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1.陆军军医大学第二附属医院内分泌科,重庆 400037
2.陆军军医大学第一附属医院内分泌科,重庆 400038
廖明钰,Email:742781319@qq.com,研究方向:垂体性腺疾病。
隆 敏,Email:longmin_casper@163.com。
收稿:2023-05-29,
修回:2023-07-02,
录用:2023-07-28,
纸质出版:2023-09-28
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廖明钰,沈如飞,廖倩,等.利拉鲁肽联合二甲双胍在超重或肥胖PCOS患者中的临床疗效观察[J].重庆医科大学学报,2023,48(9):1094-1099.
Liao Mingyu,Shen Rufei,Liao Qian,et al.Clinical efficacy of Liraglutide combined with metformin in overweight or obese patients with PCOS[J].Journal of Chongqing Medical University,2023,48(9):1094-1099.
廖明钰,沈如飞,廖倩,等.利拉鲁肽联合二甲双胍在超重或肥胖PCOS患者中的临床疗效观察[J].重庆医科大学学报,2023,48(9):1094-1099. DOI: 10.13406/j.cnki.cyxb.003321.
Liao Mingyu,Shen Rufei,Liao Qian,et al.Clinical efficacy of Liraglutide combined with metformin in overweight or obese patients with PCOS[J].Journal of Chongqing Medical University,2023,48(9):1094-1099. DOI: 10.13406/j.cnki.cyxb.003321.
目的
2
回顾性分析利拉鲁肽联合二甲双胍治疗超重或肥胖多囊卵巢综合征(polycystic ovarian syndrome,PCOS)患者的临床疗效。
方法
2
选取2018年6月至2023年4月在陆军军医大学第二附属医院就诊符合入选标准的125例PCOS患者作为研究对象,根据体质指数(body mass index,BMI)≥24 kg/m
2
分为超重组(
n
=56)和肥胖组(
n
=69)。2组受试者均给予利拉鲁肽联合二甲双胍治疗12周,评估治疗后的临床疗效。
结果
2
①治疗后,2组体质量、BMI、腰围、臀围、谷丙转氨酶较前下降(
P
<
0.05)。肥胖组体质量、体质指数下降更显著(
P
<
0.05);治疗后,2组糖脂代谢指标均较前下降(
P
<
0.05),但2组间绝对值变化差异无统计学意义(
P
>
0.05);治疗后,2组性激素球蛋白较前上升,总睾酮、游离雄激素指数、促黄体生成素、促黄体生成素/促卵泡激素较前下降(
P
<
0.05),且超重组下降更显著(
P
<
0.05)。治疗后2组月经恢复率、优势卵泡形成率较前改善,卵巢多囊样改变较前减少(
P
<
0.05)。②安全性评价2组中最常见的不良反应是恶心和腹泻、消化不良。所有的不良反应都在用药后4周内逐渐减少。
结论
2
利拉鲁肽联合二甲双胍在减轻超重或肥胖PCOS患者体质量、BMI,改善糖脂代谢紊乱及卵巢功能均有较好的疗效,尤其对于肥胖型PCOS患者在降低体质量方面获益更多,超重型PCOS患者在改善性激素水平方面更具优势,且安全性尚可。
Objective
2
To review the clinical efficacy of liraglutide combined with metformin in the treatment of overweight or obese patients with polycystic ovarian syndrome(PCOS).
Methods
2
125 patients with PCOS from The First Affiliated Hospital of Army Medical University who met the inclusion criteria from June 2018 to April 2023 were selected as study subjects and divided into hyperrecombination(
n
=56) and obesity group(
n
=69) according to body mass index(BMI)≥24 kg/m
2
. Both groups were treated with Liraglutide combined with metformin for 12 weeks to evaluate the clinical efficacy after treatment.
