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Randomized Controlled Trial
. 2025 Jan 2;25(1):2.
doi: 10.1186/s12902-024-01827-7.

Hydroxychloroquine enhances insulin sensitivity and ameliorates abnormal lipid metabolism in obese women with polycystic ovary syndrome

Ruihan Wang  1 , Shanqin Qi  1 , Qi Wang  1 , Jiajia Lang  2 , Conghui Pang  3 , Kehua Wang  4
Affiliations
Randomized Controlled Trial

Hydroxychloroquine enhances insulin sensitivity and ameliorates abnormal lipid metabolism in obese women with polycystic ovary syndrome

Ruihan Wang et al. BMC Endocr Disord. .

Abstract

Background: Hydroxychloroquine (HCQ) is frequently utilized in rheumatic immune disorders and has been discovered to exert hypoglycemic effects in some obese women with polycystic ovary syndrome(PCOS), however, the precise efficacy and mechanism of action remain ambiguous.

Objective: To examine the impact of HCQ on glucose and lipid metabolism as well as sex hormone levels in obese women with PCOS.

Method: Fifty obese women with PCOS were randomly allocated into two groups: HCQ group (n = 25) and metformin (MET) group (n = 25). The HCQ group received a daily dose of 200 mg hydroxychloroquine, while the MET group received a daily dose of 1000 mg metformin. Body fat parameters, glucose and lipid metabolism levels, as well as hormone levels were evaluated. Additionally, the incidence of pregnancy within six months following treatment was also assessed. Network pharmacology was also employed to analyze the potential molecular mechanism.

Result: Patients in the HCQ group (n = 20) and MET group (n = 23) were ultimately included for analysis. Following treatment, both groups exhibited significant improvements in body fat distribution and glucose metabolism status, with the HCQ group demonstrating a notable advantage over the MET group in increasing insulin sensitivity index (ISI)(HCQ:1.87 ± 0.21,MET:1.75 ± 0.29). Serum lipid levels [Serum total cholesterol(TC, mmol/L)(HCQ:4.51 ± 0.87,MET:5.05 ± 0.65), triglyceride(TG, mmol/L)(HCQ:1.36 ± 0.51,MET:1.67 ± 0.72), low-density lipoprotein (LDL, mmol/L)(HCQ:2.66 ± 0.98,MET:0.47 ± 1.42),decreased in both groups post-treatment, with the HCQ group displaying clear advantages compared to the MET group. The improvement of sex hormone levels was not pronounced in either group, although there was an overall downward trend.

Conclusion: The potential benefits of HCQ in the management of in obese women with PCOS include significant improvements in body fat distribution, glucose and lipid metabolism levels, as well as correction of hormonal disorders.

Clinical trial registration: The study was officially registered as a clinical trial on April 17, 2022, with the registration number ChiCTR2200058816. https://www.chictr.org.cn/showproj.html?proj=160099 .

Keywords: Hydroxychloroquine; Insulin resistance; Lipid metabolism; Polycystic ovary syndrome.

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Conflict of interest statement

Declarations. Ethical approval: This study was performed in line with the principles of the Declaration of Helsinki. The research protocol has been approved by the Ethics Committee of the Reproductive and Genetic Center of Shandong University of Traditional Chinese Medicine (2021 Clinical Research Application No. 17). Informed consent was obtained from all individual participants included in the study. Consent for publication: Informed consent was obtained from all individual participants included in the study. Identifying images or personal or clinical details of other participants presented in this article are anonymous, so this statement does not applicable. Statements& declaration: The main findings in the paper were independently conducted by the author or the research team. It is important to avoid plagiarism and properly cite the work of other authors. Additionally, there were no instances of submitting the same work to multiple publications or presenting it at different conferences. CONSORT guidelines: This manuscript is in line with the CONSORT clinical trial reporting guidelines, and we have uploaded the CONSORT guidelines as attachments. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart
Fig. 2
Fig. 2
The weight (a), BMI (a), waist (b), WHR (c), fat (d), BFR (d), VFI (e), VFA (f) and BMR (g) were compared between the two groups before and after treatment
Fig. 3
Fig. 3
Glucose metabolism indexes were compared between the two groups before and after treatment
Fig. 4
Fig. 4
Lipid metabolism indexes were compared between the two groups before and after treatment
Fig. 5
Fig. 5
The sex hormone indexes of the two groups were compared before and after treatment
Fig. 6
Fig. 6
KEGG analysis of HCQ in the treatment of PCOS
Fig. 7
Fig. 7
Molecular docking diagram of HCQ and key targets, EGFR-HCQ (a), HSP90AA1-HCQ (b), PIK3R1-HCQ (c), MAPK1-HCQ (d), PIK3CA-HCQ (e)
See this image and copyright information in PMC

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