Effect of GLP-1 Agonists on Weight Loss in Patients with Polycystic Ovary Syndrome and Obesity: A Single-center Study

Overview

Journal Obes Pillars

Date 2023 Nov 22

PMID 37990710

Authors

Dushyanth Srinivasan

Holly F Lofton

Affiliations

Soon will be listed here.

Abstract

Background: Weight loss of >5% in patients with polycystic ovary syndrome and obesity (PCOS-O) is believed to improve underlying drivers of the syndrome. Weight loss facilitated by GLP-1 agonists in patients with PCOS-O is not well characterized. In this single-center retrospective study, we determined weight loss in patients with PCOS-O with GLP-1 monotherapy versus metformin.

Methods: In this brief report, electronic records of 183 adult patients with PCOS-O were reviewed between January 2020 and April 2021. We identified 12 and 19 patients that were treated with metformin and GLP-1 monotherapy respectively. One patient in each cohort had diabetes mellitus. Weights were reviewed at baseline (prior to therapy initiation) and at six-month follow-up. We analyzed change in weight from baseline and proportion with >5% and 10% weight loss using Fisher exact -test and chi-square test. Univariate linear regression was used to identify correlations between treatment and weight loss.

Results: Baseline characteristics were similar between metformin (n = 12) and GLP-1 (n = 19) cohorts with the exception of mean days on medication. Following six months of treatment, mean weight loss was 4.9 kg (4.8%) and 9.1 kg (9.8%) in the metformin and GLP-1 cohorts (p = 0.13) respectively. Similar trends were seen in BMI with reductions of 1.8 kg/m (4.7%) and 3.5 kg/m (9.7%). A significantly greater proportion of patients achieved 5% and 10% weight loss with GLP-1 treatment (84.2% and 57.8%, p = 0.01 and p = 0.02) compared to metformin. Univariate linear regression analysis demonstrated a trend towards greater weight loss in patients treated with GLP-1 monotherapy (Coeff: 4.15, 95% CI: 1.3-9.7, p = 0.13) versus metformin.

Conclusion: Our study shows improvements in weight with GLP-1 monotherapy versus metformin as demonstrated by overall weight loss and proportion of patients achieving >5% weight loss. Further prospective randomized controlled studies are needed to establish GLP-1 weight loss efficacy in patients with PCOS-O and clinically related outcomes.

Citing Articles

The maintenance of long-term weight loss after semaglutide withdrawal in obese women with PCOS treated with metformin: a 2-year observational study.

Jensterle M, Ferjan S, Janez A Front Endocrinol (Lausanne). 2024; 15:1366940.

PMID: 38665260 PMC: 11043580. DOI: 10.3389/fendo.2024.1366940.

Therapeutic Potential of Glucagon-like Peptide-1 Agonists in Polycystic Ovary Syndrome: From Current Clinical Evidence to Future Perspectives.

Jensterle M, Herman R, Janez A Biomedicines. 2022; 10(8).

PMID: 36009535 PMC: 9405922. DOI: 10.3390/biomedicines10081989.

References

Dumesic D, Oberfield S, Stener-Victorin E, Marshall J, Laven J, Legro R . Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome. Endocr Rev. 2015; 36(5):487-525. PMC: 4591526. DOI: 10.1210/er.2015-1018. View

Harborne L, Sattar N, Norman J, Fleming R . Metformin and weight loss in obese women with polycystic ovary syndrome: comparison of doses. J Clin Endocrinol Metab. 2005; 90(8):4593-8. DOI: 10.1210/jc.2004-2283. View

Broekmans F, Knauff E, Valkenburg O, Laven J, Eijkemans M, Fauser B . PCOS according to the Rotterdam consensus criteria: Change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006; 113(10):1210-7. DOI: 10.1111/j.1471-0528.2006.01008.x. View

Nandi A, Chen Z, Patel R, Poretsky L . Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2014; 43(1):123-47. DOI: 10.1016/j.ecl.2013.10.003. View

Jensterle M, Kravos N, Pfeifer M, Kocjan T, Janez A . A 12-week treatment with the long-acting glucagon-like peptide 1 receptor agonist liraglutide leads to significant weight loss in a subset of obese women with newly diagnosed polycystic ovary syndrome. Hormones (Athens). 2015; 14(1):81-90. DOI: 10.1007/BF03401383. View

Wilding J, Batterham R, Calanna S, Davies M, Van Gaal L, Lingvay I . Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021; 384(11):989-1002. DOI: 10.1056/NEJMoa2032183. View

Fauser B, Tarlatzis B, Rebar R, Legro R, Balen A, Lobo R . Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2011; 97(1):28-38.e25. DOI: 10.1016/j.fertnstert.2011.09.024. View

Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M . A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management. N Engl J Med. 2015; 373(1):11-22. DOI: 10.1056/NEJMoa1411892. View

McCartney C, Marshall J . Polycystic Ovary Syndrome. N Engl J Med. 2016; 375(14):1398-1399. DOI: 10.1056/NEJMc1610000. View

10.

Conway G, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale H, Franks S, Gambineri A . The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 2014; 171(4):P1-29. DOI: 10.1530/EJE-14-0253. View

11.

Moran L, Pasquali R, Teede H, Hoeger K, Norman R . Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertil Steril. 2008; 92(6):1966-82. DOI: 10.1016/j.fertnstert.2008.09.018. View

12.

Rasmussen C, Lindenberg S . The effect of liraglutide on weight loss in women with polycystic ovary syndrome: an observational study. Front Endocrinol (Lausanne). 2014; 5:140. PMC: 4145240. DOI: 10.3389/fendo.2014.00140. View

13.

Legro R, Arslanian S, Ehrmann D, Hoeger K, Murad M, Pasquali R . Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013; 98(12):4565-92. PMC: 5399492. DOI: 10.1210/jc.2013-2350. View

14.

March W, Moore V, Willson K, Phillips D, Norman R, Davies M . The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2009; 25(2):544-51. DOI: 10.1093/humrep/dep399. View

15.

Naderpoor N, Shorakae S, de Courten B, Misso M, Moran L, Teede H . Metformin and lifestyle modification in polycystic ovary syndrome: systematic review and meta-analysis. Hum Reprod Update. 2015; 21(5):560-74. DOI: 10.1093/humupd/dmv025. View