scholarly journals The potential role of incretin-based therapies for polycystic ovary syndrome: a narrative review of the current evidence

2021 ◽  
Vol 12 ◽  
pp. 204201882198923
Author(s):  
Mohammed Altigani Abdalla ◽  
Harshal Deshmukh ◽  
Stephen Atkin ◽  
Thozhukat Sathyapalan
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Narrative Review ◽  
Reproductive Age ◽  
Sex Hormone Binding Globulin ◽  
Current Evidence ◽  
Ovary Syndrome ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age. Metabolic consequences associated with PCOS include, but are not limited to, insulin resistance (IR), type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This narrative review aims to provide a comprehensive overview of the potential therapeutic roles of the incretin-based therapies in the management of PCOS. Methods: We performed a systematic search of databases including PubMed, MEDLINE and EMBASE up to 1 October 2020. We developed a search string of medical subject headings (MeSH) including the terms PCOS, incretin mimetics, glucagon-like peptide-1 (GLP-1), glucagon-like peptide-1 receptor antagonists (GLP-1 RAs), liraglutide, exenatide, semaglutide, dipeptidyl peptidase-4 (DPP-4) inhibitors, combined with IR, testosterone and sex hormone-binding globulin (SHBG). Results: We identified 854 relevant articles and, after the initial screening, eight interventional animal studies, one observational animal study, 14 interventional human studies, two case–control studies and one systematic review were included. These studies showed the potential significant roles of GLP-1 RAs and DPP-4 inhibitors in the management of PCOS, with significant improvements in the metabolic parameters, including substantial weight reduction and improved insulin sensitivity. These agents also improved the hormonal parameters through decreased free androgen and increased SHBG. Moreover, they improved menstrual regularity, increased fertility with enhanced ovulation and pregnancy in obese women with PCOS. Conclusion: GLP-1 RAs and DPP-4 inhibitors have a promising therapeutic role in PCOS; however, larger clinical trials are needed to establish the role of incretin-based therapies in the management of PCOS.

Role of genetic and environmental factors in the development of polycystic ovary syndrome

2013 ◽  
Vol 154 (17) ◽  
pp. 650-657
Author(s):  
László Ságodi ◽  
Emőke Kiss-Tóth ◽  
László Barkai
Keyword(s):  
Environmental Factors ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Current Evidence ◽  
Ovary Syndrome ◽  
Genetic And Environmental Factors ◽  
Endocrine Abnormality ◽  
Ovarian Syndrome

Polycystic ovary syndrome is the most common heterogeneous endocrine abnormality in women in the reproductive age. The syndrome remains an enigmatic disorder because the aetiology is still unclear. Familial aggreagation is relatively common among patients with polycystic ovary syndrome suggesting a significant genetic component, although the way of inheritance has not been established firmly. The authors review the relevant medical literature and suggest that genetic and environmental factors play a role in the development of polycystic ovary syndrome. To date, no gene has been identified that causes or contributes substantially to the development of a polycystic ovary syndrome phenotype. Polycystic ovarian syndrome is considered to be an oligogenic disorder in which the interaction of a number of genetic and environmental factors determines the heterogeneous clinical and biochemical phenotype. To summarize current evidence the authors conclude, that when we are able to identify and then modify environmental determinants, then we will be able to safeguard better the health of those patients who are predisposed to disease development due to genotype or previous environmental effects. Orv. Hetil., 2013, 154, 650–657.

Fasting and post-prandial glucagon like peptide 1 and oral contraception in polycystic ovary syndrome

2014 ◽  
Vol 81 (4) ◽  
pp. 588-592 ◽  
Author(s):  
Kadriye Aydin ◽  
Gulcan Arusoglu ◽  
Gulden Koksal ◽  
Nese Cinar ◽  
Duygu Yazgan Aksoy ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Oral Contraception ◽  
Ovary Syndrome ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Results of treatment with myo-Inositol and D-chiro inositol combination in ratio 5:1 in women with polycystic ovary syndrome

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 84-89
Author(s):  
Tatiana A. Oboskalova ◽  
Anna V. Vorontsova ◽  
Maksim A. Zvychainyi ◽  
Karina G. Gushchina ◽  
Marietta M. Maitesian
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Nutritional Support ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Total Testosterone ◽  
Anthropometric Parameters ◽  
Ovary Syndrome ◽  
Free Androgen Index ◽  
Results Of Treatment

