Exenatide, dapagliflozin or phentermine/topiramate differentially affect metabolic profiles in polycystic ovary syndrome

2021 ◽  
Author(s):  
Karen E Elkind-Hirsch ◽  
N Chappell ◽  
Ericka Seidemann ◽  
John Storment ◽  
Drake Bellanger
Keyword(s):  
Body Composition ◽  
Insulin Sensitivity ◽  
Extended Release ◽  
Polycystic Ovary ◽  
Dual Therapy ◽  
Oral Glucose ◽  
Obese Women ◽  
Free Androgen Index ◽  
Glucagon Like Peptide 1 ◽  
Total Body

Abstract Context Glucagon-like peptide-1 receptor agonists and sodium-glucose co-transporter-2 inhibitors reduce weight and improve insulin sensitivity via different mechanisms. Objective The efficacy of once-weekly exenatide (EQW) and dapagliflozin (DAPA) alone and co-administered (EQW/DAPA), DAPA/extended release metformin (DAPA/MET), and phentermine topiramate extended release (PHEN/TPM) on metabolic parameters, body composition, and sex hormones were examined in obese women with PCOS. Research Design and Methods Non-diabetic women (n=119; 18-45y) with BMI>30 <45 and PCOS (NIH criteria) were randomized in a single-blind fashion to EQW (2 mg weekly); DAPA (10 mg daily), EQW/DAPA (2 mg weekly/10 mg daily), DAPA (10 mg)/MET (2000mg XR daily) or PHEN (7.5 mg)/TPM (46mg ER daily) treatment for 24 weeks. Study visits at baseline and 24 weeks included weight, blood pressure (BP), waist (WC) measures and body composition evaluated by dual-energy X-ray absorptiometry (DXA). Oral glucose tolerance tests (OGTT) were done to assess glycemia, mean blood glucose (MBG), and compute insulin sensitivity (SI) and secretion (IS) measures. Sex steroids, free androgen index (FAI) and lipid profiles were measured in the fasting sample. Results EQW/DAPA and PHEN/TPM resulted in the most loss of weight, total body fat by DXA, and WC. Despite equivalent reductions in BMI and WC with PHEN/TPM, only EQW/DAPA and EQW resulted in significant improvements in MBG, SI and IS. Reductions in fasting glucose, testosterone, FAI and BP were seen with all drugs. Conclusion Dual therapy with EQW/DAPA was superior to either alone, DAPA/MET and PHEN/TPM in terms of clinical and metabolic benefits in this patient population.

scholarly journals SUN-010 Efficacy of High Intensity Intermittent Training for Improving Cardio-Metabolic Health in Women with Polycystic Ovary Syndrome: A Pilot Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Rhiannon Kate Patten ◽  
Luke McIlvenna ◽  
Alba Moreno-Asso ◽  
Nigel Nigel Stepto ◽  
Danielle Hiam
Keyword(s):  
Body Composition ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
High Intensity ◽  
Polycystic Ovary ◽  
Metabolic Health ◽  
Moderate Intensity ◽  
Sensitivity Index ◽  
Maximal Heart Rate ◽  
Ovary Syndrome

Abstract Polycystic ovary syndrome (PCOS) is a common and complex endocrinopathy with reproductive and metabolic manifestations, carrying a major health and economic burden. Exercise training has consistently been found improve clinical outcomes in women with PCOS, but shortfalls with exercise prescription are evident. Research suggests that high intensity intermittent exercise (HIIT) is feasible, well tolerated and enjoyable for people with or at risk of chronic disease and can address many of the shortfalls and barriers to exercise participation. To investigate the effects of high intensity exercise, twenty-four reproductive aged, overweight and obese, previously sedentary women with PCOS were recruited from the community and randomised to complete either 12 weeks of moderate intensity continuous cycling exercise (MOD; 50-60% of maximal heart rate [HRmax]; n=11) or HIIT (90-95% HRmax; n=13). All exercise was supervised by an exercise physiologist and completed 3 times per week on a cycle ergometer. Baseline and post testing measures consisted of peak oxygen consumption (VO2peak) determine by a graded maximal exercise test, insulin sensitivity determined by hyperinsulinaemic-euglycaemic clamp, body composition outcomes and anti-mullerian hormone (AMH). Enjoyment was also measured throughout the intervention using feeling scales. Significant improvements were seen for VO2peak after HIIT with an average increase of 5.6 ± 2.5 mL.kg-1.min-1 (P=0.013) and non-significant increases in the MOD group (3.4 ± 2.1 mL/kg/min; P=0.20). Body composition, fasting insulin and AMH values remained unchanged in both groups. Non-significant improvements in glucose infusion rate (3.3 ± 2.8 mg.lbmkg-1.min-1; P=0.06) and insulin sensitivity index (M-to-I ratio; 3.0 ± 3.8 mg.lbmkg-1.min-1[mU/I]-1 x 100; P=0.17) were found as a result of HIIT compared to no changes after moderate intensity exercise. Importantly, HIIT was also found to be more enjoyable than moderate intensity continuous exercise. The present study is the first to compare current exercise recommendations of moderate and vigorous intensities in women with PCOS. The results of this study provide preliminary validation of HIIT and should be considered for improving cardio-metabolic health in women with PCOS.

