The Role of Glp-1 Receptor Agonists in Insulin Resistance with Concomitant Obesity Treatment in Polycystic Ovary Syndrome.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101092791 Publication Model: Electronic Cited Medium: Internet ISSN: 1422-0067 (Electronic) Linking ISSN: 14220067 NLM ISO Abbreviation: Int J Mol Sci Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI, [2000-

Anti-Obesity Agents*/therapeutic use ; Insulin Resistance* ; Polycystic Ovary Syndrome*/complications ; Polycystic Ovary Syndrome*/drug therapy ; Polycystic Ovary Syndrome*/metabolism; Female ; Glucagon-Like Peptide-1 Receptor/agonists ; Humans ; Inflammation/complications ; Insulin/therapeutic use ; Obesity/complications ; Obesity/drug therapy ; Obesity/metabolism

Insulin resistance is documented in clamp studies in 75% of women with polycystic ovary syndrome (PCOS). Although it is not included in the diagnostic criteria of PCOS, there is a crucial role of this metabolic impairment, which along with hormonal abnormalities, increase each other in a vicious circle of PCOS pathogenesis. Insulin resistance in this group of patients results from defects at the molecular level, including impaired insulin receptor-related signaling pathways enhanced by obesity and its features: Excess visceral fat, chronic inflammation, and reactive oxygen species. While lifestyle intervention has a first-line role in the prevention and management of excess weight in PCOS, the role of anti-obesity pharmacological agents in achieving and maintaining weight loss is being increasingly recognized. Glucagon-like peptide-1 receptor agonists (GLP1-RAs) not only act by reducing body weight but also can affect the mechanisms involved in insulin resistance, like an increasing expression of glucose transporters in insulin-dependent tissues, decreasing inflammation, reducing oxidative stress, and modulating lipid metabolism. They also tend to improve fertility either by increasing LH surge in hypothalamus-pituitary inhibition due to estrogen excess connected with obesity or decreasing too high LH levels accompanying hyperinsulinemia. GLP1-RAs seem promising for effective treatment of obese PCOS patients, acting on one of the primary causes of PCOS at the molecular level.

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Keywords: glucagon-like peptide-1 receptor agonists (GLP-1RAs); infertility; inflammation; insulin resistance (IR); lipid metabolism; obesity; oxidative stress; polycystic ovary syndrome (PCOS)

0 (Anti-Obesity Agents)
0 (Glucagon-Like Peptide-1 Receptor)
0 (Insulin)

Date Created: 20220423 Date Completed: 20220426 Latest Revision: 20220716

20240513

PMC9029608

10.3390/ijms23084334

35457152