Results
2
①After treatment,the body weight,BMI,waist circumference,hip circumference and alanine aminotransferase in two groups were decreased(
P
<
0.05). The decrease of body weight and BMI in obese group was more significant(
P
<
0.05). After treatment,the indexes of glucose and lipid metabolism were decreased in both groups(
P
<
0.05),but there was no significant difference in absolute value between the two groups(
P
>
0.05). After treatment,sex hormone globulin increased,while total testosterone,free androgen index,luteinizing hormone,luteinizing hormone/follicle-stimulating hormone decreased(
P
<
0.05),and superrecombinant decreased more significantly(
P
<
0.05). After treatment,the recovery rate of menstruation and dominant follicle formation rate were improved,and the polycystic changes of ovary were decreased(
P
<
0.05).②The most common adverse reactions in the two groups were nausea,diarrhea and dyspepsia. All of the adverse reactions were gradually reduced within 4 weeks of administration.
Conclusion
2
Liraglutide combined with metformin has good efficacy in reducing body weight and body mass index in overweight or obese PCOS patients,improving glycemic and lipid metabolism disorders and ovarian function,especially in obese PCOS patients with more benefits in reducing body weight,and patients with super severe PCOS have more advantages in improving sex hormone levels.
Escobar-Morreale HF . Polycystic ovary syndrome:definition,aetiology,diagnosis and treatment [J ] . Nat Rev Endocrinol , 2018 , 14 ( 5 ): 270 - 284 .
Weickert MO , Pfeiffer AFH . Impact of dietary fiber consumption on insulin resistance and the prevention of type 2 diabetes [J ] . J Nutr , 2018 , 148 ( 1 ): 7 - 12 .
Moran LJ , Norman RJ , Teede H J . Metabolic risk in PCOS:phenotype and adiposity impact [J ] . Trends Endocrinol Metab , 2015 , 26 ( 3 ): 136 - 143 .
赵花 , 彭顺英 , 黄芳 , 等 . 二甲双胍对中心性肥胖和非中心性肥胖多囊卵巢综合征患者生殖内分泌及糖脂代谢的影响 [J ] . 吉林医学 , 2019 , 42 ( 2 ): 378 - 379 .
Zhao H , Peng SY , Huang F , et al . Effect of metformin on reproductive endocrine and glucose and lipid metabolism of polycystic ovary syndrome patients with or without central obesity [J ] . Jilin Med J , 2019 , 42 ( 2 ): 378 - 379 .
Sfairopoulos D , Liatis S , Tigas S , et al . Clinical pharmacology of glucagon-like peptide-1 receptor agonists [J ] . Hormones(Athens) , 2018 , 17 ( 3 ): 333 - 350 .
李蔚鑫 , 李行 , 廖明钰 , 等 . 二甲双胍联合利拉鲁肽治疗超重多囊卵巢综合征患者后MFAP5水平变化与临床指标改善的相关性研究 [J ] . 第三军医大学学报 , 2022 , 44 ( 3 ): 217 - 223 .
Li WX , Li H , Liao MY , et al . Correlation between alteration of MFAP5 level and improvement of clinical indicators in patients with overweight polycystic ovary syndrome treated with metformin combined with liraglutide [J ] . J Third Mil Med Univ , 2022 , 44 ( 3 ): 217 - 223 .
Hampton JR . Guidelines--for the obedience of fools and the guidance of wise men? [J ] . Clin Med(Lond) , 2003 , 3 ( 3 ): 279 - 284 .
Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group . Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome(PCOS) [J ] . Hum Reprod , 2004 , 19 ( 1 ): 41 - 47 .
Barber TM , Hanson P , Weickert M O , et al . Obesity and Polycystic Ovary Syndrome:Implications for Pathogenesis and Novel Management Strategies [J ] . Clin Med Insights Reprod Health , 2019 , 13 : 1179558119874042 .
Lim SS , Hutchison SK , Van Ryswyk E , et al . Lifestyle changes in women with polycystic ovary syndrome [J ] . Cochrane Database Syst Rev , 2019 , 3 ( 3 ): Cd007506 .
Htike ZZ , Zaccardi F , Papamargaritis D , et al . Efficacy and safety of glucagon-like peptide-1 receptor agonists in type 2 diabetes:A systematic review and mixed-treatment comparison analysis [J ] . Diabetes Obes Metab , 2017 , 19 ( 4 ): 524 - 536 .