A low-calorie diet with or without interval exercise training improves adiposopathy in obese women

2019 ◽  
Vol 44 (10) ◽  
pp. 1057-1064 ◽  
Author(s):  
Nicole M. Gilbertson ◽  
Natalie Z.M. Eichner ◽  
Emily M. Heiston ◽  
Julian M. Gaitán ◽  
Monique E. Francois ◽  
...  
Keyword(s):  
Heart Rate ◽  
Body Composition ◽  
Insulin Sensitivity ◽  
Oxygen Uptake ◽  
Peak Oxygen Uptake ◽  
Energy Deficit ◽  
Obese Women ◽  
Interval Exercise ◽  
Low Calorie Diet ◽  
Calorie Diet

The objective of this study was to test if a low-calorie diet plus interval exercise (LCD+INT) improves adiposopathy, an endocrine dysfunction, when compared with an energy-deficit–matched LCD in obese women. Subjects (age: 48.2 ± 2.4 years, body mass index: 37.8 ± 1.3 kg/m2) were randomized to a 13-day LCD (n = 12; mixed meals of ∼1200 kcal/day) or LCD+INT (n = 12; 12 sessions of 60 min/day alternating 3 min at 50% and 90% peak heart rate). Exercise was estimated to expend 350 kcal per oxygen uptake–heart rate regression analysis and individuals were refed calories expended to match energy availability between groups. Absolute (post – pre caloric intake) and relative (total daily and exercise energy expenditure relative to calorie intake) energy deficits were calculated. Fitness (peak oxygen uptake) and body composition (BodPod; Cosmed USA Inc.) were measured and a 120-min, 75g oral glucose tolerance test was performed at pre- and post-intervention to assess adiposopathy (i.e., ratio of high molecular weight–adiponectin to leptin) and estimate insulin sensitivity. LCD and LCD+INT had similar absolute (P = 0.55) and relative (P = 0.76) energy deficits. LCD and LCD+INT had similar reductions in fat mass (both P < 0.001), despite LCD inducing greater weight loss (P = 0.02) than LCD+INT. Both treatments improved adiposopathy (P = 0.003) and peripheral insulin sensitivity (P = 0.02). Absolute energy deficit correlated to improved adiposopathy (r = –0.41, P = 0.05), and absolute and relative energy deficits were associated with increased insulin sensitivity (r = –0.47, P = 0.02; and r = –0.40, P = 0.05, respectively), independent of body composition changes and increased peak oxygen uptake. Taken together, LCD, with or without INT, improves adiposopathy in relation to insulin sensitivity in obese women, suggesting that a short-term energy deficit is key for reducing risk of type 2 diabetes.

