results on body weight, and in patients who did not obtain a 5% decrease in their body weight, insulin basal values decreased, and HOMA-IR improved. Fasting blood glucose normalized in 80% of semaglutide-treated IFG PCOS women. In patients who were responsive to semaglutide (weight loss > 5%), the treatment was continued for additional three months. Weight loss slowed but continued and, at the end of the six months of therapy, the mean body weight loss was 11.5 kg and mean BMI reduced from 34.4 to 29.4. A total of 80% of responsive patients normalized menstrual cycles. In conclusion, treatment with semaglutide, at low doses, significantly reduces body weight in almost 80% of obese PCOS patients who were unresponsive to a previous lifestyle plan. It is often associated with the normalization of menstrual cycles, and these important results are obtained with very few side effects.
尽管生活方式改善计划被广泛应用，但许多多囊卵巢综合征（PCOS）患者仍肥胖，且PCOS患者的肥胖患病率依然很高。在本研究中，我们展示了关于在对生活方式改善计划无反应的肥胖PCOS患者中使用胰高血糖素样肽-1（GLP-1）类似物司美格鲁肽的数据。27例诊断为PCOS的肥胖患者，他们未通过生活方式改善计划减轻体重，被纳入本研究并接受司美格鲁肽治疗，每周皮下注射0.5毫克。治疗三个月后，观察到体重有所改善，平均体重下降7.6千克，平均体重指数（BMI）降低3.1，同时报告的副作用很少。近80%的研究肥胖PCOS患者体重至少下降了5%。只有少数患者（22%）体重下降低于5%，被认为对司美格鲁肽无反应，至少在所使用的剂量下如此。这些患者的肥胖程度比有反应的患者更严重。与体重结果无关，在未实现体重下降5%的患者中，基础胰岛素值下降，胰岛素抵抗稳态模型评估（HOMA-IR）得到改善。80%接受司美格鲁肽治疗的空腹血糖受损（IFG）PCOS女性空腹血糖恢复正常。对司美格鲁肽有反应（体重减轻>5%）的患者，治疗持续额外三个月。体重减轻速度放缓但仍在继续，在治疗六个月结束时，平均体重减轻11.5千克，平均BMI从34.4降至29.4。总共80%有反应的患者月经周期恢复正常。总之，低剂量司美格鲁肽治疗能使近80%对先前生活方式计划无反应的肥胖PCOS患者显著减轻体重。它常与月经周期恢复正常相关，且这些重要结果是在很少有副作用的情况下获得的。
