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A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metabolic sequelae associated with PCOS range from insulin resistance to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Insulin resistance plays a significant role in the pathophysiology...

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Autores principales: Abdalla, Mohammed Altigani, Deshmukh, Harshal, Atkin, Stephen, Sathyapalan, Thozhukat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338645/
https://www.ncbi.nlm.nih.gov/pubmed/32670541
http://dx.doi.org/10.1177/2042018820938305
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author Abdalla, Mohammed Altigani
Deshmukh, Harshal
Atkin, Stephen
Sathyapalan, Thozhukat
author_facet Abdalla, Mohammed Altigani
Deshmukh, Harshal
Atkin, Stephen
Sathyapalan, Thozhukat
author_sort Abdalla, Mohammed Altigani
collection PubMed
description Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metabolic sequelae associated with PCOS range from insulin resistance to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Insulin resistance plays a significant role in the pathophysiology of PCOS and it is a reliable marker for cardiometabolic risk. Although insulin sensitising agents such as metformin have been traditionally used for managing metabolic aspects of PCOS, their efficacy is low in terms of weight reduction and cardiovascular risk reduction compared with newer agents such as incretin mimetics and SGLT2 inhibitors. With current pharmaceutical advances, potential therapeutic options have increased, giving patients and clinicians more choices. Incretin mimetics are a promising therapy with a unique metabolic target that could be used widely in the management of PCOS. Likewise, bariatric procedures have become less invasive and result in effective weight loss and the reversal of metabolic morbidities in some patients. Therefore, surgical treatment targeting weight loss becomes increasingly common in the management of obese women with PCOS. Newer emerging therapies, including twincretins, triple GLP-1 agonists, glucagon receptor antagonists and imeglemin, are promising therapeutic options for treating T2DM. Given the similarity of metabolic and pathological features between PCOS and T2DM and the variety of therapeutic options, there is the potential to widen our strategy for treating metabolic disorders in PCOS in parallel with current therapeutic advances. The review was conducted in line with the recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018.
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spelling pubmed-73386452020-07-14 A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome Abdalla, Mohammed Altigani Deshmukh, Harshal Atkin, Stephen Sathyapalan, Thozhukat Ther Adv Endocrinol Metab Review Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metabolic sequelae associated with PCOS range from insulin resistance to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Insulin resistance plays a significant role in the pathophysiology of PCOS and it is a reliable marker for cardiometabolic risk. Although insulin sensitising agents such as metformin have been traditionally used for managing metabolic aspects of PCOS, their efficacy is low in terms of weight reduction and cardiovascular risk reduction compared with newer agents such as incretin mimetics and SGLT2 inhibitors. With current pharmaceutical advances, potential therapeutic options have increased, giving patients and clinicians more choices. Incretin mimetics are a promising therapy with a unique metabolic target that could be used widely in the management of PCOS. Likewise, bariatric procedures have become less invasive and result in effective weight loss and the reversal of metabolic morbidities in some patients. Therefore, surgical treatment targeting weight loss becomes increasingly common in the management of obese women with PCOS. Newer emerging therapies, including twincretins, triple GLP-1 agonists, glucagon receptor antagonists and imeglemin, are promising therapeutic options for treating T2DM. Given the similarity of metabolic and pathological features between PCOS and T2DM and the variety of therapeutic options, there is the potential to widen our strategy for treating metabolic disorders in PCOS in parallel with current therapeutic advances. The review was conducted in line with the recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. SAGE Publications 2020-07-06 /pmc/articles/PMC7338645/ /pubmed/32670541 http://dx.doi.org/10.1177/2042018820938305 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Abdalla, Mohammed Altigani
Deshmukh, Harshal
Atkin, Stephen
Sathyapalan, Thozhukat
A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title_full A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title_fullStr A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title_full_unstemmed A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title_short A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
title_sort review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7338645/
https://www.ncbi.nlm.nih.gov/pubmed/32670541
http://dx.doi.org/10.1177/2042018820938305
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