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胰高血糖素样肽-1激动剂用于多囊卵巢综合征女性减肥的临床效果:一项范围综述

Clinical Effects of Glucagon-Like Peptide-1 Agonist Use for Weight Loss in Women With Polycystic Ovary Syndrome: A Scoping Review.

作者信息

Frangie Machado Melissa, Shunk Taylor, Hansen Grace, Harvey Charles, Fulford Baylee, Hauf Shane, Schuh Olivia, Kaldas Matthew, Arcaroli Elena, Ortiz Justin, De Gaetano Joseph

机构信息

Family Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa, USA.

Family Medicine, Nova Southeastern University, Fort Lauderdale, USA.

出版信息

Cureus. 2024 Aug 12;16(8):e66691. doi: 10.7759/cureus.66691. eCollection 2024 Aug.

Abstract

Glucagon-like peptide-1 (GLP-1) is a gastrointestinal regulatory hormone that stimulates insulin release from the pancreas. While GLP-1 receptor agonists (GLP-1 RAs) have traditionally been utilized to address insulin resistance, their potential application in treating polycystic ovary syndrome (PCOS) has recently garnered attention. This study aimed to investigate the therapeutic efficacy of GLP-1 RAs use for weight loss in women diagnosed with PCOS. We conducted a scoping review following the Joanna Briggs Institute (JBI) methodology and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our investigation delved into the clinical effects experienced by women of diverse racial and ethnic backgrounds with PCOS who were prescribed GLP-1 RAs for weight loss. Peer-reviewed articles from Ovid Medline, Web of Science, CINAHL, Cochrane CENTRAL, SCOPUS, and ClinicalTrials.gov spanning from 2012 to 2023 were scrutinized. After eliminating duplicates, 811 articles were identified, and ultimately, eight met the eligibility criteria for inclusion. All studies were published in English and exhibited wide geographic diversity. The included studies uniformly reported reductions in weight and body mass index (BMI) among patients who were prescribed GLP-1 RAs, specifically liraglutide or exenatide. Additionally, evidence pointed towards improvements in anthropometric parameters (MF1) (including total body weight, BMI, reduction in waist circumference, and total fat percentage), glucose homeostasis, cardiovascular inflammatory markers (midregional pro-atrial natriuretic peptide (MR-proANP) and mid-regional pro-adrenomedullin (MR-proADM)), rates of pregnancy, and menstrual regulation. However, findings regarding the impact of GLP-1 RAs on lipid profiles were inconsistent. Although some short-term adverse effects were noted, long-term effects of GLP-1 RAs use remain undetermined. GLP-1 RA use demonstrated promising clinical outcomes for women with PCOS, including reduced BMI, improved metabolic parameters, menstrual regularity, and increased rates of natural pregnancy. While the current evidence is encouraging, further research is warranted to elucidate both short- and long-term adverse effects of GLP-1 RA therapy for PCOS.

摘要

胰高血糖素样肽-1(GLP-1)是一种胃肠调节激素,可刺激胰腺释放胰岛素。虽然传统上GLP-1受体激动剂(GLP-1 RAs)一直用于解决胰岛素抵抗问题,但它们在治疗多囊卵巢综合征(PCOS)方面的潜在应用最近受到了关注。本研究旨在调查GLP-1 RAs用于诊断为PCOS的女性减肥的治疗效果。我们按照乔安娜·布里格斯研究所(JBI)的方法并遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南进行了一项范围综述。我们的调查深入研究了不同种族和族裔背景的PCOS女性在使用GLP-1 RAs减肥时所经历的临床效果。对2012年至2023年期间来自Ovid Medline、科学网、CINAHL、Cochrane CENTRAL、SCOPUS和ClinicalTrials.gov的同行评审文章进行了审查。在消除重复项后,共识别出811篇文章,最终有8篇符合纳入标准。所有研究均以英文发表,且地域分布广泛。纳入的研究一致报告称,使用GLP-1 RAs(特别是利拉鲁肽或艾塞那肽)的患者体重和体重指数(BMI)有所降低。此外,有证据表明人体测量参数(MF1)(包括总体重、BMI、腰围减小和总脂肪百分比)、葡萄糖稳态、心血管炎症标志物(中段心房利钠肽原(MR-proANP)和中段肾上腺髓质素原(MR-proADM))、妊娠率和月经调节有所改善。然而,关于GLP-1 RAs对血脂谱影响的研究结果并不一致。虽然注意到了一些短期不良反应,但GLP-1 RAs使用的长期影响仍未确定。GLP-1 RAs的使用对PCOS女性显示出有希望的临床结果,包括降低BMI、改善代谢参数、月经规律和自然妊娠率增加。虽然目前的证据令人鼓舞,但仍有必要进一步研究以阐明GLP-1 RA治疗PCOS的短期和长期不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d54d/11389649/8301407dcac6/cureus-0016-00000066691-i01.jpg

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