Comparison of Body Composition Methods During Weight Loss in Obese Women Using Herbal Formula

2005 ◽  
Vol 33 (06) ◽  
pp. 851-858 ◽  
Author(s):  
Ho-Jun Kim ◽  
Dympna Gallagher ◽  
Mi-Yeon Song
Keyword(s):  
Body Composition ◽  
Body Mass ◽  
Body Fat ◽  
Intervention Program ◽  
Low Cost ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Obese Women ◽  
Before And After ◽  
Total Body

Bioelectrical impedance analysis (BIA), a device that analyzes the current conduction differences between the fat and water components is widely used for reasons that include convenience of use, non-invasiveness, safety, and low cost. Dual energy X-ray absorptiometry (DXA) allows for the assessment of total body and regional lean and fat tissues and bone mineral content (BMC). The objective of this study was to compare body composition assessments by BIA and DXA before and after a 6-week herbal diet intervention program in 50 pre-menopausal women [mean ± SD: age 30.58 ± 6.15, body mass index (BMI) 31.72 ± 3.78]. Waist-to-hip ratio (WHR) was measured by BIA and anthropometry. Lean body mass (LBM), body fat (BF), BMC and percent body fat (%BF) were measured by BIA and DXA. Highly significant correlations were observed between BIA and DXA measurements for LBM, BF, BMC and %BF (r = 0.73, 0.93, 0.53, 0.79, respectively) before the intervention. Differences between BIA and DXA measurements were observed in LBM, BF, %BF and BMC before intervention ( p < 0.01) where WHR by BIA was significantly higher compared to anthropometry before ( p < 0.01) and after the intervention ( p < 0.01). BIA underestimated LBM by 1.85 kg and overestimated BF by 2.54 kg compared to DXA before the intervention. Although BIA and DXA showed highly significant correlations for LBM, BF, BMC and %BF before the intervention, they did not produce statistically comparable results in pre-menopausal Korean women and therefore should not be used interchangeably when measuring body composition.

scholarly journals The Altered Mononuclear Cell-Derived Cytokine Response to Glucose Ingestion Is Not Regulated by Excess Adiposity in Polycystic Ovary Syndrome

2014 ◽  
Vol 99 (11) ◽  
pp. E2244-E2251 ◽  
Author(s):  
Frank González ◽  
Chang Ling Sia ◽  
Marguerite K. Shepard ◽  
Neal S. Rote ◽  
Judi Minium
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Normal Weight ◽  
Cytokine Release ◽  
Ovary Syndrome ◽  
Excess Adiposity ◽  
Glucose Ingestion

Context: Excess adipose tissue is a source of inflammation. Polycystic ovary syndrome (PCOS) is a proinflammatory state and is often associated with excess abdominal adiposity (AA) alone and/or frank obesity. Objective: To determine the effect of glucose ingestion on cytokine release from mononuclear cells (MNC) in women with PCOS with and without excess AA and/or obesity. Design: A cross-sectional study. Setting: Academic medical center. Patients: Twenty-three women with PCOS (seven normal weight with normal AA, eight normal weight with excess AA, eight obese) and 24 ovulatory controls (eight normal weight with normal AA, eight normal weight with excess AA, eight obese). Intervention: Three-hour 75-g oral glucose tolerance test (OGTT). Main Outcome Measures: Body composition was measured by dual energy x-ray absorptiometry. Insulin sensitivity was derived from the OGTT (ISOGTT). TNFα, IL-6, and IL-1β release was measured in supernatants of cultured MNC isolated from blood samples drawn while fasting and 2 hours after glucose ingestion. Results: Insulin sensitivity was lower in obese subjects regardless of PCOS status and in normal-weight women with PCOS compared with normal-weight controls regardless of body composition status. In response to glucose ingestion, MNC-derived TNFα, IL-6, and IL-1β release decreased in both normal-weight control groups but failed to suppress in either normal-weight PCOS group and in obese women regardless of PCOS status. For the combined groups, the cytokine responses were negatively correlated with insulin sensitivity and positively correlated with abdominal fat and androgens. Conclusions: Women with PCOS fail to suppress MNC-derived cytokine release in response to glucose ingestion, and this response is independent of excess adiposity. Nevertheless, a similar response is also a feature of obesity per se. Circulating MNC and excess adipose tissue are separate and distinct sources of inflammation in this population.

Prediction of insulin sensitivity in non-obese women with polycystic ovary syndrome

2002 ◽  
Vol 78 ◽  
pp. S279
Author(s):  
David Cibula ◽  
Jan Skrha ◽  
Martin Hill ◽  
Michael Fanta ◽  
Lucie Haakova ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Ovary Syndrome
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