Effects of GLP-1R agonist or co-cyprindiol, in combination with metformin, on polycystic ovary syndrome in overweight women: A Randomized Clinical Trial
Abstract
Objective:Polycystic ovary syndrome (PCOS) is characterized by
reproductive dysfunctions and metabolic disorders. This study aims to
compare the therapeutic effectiveness of glucagon-like peptide-1
receptor agonist (GLP-1RA) + Metformin (Met) versus co-cyprindiol
(cyproterone acetate/ethinylestradiol, CPA/EE) + Met in overweight PCOS
women and identify potential biomarkers. Methods: In this prospective,
open-label randomized controlled trial, we recruited 60 overweight PCOS
women into two groups at a 1:1 ratio to receive CPA/EE (2 mg/day) + Met
(1,500 mg/day) or GLP-1RA (liraglutide, 0.6-1.2 mg/day) + Met (1,500
mg/day) for 12 weeks. The clinical effectiveness and adverse effects
were evaluated, followed by plasma proteomic analysis and verification
of critical biomarkers by ELISA. Results: Both interventions improved
menstrual cycle, polycystic ovaries, LH levels, and LH/FSH ratio;
meanwhile reduced the body weight, BMI, HbA1c, FBG, OGTT-30 min insulin,
IL-6 and TNF-α. Whereas, GLP-1RA + Met showed a more robust improvement
on HbA1c, HOMA-IR, lipid profiles, inflammatory parameters, and
ovulation. CPA/EE + Met was more effective in reducing
hyperandrogenemia. Plasma proteomic analysis revealed that the
interventions altered proteins involved in reactive oxygen species
detoxification (PRDX6, GSTO1, GSTP1, GSTM2), platelet degranulation
(FN1), and the immune response (SERPINB9). Conclusions: CPA/EE+Met or
GLP-1RA + Met treatment improved reproductive functions and alleviated…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 60 participants or records.
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