We conducted an observational descriptive study evaluating the effectiveness of therapeutic modification of lifestyle with adding of 1000 mg of myo-inositol and 200 mg of D-chiro inositol combination (ratio 5:1) for nutritional support in 104 women of reproductive age with polycystic ovary syndrome (classic phenotype and nonclassical phenotypes in the presence of hyperandrogenism) for 6 months. Revealed changes in anthropometric parameters (decrease in body mass index by 0.89 kg/m2; p0.05 and waist circumference by 3.0 cm; p0.05), skin status (decrease in the incidence of acne from 96.2 up to 58.6%; p0.05 and seborrhea from 34.6 to 5.8%; p0.05), hormonal profile (statistically significant change in all studied parameters; p0.05: decrease in total testosterone to 1.27 nmol/L and a free androgen index up to 4.12% under an increase in globulin binding sex hormones), carbohydrate metabolism (normalization of glucose tolerance without the development of hypoglycemia) and restoration of menstrual cycle (MC) parameters (regular MC in 76.9 %; p0.05, MC duration 33.4 days; p0.05) indicate a significant role of stage I therapy in patients with polycystic ovary syndrome and the possible benefits of 1000 mg of myo-inositol and 200 mg of D-chiro inositol combination as a nutritional support.

scholarly journals Effect of rimonabant and metformin on glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 in obese women with polycystic ovary syndrome

2010 ◽  
Vol 72 (3) ◽  
pp. 423-425 ◽  
Author(s):  
Thozhukat Sathyapalan ◽  
LiWei Cho ◽  
Eric S. Kilpatrick ◽  
Carel W. Le Roux ◽  
Anne-Marie Coady ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

scholarly journals The synergistic effect of sex hormone-binding globulin and aromatase genes on polycystic ovary syndrome phenotype.

2008 ◽  
Vol 158 (6) ◽  
pp. 861-865 ◽  
Author(s):  
Nectaria Xita ◽  
Ioannis Georgiou ◽  
Leandros Lazaros ◽  
Vasiliki Psofaki ◽  
George Kolios ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Sex Hormone ◽  
The Body ◽  
Reproductive Age ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Aromatase Activity ◽  
Hormone Binding ◽  
Ovary Syndrome

ObjectiveExperimental evidence suggests that fetal exposure to androgen excess may program the development of polycystic ovary syndrome (PCOS) in utero. The aim of this study was to examine whether the sex hormone binding globulin (SHBG)(TAAAA)n and the cytochrome P450, family 19 (CYP19)(TTTA)n polymorphisms, known to influence sex hormone-binding globulin (SHBG) levels and aromatase activity respectively, play a synergistic role in the development of PCOS.Design and methodsWe studied 180 women with PCOS and 160 healthy women of reproductive age. The body mass index (BMI) was recorded and the hormonal profile determined from the third to fifth day of menstrual cycle. DNA was extracted from blood leucocytes and the SHBG(TAAAA)n and CYP19(TTTA)n polymorphisms were genotyped.ResultsGenotype analysis revealed 6 SHBG(TAAAA)n alleles with 6–11 repeats and 6 CYP19(TTTA)n alleles with 7–12 repeats. Women were subdivided into four groups: those with short SHBG (≤8 TAAAA repeats) and CYP19 alleles (≤9 TTTA repeats), those with short SHBG–long CYP19 alleles, those with long SHBG–short CYP19 alleles, and those with long SHBG and CYP19 alleles. Women with PCOS tended to have at greater frequency, long SHBG–short CYP19 alleles compared with controls (57.3 vs 42.4%, P=0.07). Importantly, PCOS women with long SHBG–short CYP19 alleles had the lowest SHBG levels (P=0.02) and the highest total testosterone (P=0.008), free androgen index (P=0.002), DHEAS (P=0.02), and testosterone/estradiol ratio (P=0.03), compared with those with other genotypes. This association was independent of age, BMI, and insulin resistance indexes.ConclusionWe speculate that the SHBG and CYP19 genes may have a synergistic role in the developmental programming of PCOS, by affecting androgen bioavailability and aromatization respectively.

scholarly journals The role of melatonin in polycystic ovary syndrome: A review

2019 ◽  
Author(s):  
Sina Mojaverrostami ◽  
Narjes Asghari ◽  
Mahsa Khamisabadi ◽  
Heidar Heidari Khoei
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Follicular Fluid ◽  
Polycystic Ovary ◽  
Free Radical Scavenger ◽  
Melatonin Receptors ◽  
Reproductive Age ◽  
Radical Scavenger ◽  
Ovary Syndrome ◽  
Follicular Maturation

