Canagliflozin combined with metformin versus metformin monotherapy for endocrine and metabolic profiles in overweight and obese women with polycystic ovary syndrome: A single-center, open-labeled prospective randomized controlled trial

Zhang, Jiaqi; Xing, Chuan; Cheng, Xiangyi; He, Bing

doi:10.3389/fendo.2022.1003238

Cited by 22 publications

(34 citation statements)

References 51 publications

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“…A study that compared the use of canagliflozin with metformin alone showed no changes in the menstrual cycle, level of FSH, LH, free androgen, androgen-binding globulin, A4, or lipid status. However, there was a significant difference in the reduction of free testosterone, BMI, regulation of glycemic status, and insulin secretion [ 58 ]. Zhang also demonstrated that SGLT-2is reduce lipotoxicity and improve androgen metabolism in PCOS [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, there was a significant difference in the reduction of free testosterone, BMI, regulation of glycemic status, and insulin secretion [ 58 ]. Zhang also demonstrated that SGLT-2is reduce lipotoxicity and improve androgen metabolism in PCOS [ 58 ]. In addition, in obese women with PCOS, canagliflozin therapy in combination with metformin compared to metformin as a monotherapy has similar effects on the menstrual cycle, body weight, and IR, but lowers the free testosterone levels more and has a better effect on glucose metabolism [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…Zhang also demonstrated that SGLT-2is reduce lipotoxicity and improve androgen metabolism in PCOS [ 58 ]. In addition, in obese women with PCOS, canagliflozin therapy in combination with metformin compared to metformin as a monotherapy has similar effects on the menstrual cycle, body weight, and IR, but lowers the free testosterone levels more and has a better effect on glucose metabolism [ 58 ]. Therefore, Zhang concluded, after considering the beneficial effect on metabolic parameters and the cardioprotective effect, that the application of SGLT-2is could be effective in the treatment of PCOS.…”

Section: Discussionmentioning

confidence: 99%

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The Potential of SGLT-2 Inhibitors in the Treatment of Polycystic Ovary Syndrome: The Current Status and Future Perspectives

et al. 2023

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Polycystic ovary syndrome (PCOS) is the most frequent endocrinopathy during women’s reproductive age. PCOS is a heterogeneous disorder featuring specific cardiometabolic properties. The association between the presence of metabolic disorders and PCOS supports the claim that the regulation of glycemic status is very important in these patients. There is a wide range of therapeutic options (including those treating diabetes mellitus type 2) with potential advantages available for the management of PCOS. Sodium–glucose cotransporter type 2 inhibitors (SGLT-2is) improve glucose metabolism, reduce fat tissue, lower blood pressure, reduce oxidative stress and inflammation, and protect the cardiovascular system. Currently, the use of SGLT-2is is not widespread in PCOS therapy, although these drugs represent a promising new therapeutic approach. Therefore, it is necessary to initiate further study in order to determine more effective therapies for PCOS and investigate the effect of SGLT-2is, both as a monotherapy and in combination with other drugs. It is necessary to understand the mechanisms underlying SGLT-2is in PCOS and their effects on long-term complications, especially since the gold standard treatment for PCOS, such as metformin and oral contraceptives, do not have long-term cardioprotective effects. The effects of SGLT-2is seem to involve cardiac protection, while diminishing endocrine and reproductive abnormalities in PCOS. In the current narrative review, we examine the most recent clinical evidence and discuss the potential applications of SGLT-2is for PCOS therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Potential of SGLT-2 Inhibitors in the Treatment of Polycystic Ovary Syndrome: The Current Status and Future Perspectives

et al. 2023

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“…Compared with MET monotherapy, CANA/MET may have greater benefits in reducing total testosterone, AUC for glucose, and AUC for insulin over three months. However, more studies are needed to evaluate the long-term effects of SGLT-2 inhibitors in patients with PCOS [3].…”

