Lin Shike, Deng Yan, Huang Jing, Li Meiyan, Sooranna Suren Rao, Qin Minzhen, Tan Bing
Office of Science and Technology, Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
National Immunological Laboratory of Traditional Chinese Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, 533000, Guangxi, China.
Sci Rep. 2025 May 13;15(1):16512. doi: 10.1038/s41598-025-99622-4.
This meta-analysis aimed to evaluate the efficacy and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) when compared to metformin and placebo in the management of body weight, glucose homeostasis and hormone levels in women polycystic ovary syndrome (PCOS). A systematic search of "PubMed", "EMBASE", "Cochrane Library", "Web of Science" and "Google Scholar" was conducted up to October 2024 for randomized controlled trials involving adult women with PCOS treated with GLP-1RAs compared to metformin or placebo. The primary outcomes were changes in body mass index (BMI), body weight, waist circumference (WC), waist-to-hip ratio (WHR) and abdominal girth (AG). Secondary outcomes included glucose homeostasis (fasting glucose, fasting insulin, OGTT results and HOMA-IR), hormone levels (DHEAS, SHBG, total and free testosterone and FAI), lipid profiles (total cholesterol, HDL, LDL and triglycerides) and safety. GLP-1RAs significantly reduced BMI, body weight, WC, WHR and AG (P < 0.0001 in all cases). For glucose homeostasis, GLP-1RAs significantly reduced fasting insulin, glucose level at 2 h after OGTT, and HOMA-IR. There was also a reduction in HDL. All the other parameters measured were unchanged. In addition, GLP-1RAs increased nausea (P = 0.02), vomiting (0.04) and dizziness (0.03). GLP-1RAs effectively reduced body weight, BMI and insulin resistance in patients with PCOS, although they were accompanied by nausea, vomiting and dizziness. Further studies are needed to explore their long-term effects on glucose homeostasis and lipid profiles.
本荟萃分析旨在评估与二甲双胍和安慰剂相比，胰高血糖素样肽-1受体激动剂（GLP-1RAs）在治疗多囊卵巢综合征（PCOS）女性的体重、血糖稳态和激素水平方面的疗效和安全性。截至2024年10月，对“PubMed”、“EMBASE”、“Cochrane图书馆”、“Web of Science”和“谷歌学术”进行了系统检索，以查找涉及接受GLP-1RAs治疗的成年PCOS女性与二甲双胍或安慰剂对照的随机对照试验。主要结局为体重指数（BMI）、体重、腰围（WC）、腰臀比（WHR）和腹围（AG）的变化。次要结局包括血糖稳态（空腹血糖、空腹胰岛素、口服葡萄糖耐量试验结果和胰岛素抵抗稳态模型评估[HOMA-IR]）、激素水平（硫酸脱氢表雄酮、性激素结合球蛋白、总睾酮和游离睾酮以及游离雄激素指数[FAI]）、血脂谱（总胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯）和安全性。GLP-1RAs显著降低了BMI、体重、WC、WHR和AG（所有情况下P均<0.0001）。对于血糖稳态，GLP-1RAs显著降低了空腹胰岛素、口服葡萄糖耐量试验后2小时的血糖水平以及HOMA-IR。高密度脂蛋白也有所降低。所测量的所有其他参数均未改变。此外，GLP-1RAs增加了恶心（P=0.02）、呕吐（0.04）和头晕（0.03）的发生率。GLP-1RAs有效降低了PCOS患者的体重、BMI和胰岛素抵抗，尽管会伴有恶心、呕吐和头晕。需要进一步研究来探索它们对血糖稳态和血脂谱的长期影响。
