Etrusco Andrea, Mikuš Mislav, D'Amato Antonio, Barra Fabio, Planinić Petar, Goluža Trpimir, Buzzaccarini Giovanni, Marušić Jelena, Tešanović Mara, Laganà Antonio Simone
Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia.
Biomedicines. 2024 Mar 14;12(3):653. doi: 10.3390/biomedicines12030653.
The purpose of this narrative review is to describe the mechanisms that are responsible for the development of infertility and PCOS, with a focus on the role of obesity, insulin sensitivity and treatment with metformin and GLP-1s.
The relevant publications were identified after systematic queries of the following sources: PubMed, Google Scholar, Web of Science, and publishers' databases, complemented by a cross-check of the reference lists. We used a combination of the search terms "polycystic ovary syndrome", "obesity" and "insulin resistance" with "metformin", "exenatide", "liraglutide", "semaglutide", "orlistat" and terms relevant to the topic of each paragraph (e.g., "pathophysiology", "metabolism", "infertility", "treatment").
All articles describing the mechanisms responsible for the development of infertility and PCOS, with a focus on the role of obesity, insulin sensitivity and treatment with metformin and GLP-1s, were considered for this review.
The existing research on GLP-1 receptor agonists (GLP-1RAs) has not conclusively established a specific therapeutic use for these drugs. Additionally, the efficacy of the newer generation of GLP-1RAs, particularly in terms of dosage and duration of exposure, warrants more extensive research. Understanding the optimal dosing and treatment duration could significantly enhance the therapeutic use of GLP-1RAs in managing PCOS and its associated conditions.
本叙述性综述的目的是描述导致不孕和多囊卵巢综合征（PCOS）发生的机制，重点关注肥胖、胰岛素敏感性以及二甲双胍和胰高血糖素样肽-1（GLP-1）类似物治疗的作用。
通过对以下来源进行系统检索来确定相关出版物：PubMed、谷歌学术、科学网和出版商数据库，并对参考文献列表进行交叉核对。我们将搜索词“多囊卵巢综合征”“肥胖”和“胰岛素抵抗”与“二甲双胍”“艾塞那肽”“利拉鲁肽”“司美格鲁肽”“奥利司他”以及与各段落主题相关的术语（如“病理生理学”“代谢”“不孕”“治疗”）相结合。
本综述纳入了所有描述导致不孕和PCOS发生的机制、重点关注肥胖、胰岛素敏感性以及二甲双胍和GLP-1类似物治疗作用的文章。
现有关于GLP-1受体激动剂（GLP-1RAs）的研究尚未明确确定这些药物的具体治疗用途。此外，新一代GLP-1RAs的疗效，尤其是在剂量和暴露持续时间方面，值得进行更广泛的研究。了解最佳剂量和治疗持续时间可显著提高GLP-1RAs在治疗PCOS及其相关病症中的治疗用途。