Background: Polycystic ovary syndrome (PCOS) is a widespread endocrine disorder, affecting approximately 20% of women within reproductive age. It is associated with hyperandrogenism, obesity, menstrual irregularity, and anovulatory infertility. Melatonin is the main pineal gland hormone involved in the regulation of the circadian rhythm. In recent years, it has been observed that a reduction in melatonin levels of follicular fluid exists in PCOS patients. Melatonin receptors in the ovary and intra-follicular fluid adjust sex steroid secretion at different phases of ovarian follicular maturation. Moreover, melatonin is a strong antioxidant and an effective free radical scavenger, which protects ovarian follicles during follicular maturation. Objective: In this paper, we conducted a literature review and the summary of the current research on the role of melatonin in PCOS. Materials and Methods: Electronic databases including PubMed/MEDLINE, Web of Science, Scopus, and Reaxys were searched from their inception to October 2018 using the keywords ″Melatonin″ AND ″Polycystic ovary syndrome" OR "PCOS.″ Results: Based on the data included in our review, it was found that the administration of melatonin can improve the oocyte and embryo quality in PCOS patients. It may also have beneficial effects in correcting the hormonal alterations in PCOS patients. Conclusion: Since metabolic dysfunction is the major finding contributing to the initiation of PCOS, melatonin can hinder this process via its improving effects on metabolic functions. Key words: Hyperandrogenism, Infertility, Melatonin, PCOS.

scholarly journals The Role of Antiobesity Agents in the Management of Polycystic Ovary Syndrome

Folia Medica ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. 512-520 ◽  
Author(s):  
Panagiotis Chatzis ◽  
Konstantinos Tziomalos ◽  
Georgios C. Pratilas ◽  
Vasileios Makris ◽  
Alexandros Sotiriadis ◽  
...  
Keyword(s):  
Weight Loss ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Current Data ◽  
Reproductive Age ◽  
Metabolic Abnormalities ◽  
Ovary Syndrome ◽  
Antiobesity Agents ◽  
Androgen Levels

Abstract Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women of reproductive age. Obesity is frequently present in these patients and plays a key role in the pathogenesis of both the endocrine and metabolic abnormalities of the syndrome, particularly infertility, hyperandrogenism and insulin resistance (IR). Diet and exercise is the mainstay of management of obesity in patients with PCOS. In contrast, the eff ects of antiobesity agents on weight and on the obesityrelated characteristics of the syndrome remain unclear. The aim of the present review is to summarize the current data on the eff ects of antiobesity drugs approved in Europe (orlistat, liraglutide 3 mg od and naltrexone/bupropion) on weight loss in patients with PCOS and to discuss their impact on the endocrine, reproductive and metabolic abnormalities of this population. Several studies reported that orlistat induces weight loss, improves IR and reduces androgen levels in PCOS. In contrast, data regarding the eff ects of the dose of liraglutide that is approved for the treatment of obesity (3 mg od) are very limited. Liraglutide 1.2-1.8 mg od results in weight loss in these patients but does not aff ect IR or androgen levels. Finally, there are no studies that evaluated naltrexone/bupropion in patients with PCOS and early studies reported conflicting results regarding the eff ects of naltrexone monotherapy on weight, IR and androgen levels. In conclusion, orlistat appears to have a role in the management of overweight and obese patients with PCOS whereas more studies are needed to clarify the role of liraglutide and naltrexone/bupropion.

scholarly journals Effect of Acupuncture on Polycystic Ovary Syndrome in Animal Models: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Yan Li ◽  
Lijia Zhang ◽  
Jinjin Gao ◽  
Jun Yan ◽  
Xue Feng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Animal Models ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Risk Of Bias ◽  
Reproductive Age ◽  
Current Evidence ◽  
Manual Acupuncture ◽  
Ovary Syndrome ◽  
Complementary And Alternative Therapy

Background. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. As a widely used complementary and alternative therapy, acupuncture is increasingly used to treat PCOS. However, the effect of acupuncture in treating PCOS is uncertain, and the mechanisms are unclear. This systematic review aims to determine the efficacy of acupuncture on PCOS in animal preclinical models. Methods. Experimental animal studies of acupuncture in PCOS animal models were searched in PubMed, Web of Science, China National Knowledge Infrastructure, and the Chinese Science and Technology Periodical Database from inception to December 2020. The risk of bias was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool. Results. A total of 358 studies were screened based on the title and abstract, and 31 studies were included. A total of 722 animals were involved, and all studies used either Wistar rats or SD rats. Twenty-six studies used electroacupuncture, 9 studies used manual acupuncture, and 5 of them employed both electroacupuncture and manual acupuncture. A total of 22 acupoints were involved; 7 studies followed the modern acupuncture pattern, and the rest followed classic acupuncture theory. Conclusions. The present review summarizes the current evidence of the effects of acupuncture on PCOS in animal models. Unfortunately, we could not draw a definite conclusion due to the methodological weakness of the included studies and the high heterogeneity. Well-designed studies are needed in the future to fill this gap.

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