Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

doi:10.3390/biomedicines12030653

Review

. 2024 Mar 14;12(3):653.

doi: 10.3390/biomedicines12030653.

Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

Affiliations

¹ Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
² Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia.
³ Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Policlinico of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
⁴ Unit of Obstetrics and Gynecology, P.O. "Ospedale del Tigullio"-ASL4, 16043 Chiavari, Italy.
⁵ Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
⁶ Department of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.
⁷ University Department of Health Studies, University of Split, R. Boskovica 35, 21 000 Split, Croatia.
⁸ Hormona Polyclinic, Kranjceviceva 45, 21 000 Split, Croatia.
⁹ Department of Obstetrics and Gynecology, General Hospital Dubrovnik, 20 000 Dubrovnik, Croatia.

PMID: 38540265
PMCID: PMC10967775
DOI: 10.3390/biomedicines12030653

Review

Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

Andrea Etrusco et al. Biomedicines. 2024.

. 2024 Mar 14;12(3):653.

doi: 10.3390/biomedicines12030653.

Authors

Affiliations

¹ Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy.
² Department of Obstetrics and Gynecology, Clinical Hospital Center Zagreb, 10 000 Zagreb, Croatia.
³ Unit of Obstetrics and Gynecology, Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Policlinico of Bari, Piazza Giulio Cesare 11, 70124 Bari, Italy.
⁴ Unit of Obstetrics and Gynecology, P.O. "Ospedale del Tigullio"-ASL4, 16043 Chiavari, Italy.
⁵ Department of Health Sciences (DISSAL), University of Genoa, 16132 Genoa, Italy.
⁶ Department of Obstetrics and Gynaecology, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.
⁷ University Department of Health Studies, University of Split, R. Boskovica 35, 21 000 Split, Croatia.
⁸ Hormona Polyclinic, Kranjceviceva 45, 21 000 Split, Croatia.
⁹ Department of Obstetrics and Gynecology, General Hospital Dubrovnik, 20 000 Dubrovnik, Croatia.

PMID: 38540265
PMCID: PMC10967775
DOI: 10.3390/biomedicines12030653

Abstract

Background: The purpose of this narrative review is to describe the mechanisms that are responsible for the development of infertility and PCOS, with a focus on the role of obesity, insulin sensitivity and treatment with metformin and GLP-1s.

Methods: The relevant publications were identified after systematic queries of the following sources: PubMed, Google Scholar, Web of Science, and publishers' databases, complemented by a cross-check of the reference lists. We used a combination of the search terms "polycystic ovary syndrome", "obesity" and "insulin resistance" with "metformin", "exenatide", "liraglutide", "semaglutide", "orlistat" and terms relevant to the topic of each paragraph (e.g., "pathophysiology", "metabolism", "infertility", "treatment").

Results: All articles describing the mechanisms responsible for the development of infertility and PCOS, with a focus on the role of obesity, insulin sensitivity and treatment with metformin and GLP-1s, were considered for this review.

Conclusions: The existing research on GLP-1 receptor agonists (GLP-1RAs) has not conclusively established a specific therapeutic use for these drugs. Additionally, the efficacy of the newer generation of GLP-1RAs, particularly in terms of dosage and duration of exposure, warrants more extensive research. Understanding the optimal dosing and treatment duration could significantly enhance the therapeutic use of GLP-1RAs in managing PCOS and its associated conditions.

Keywords: GLP-1 receptor agonists; insulin sensitivity; metformin; obesity; polycystic ovary syndrome.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

**Figure 1**
Flow diagram of narrative review search.

See this image and copyright information in PMC

Cited by

Tirzepatide Affect Sexual Function in Women: Case Report.
Mohammed GF, Al-Dhubaibi MS, Bahaj SS, Mohammed RM. Mohammed GF, et al. Clin Med Insights Case Rep. 2025 Jun 6;18:11795476251347753. doi: 10.1177/11795476251347753. eCollection 2025. Clin Med Insights Case Rep. 2025. PMID: 40487373 Free PMC article.
Reverse Effects of Nicotinamide Mononucleotide Supplementation on Declining Quality of Oocytes With Polycystic Ovary Syndrome.
Fan Y, Hu Q, Wu X, Lang P, Wei Y, Yi R, He C, Geng T, Zhao C, Zhou S, Zhang J, Ling X. Fan Y, et al. FASEB J. 2025 Jul 31;39(14):e70846. doi: 10.1096/fj.202500921R. FASEB J. 2025. PMID: 40678956 Free PMC article.
Dissociation of plasma oxyntomodulin levels from anthropometric measures and metabolic markers in women with polycystic ovary syndrome.
Damasceno RC, Oliveira FR, Cândido AL, Gomes KB, Bizzi MF, Azevedo RC, Comim FV, Reis FM, Rocha ALL. Damasceno RC, et al. Arch Endocrinol Metab. 2025 Jun 18;69(3):e240451. doi: 10.20945/2359-4292-2024-0451. Arch Endocrinol Metab. 2025. PMID: 40532052 Free PMC article.
Decisional needs and interventions for young women considering contraceptive options: an umbrella review.
Bortoli MM, Kantymir S, Pacheco-Brousseau L, Dahl B, Hansen EH, Lewis KB, Zhang Q, Cole V, Westergren T, Stacey D. Bortoli MM, et al. BMC Womens Health. 2024 Jun 8;24(1):336. doi: 10.1186/s12905-024-03172-2. BMC Womens Health. 2024. PMID: 38851748 Free PMC article.
Validation of the follicular and ovarian thresholds by an 18-MHz ultrasound imaging in polycystic ovary syndrome: a pilot cutoff for North African patients.
Ach T, Guesmi A, Kalboussi M, Ben Abdessalem F, Mraihi E, El Mhabrech H. Ach T, et al. Ther Adv Reprod Health. 2024 Aug 20;18:26334941241270372. doi: 10.1177/26334941241270372. eCollection 2024 Jan-Dec. Ther Adv Reprod Health. 2024. PMID: 39170801 Free PMC article.