Section: Treatment Of Irregular Menstrual Cycle and Hyperandrogenismmentioning

confidence: 99%

Modern Aspects of Treatment of Women With Polycystic Ovary Syndrome

Semenyna

2023

Grundlagen Der Modernen Wissenschaftlichen Forschung

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Polycystic ovary syndrome (PCOS) is one of the most common neuroendocrine syndromes of reproductive age, affecting up to 20% of women in this age group. This condition is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovary morphology. In the pathophysiology of PCOS, there is a violation of the circadian rhythm of GnRH secretion, which increases the release of LH and decreases FSH. The latter is necessary for the synthesis of aromatases, which convert androgens into estrogens [7]. Another pathophysiological link in the development of PCOS is insulin resistance. Androgen hypersecretion increases the level of insulin resistance, and the hyperinsulinemia that develops due to insulin resistance further increases androgen secretion and induces the production of sex hormone-binding globulin (SHBG) in the liver, thereby increasing the concentration of free testosterone in the blood and even more aggravates disorders associated with hyperandrogenism. In 2003, a consensus of experts at a joint ESHRE/ASRM symposium in Rotterdam adopted diagnostic criteria (remaining relevant to this day), which include a triad of signs: oligoovulation or anovulation; hyperandrogenism (clinical and/or biochemical manifestations); polycystic ovaries detected during ultrasound; diagnosed on the basis of at least two of the following signs [7]. Patients may have different manifestations of this triad depending on the disease phenotype, patient age, and lifestyle. Therefore, treatment strategies are symptomatic and depend on desired goals and clinical preferences.

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“…Тaking into account the importance of the correction of metabolic parameters in PCOS, a number of measures of both medicinal nature and non-medicinal means (diet therapy, physical exercise, phytotherapy) are proposed [7,8].…”

Section: Introductionmentioning

confidence: 99%

Study of the Effectiveness of Diet Therapy in the Correction of Metabolic Parameters in Women With Polycystic Ovary Syndrome and Insulin Resistance

Semenyna

Фартушок²,

Кomarnitska³

2023

GoS

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Taking into account the importance of correction of metabolic parameters in PCOS, diet therapy is offered. Diet therapy is appropriate as the first stage of treatment in patients with PCOS and IR, but the optimal diet has not been determined at the moment [8]. Purpose: to conduct an analysis of studies on the effectiveness of various types of diet therapy. Materials and methods. 12 articles from 2020 to 2022 were analyzed. Research results and their discussion. A review and analysis of a cohort study on the effects of a ketogenic diet (KD), in which 14 overweight women with a diagnosis of PCOS participated [1].The main argument for the use of KD in PCOS and IR is physiological ketosis [4], which occurs as a result of a low carbohydrate content in the diet, which in turn reduces the level of circulating insulin, and therefore the receptor for insulin-like growth factor type 1. As a result, production of androgens in both ovaries and adrenal glands is inhibited.The results of a 12-week study suggest that a ketogenic diet is appropriate for correcting metabolic disorders and obesity in PCOS and IR.The Mediterranean diet (MED) has proven to be one of the most effective diets in the treatment of metabolic and reproductive problems in women with PCOS and IR [5].The results of the research showed that both approaches to diet therapy are productive in normalizing metabolic processes. It is worth noting that the group of patients who used the MED/LC diet combination showed excellent results in the normalization of the menstrual cycle (86.7% recovered a regular menstrual cycle).Соnclusions. The advantages of KD are a good result in reducing weight and anthropometric indicators in a short period of time. The most promising in the context of PCOS and IR treatment with further introduction into the patients' lifestyle is the Mediterranean diet.

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Canagliflozin combined with metformin versus metformin monotherapy for endocrine and metabolic profiles in overweight and obese women with polycystic ovary syndrome: A single-center, open-labeled prospective randomized controlled trial

Cited by 22 publications

References 51 publications

The Potential of SGLT-2 Inhibitors in the Treatment of Polycystic Ovary Syndrome: The Current Status and Future Perspectives

The Potential of SGLT-2 Inhibitors in the Treatment of Polycystic Ovary Syndrome: The Current Status and Future Perspectives

Modern Aspects of Treatment of Women With Polycystic Ovary Syndrome

Study of the Effectiveness of Diet Therapy in the Correction of Metabolic Parameters in Women With Polycystic Ovary Syndrome and Insulin Resistance

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