Bennett WL , Aschmann HE , Puhan MA , et al . A benefit-harm analysis of adding basal insulin vs. sulfonylurea to metformin to manage type II diabetes mellitus in people with multiple chronic conditions [J ] . J Clin Epidemiol , 2019 , 113 : 92 - 100 .
Abdalla MA , Deshmukh H , Atkin S , et al . A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome [J ] . Ther Adv Endocrinol Metab , 2020 , 11 : 2042018820938305 .
Glintborg D , Mumm H , Holst JJ , et al . Effect of oral contraceptives and/or metformin on GLP-1 secretion and reactive hypoglycaemia in polycystic ovary syndrome [J ] . Endocr Connect , 2017 , 6 ( 4 ): 267 - 277 .
Lamos EM , Malek R , Davis S N . GLP-1 receptor agonists in the treatment of polycystic ovary syndrome [J ] . Expert Rev Clin Pharmacol , 2017 , 10 ( 4 ): 401 - 408 .
Sharma N , Siriesha , Lugani Y , et al . Effect of metformin on insulin levels,blood sugar,and body mass index in polycystic ovarian syndrome cases [J ] . J Family Med Prim Care , 2019 , 8 ( 8 ): 2691 - 2695 .
Shi Y , Cui Y , Sun X , et al . Hypertension in women with polycystic ovary syndrome:prevalence and associated cardiovascular risk factors [J ] . Eur J Obstet Gynecol Reprod Biol , 2014 , 173 : 66 - 70 .
Jensterle M , Goricar K , Janez A . Metformin as an initial adjunct to low-dose liraglutide enhances the weight-decreasing potential of liraglutide in obese polycystic ovary syndrome:Randomized control study [J ] . Exp Ther Med , 2016 , 11 ( 4 ): 1194 - 1200 .
Ma RL , Deng Y , Wang YF , et al . Short-term combined treatment with exenatide and metformin for overweight obse women with polycystic ovary syndrome [J ] . Chin Med J(Engl) , 2021 , 134 ( 23 ): 2882 - 2889 .
Jensterle M , Janez A , Fliers E , et al . The role of glucagon-like peptide-1 in reproduction:from physiology to therapeutic perspective [J ] . Hum Reprod Update , 2019 , 25 ( 4 ): 504 - 517 .
Salamun V , Jensterle M , Janez A , et al . Liraglutide increases IVF pregnancy rates in obese PCOS women with poor response to first-line reproductive treatments:a pilot randomized study [J ] . Eur J Endocrinol , 2018 , 179 ( 1 ): 1 - 11 .
Xing C , Zhao H , Zhang J , et al . Effect of metformin versus metformin plus liraglutide on gonadal and metabolic profiles in overweight patients with polycystic ovary syndrome [J ] . Front Endocrinol(Lausanne) , 2022 , 13 : 945609 .
周启敏 , 李亚婷 , 朱荣妍 , 等 . 胰高血糖素样肽-1受体激动剂在多囊卵巢综合征中的临床应用 [J ] . 中华生殖与避孕杂志 , 2019 , 39 ( 7 ): 579 - 585 .
Zhou QM , Li YT , Zhu RY , et al . Application of glucagon like peptide-1 receptor agonists in the treatment of polycystic ovary syndrome [J ] . Chine J Reprod Contraception , 2019 , 39 ( 7 ): 579 - 585 .
刘其聪 , 刘 清 , 姚火娣 , 等 . 二甲双胍、吡格列酮及其联合用药对缓解多囊卵巢综合征患者早期糖代谢异常的比较 [J ] . 重庆医科大学学报 , 2022 , 47 ( 11 ): 1359 - 1364 .
Liu QC , Liu Q , Yao HD , et al . Comparison of remission of metformin,pioglitazone and their combination on early abnormal glucose metabolism in patients with polycystic ovary syndrome [J ] . J Chongqing Med Univ , 2022 , 47 ( 11 ): 1359 - 1364 .
Wu LM , Wang YX , Zhan Y , et al . Dulaglutide,a long-acting GLP-1 receptor agonist,can improve hyperandrogenemia and ovarian function in DHEA-induced PCOS rats [J ] . Peptides , 2021 , 145 : 170624 .
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