Effect of GLP-1 agonists on weight loss in patients with polycystic ovary syndrome and obesity: A single-center study

Dushyanth Srinivasan; Holly F Lofton

doi:10.1016/j.obpill.2022.100016

Effect of GLP-1 agonists on weight loss in patients with polycystic ovary syndrome and obesity: A single-center study

Obes Pillars. 2022 Apr 10:2:100016. doi: 10.1016/j.obpill.2022.100016. eCollection 2022 Jun.

Authors

Dushyanth Srinivasan^{1

2}, Holly F Lofton^{2

3}

Affiliations

¹ Division of Hospitalist Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
² General Internal Medicine, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA.
³ Division of Bariatric Surgery, Department of Surgery, NYU Grossman School of Medicine, New York, NY, USA.

Abstract

Background: Weight loss of >5% in patients with polycystic ovary syndrome and obesity (PCOS-O) is believed to improve underlying drivers of the syndrome. Weight loss facilitated by GLP-1 agonists in patients with PCOS-O is not well characterized. In this single-center retrospective study, we determined weight loss in patients with PCOS-O with GLP-1 monotherapy versus metformin.

Methods: In this brief report, electronic records of 183 adult patients with PCOS-O were reviewed between January 2020 and April 2021. We identified 12 and 19 patients that were treated with metformin and GLP-1 monotherapy respectively. One patient in each cohort had diabetes mellitus. Weights were reviewed at baseline (prior to therapy initiation) and at six-month follow-up. We analyzed change in weight from baseline and proportion with >5% and 10% weight loss using Fisher exact t-test and chi-square test. Univariate linear regression was used to identify correlations between treatment and weight loss.

Results: Baseline characteristics were similar between metformin (n = 12) and GLP-1 (n = 19) cohorts with the exception of mean days on medication. Following six months of treatment, mean weight loss was 4.9 kg (4.8%) and 9.1 kg (9.8%) in the metformin and GLP-1 cohorts (p = 0.13) respectively. Similar trends were seen in BMI with reductions of 1.8 kg/m² (4.7%) and 3.5 kg/m² (9.7%). A significantly greater proportion of patients achieved 5% and 10% weight loss with GLP-1 treatment (84.2% and 57.8%, p = 0.01 and p = 0.02) compared to metformin. Univariate linear regression analysis demonstrated a trend towards greater weight loss in patients treated with GLP-1 monotherapy (Coeff: 4.15, 95% CI: 1.3-9.7, p = 0.13) versus metformin.

Conclusion: Our study shows improvements in weight with GLP-1 monotherapy versus metformin as demonstrated by overall weight loss and proportion of patients achieving >5% weight loss. Further prospective randomized controlled studies are needed to establish GLP-1 weight loss efficacy in patients with PCOS-O and clinically related outcomes.