Short-term combined treatment with exenatide and metformin for overweight/obese women with polycystic ovary syndrome  

作　　者：Rui-Lin Ma Yan Deng Yan-Fang Wang Shi-Yang Zhu Xue-Song Ding Ai-Jun Sun 

机构地区：[1]Department of Obstetrics and Gynecology,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China

出　　处：《Chinese Medical Journal》2021年第23期2882-2889,共8页中华医学杂志（英文版）

摘　　要：Background:Obesity and insulin resistance(IR)are common features of polycystic ovary syndrome(PCOS).Metformin(MET)increases insulin sensitivity,but it is associated with unsatisfactory weight loss.The glucagon-like peptide-1 receptor agonist exenatide has been shown to reduce weight and IR in patients with diabetes.This study aimed to explore the therapeutic effects of exenatide once-weekly(QW)combined with MET on body weight,as well as metabolic and endocrinological parameters in overweight/obese women with PCOS.Methods:Fifty overweight/obese women with PCOS diagnosed via the Rotterdam criteria were randomized to one of two treatment groups:MET(500 mg three times a day[TID])or combination treatment(COM)(MET 500 mg TID,exenatide 2 mg QW)for 12 weeks.The primary outcomes were anthropometric changes associated with obesity,and the secondary outcomes included changes in reproductive hormone levels,glucose and lipid metabolism,and C-reactive protein.Results:Forty(80%)patients completed the study.COM therapy was superior to MET monotherapy in reducing weight(P=0.045),body mass index(BMI)(P=0.041),and waist circumference(P=0.023).Patients in the COM group on an average lost 3.8±2.4 kg compared with 2.1±3.0 kg in the MET group.In the COM group,BMI and waist circumference decreased by 1.4±0.87 kg/m2 and 4.63±4.42 cm compared with 0.77±1.17 kg/m2 and 1.72±3.07 cm in the MET group,respectively.Moreover,levels of fasting glucose,oral glucose tolerance test(OGTT)2-h glucose,and OGTT 2-h insulin were significantly lower with COM therapy than with MET(P<0.050).Mild and moderate gastrointestinal reactions were the most common adverse events in both groups.Conclusions:COM therapy was more effective than MET alone in reducing body weight,BMI,and waist circumference,and improving insulin sensitivity in overweight/obese women with PCOS,with acceptable short-term side effects.

关 键 词：Exenatide once-weekly Insulin resistance METFORMIN Obesity Polycystic ovary syndrome 

分 类 号：R589.2[医药卫生—内分泌] R711.75[医药卫生—内科学]