See all "Cited by" articles

References

1. Anekwe C.V., Jarrell A.R., Townsend M.J., Gaudier G.I., Hiserodt J.M., Stanford F.C. Socioeconomics of Obesity. Curr. Obes. Rep. 2020;9:272–279. doi: 10.1007/s13679-020-00398-7. - DOI - PMC - PubMed
1. NCD Risk Factor Collaboration (NCD-RisC) Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128.9 Million Children, Adolescents, and Adults. Lancet. 2017;390:2627–2642. doi: 10.1016/S0140-6736(17)32129-3. - DOI - PMC - PubMed
1. Powell-Wiley T.M., Poirier P., Burke L.E., Després J.-P., Gordon-Larsen P., Lavie C.J., Lear S.A., Ndumele C.E., Neeland I.J., Sanders P., et al. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation. 2021;143:e984–e1010. doi: 10.1161/CIR.0000000000000973. - DOI - PMC - PubMed
1. Chadt A., Scherneck S., Joost H.-G., Al-Hasani H. Molecular Links between Obesity and Diabetes: “Diabesity”. In: Feingold K.R., Anawalt B., Blackman M.R., Boyce A., Chrousos G., Corpas E., de Herder W.W., Dhatariya K., Dungan K., Hofland J., et al., editors. Endotext. MDText.com, Inc.; South Dartmouth, MA, USA: 2000.
1. Dixon A.E., Peters U. The Effect of Obesity on Lung Function. Expert. Rev. Respir. Med. 2018;12:755–767. doi: 10.1080/17476348.2018.1506331. - DOI - PMC - PubMed

Publication types

Actions

LinkOut - more resources

Full Text Sources

[1] Anekwe C.V., Jarrell A.R., Townsend M.J., Gaudier G.I., Hiserodt J.M., Stanford F.C. Socioeconomics of Obesity. Curr. Obes. Rep. 2020;9:272–279. doi: 10.1007/s13679-020-00398-7. - DOI - PMC - PubMed

[2] Anekwe C.V., Jarrell A.R., Townsend M.J., Gaudier G.I., Hiserodt J.M., Stanford F.C. Socioeconomics of Obesity. Curr. Obes. Rep. 2020;9:272–279. doi: 10.1007/s13679-020-00398-7. - DOI - PMC - PubMed

[3] NCD Risk Factor Collaboration (NCD-RisC) Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128.9 Million Children, Adolescents, and Adults. Lancet. 2017;390:2627–2642. doi: 10.1016/S0140-6736(17)32129-3. - DOI - PMC - PubMed

[4] NCD Risk Factor Collaboration (NCD-RisC) Worldwide Trends in Body-Mass Index, Underweight, Overweight, and Obesity from 1975 to 2016: A Pooled Analysis of 2416 Population-Based Measurement Studies in 128.9 Million Children, Adolescents, and Adults. Lancet. 2017;390:2627–2642. doi: 10.1016/S0140-6736(17)32129-3. - DOI - PMC - PubMed

[5] Powell-Wiley T.M., Poirier P., Burke L.E., Després J.-P., Gordon-Larsen P., Lavie C.J., Lear S.A., Ndumele C.E., Neeland I.J., Sanders P., et al. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation. 2021;143:e984–e1010. doi: 10.1161/CIR.0000000000000973. - DOI - PMC - PubMed

[6] Powell-Wiley T.M., Poirier P., Burke L.E., Després J.-P., Gordon-Larsen P., Lavie C.J., Lear S.A., Ndumele C.E., Neeland I.J., Sanders P., et al. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation. 2021;143:e984–e1010. doi: 10.1161/CIR.0000000000000973. - DOI - PMC - PubMed

[7] Chadt A., Scherneck S., Joost H.-G., Al-Hasani H. Molecular Links between Obesity and Diabetes: “Diabesity”. In: Feingold K.R., Anawalt B., Blackman M.R., Boyce A., Chrousos G., Corpas E., de Herder W.W., Dhatariya K., Dungan K., Hofland J., et al., editors. Endotext. MDText.com, Inc.; South Dartmouth, MA, USA: 2000.

[8] Chadt A., Scherneck S., Joost H.-G., Al-Hasani H. Molecular Links between Obesity and Diabetes: “Diabesity”. In: Feingold K.R., Anawalt B., Blackman M.R., Boyce A., Chrousos G., Corpas E., de Herder W.W., Dhatariya K., Dungan K., Hofland J., et al., editors. Endotext. MDText.com, Inc.; South Dartmouth, MA, USA: 2000.

[9] Dixon A.E., Peters U. The Effect of Obesity on Lung Function. Expert. Rev. Respir. Med. 2018;12:755–767. doi: 10.1080/17476348.2018.1506331. - DOI - PMC - PubMed

[10] Dixon A.E., Peters U. The Effect of Obesity on Lung Function. Expert. Rev. Respir. Med. 2018;12:755–767. doi: 10.1080/17476348.2018.1506331. - DOI - PMC - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

Affiliations

Incretin Hormone Secretion in Women with Polycystic Ovary Syndrome: Roles of Obesity, Insulin Sensitivity and Treatment with Metformin and GLP-1s

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

LinkOut - more resources

Full Text Sources

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

Publication types

Related information

LinkOut - more resources

Full Text Sources