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The effect of exenatide on cardiovascular risk markers in women with Polycystic Ovary Syndrome

Dawson, Alison J.; Sathyapalan, Thozhukat; Vince, Rebecca; Coady, Anne-Marie; Ajjan, Ramzi A.; Kilpatrick, Eric S.; Atkin, Stephen L.

Authors

Alison J. Dawson

Thozhukat Sathyapalan

Anne-Marie Coady

Ramzi A. Ajjan

Eric S. Kilpatrick

Stephen L. Atkin



Abstract

Background: Polycystic ovary syndrome (PCOS) is associated with an adverse cardiovascular risk profile including a prothrombotic state. Exenatide has been shown to be effective at improving insulin sensitivity and weight loss in PCOS; therefore this study was undertaken to assess its effects on weight, endothelial function, inflammatory markers, and fibrin structure/function in overweight/obese women with PCOS.

Methods: Thirty overweight/obese anovulatory women with all 3 Rotterdam criteria received exenatide 5 mcg bd for 4 weeks then 10 mcg bd for 12 weeks. The primary outcome was change in weight; secondary outcomes were changes in endothelial function [Reactive Hyperemia-Peripheral Arterial Tonometry (RH-PAT)], serum endothelial markers (ICAM-1, VCAM-1, E-selectin, and P-selectin), change in inflammation (hsCRP), and alteration in clot structure and function [maximum absorbance (MA), and time from full clot formation to 50% lysis (LT)].

Results: Twenty patients completed the study. Exenatide reduced weight 111.8 ± 4.8 to 108.6 ± 4.6 kg p = 0.003. Serum endothelial markers changed with a reduction in ICAM-1 (247.2 ± 12.9 to 231.3 ± 11.5 ng/ml p = 0.02), p-selectin (101.1 ± 8.2 to 87.4 ± 6.6 ng/ml p = 0.01), and e-selectin (38.5 ± 3.3 to 33.6 ± 2.6 ng/ml p = 0.03), without an overt change in endothelial function. Inflammation improved (CRP; 8.5 ± 1.4 to 5.6 ± 0.8 mmol/L p = 0.001), there was a reduction in clot function (LT; 2,987 ± 494 to 1,926 ± 321 s p = 0.02) but not clot structure.

Conclusion: Exenatide caused a 3% reduction in weight, improved serum markers of endothelial function, inflammation, and clot function reflecting an improvement in cardiovascular risk indices in these women with PCOS. This suggests exenatide could be an effective treatment for obese women with PCOS.

Journal Article Type Article
Publication Date Apr 2, 2019
Journal Frontiers in Endocrinology
Print ISSN 1664-2392
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 10
Article Number 189
APA6 Citation Dawson, A. J., Sathyapalan, T., Vince, R., Coady, A., Ajjan, R. A., Kilpatrick, E. S., & Atkin, S. L. (2019). The effect of exenatide on cardiovascular risk markers in women with Polycystic Ovary Syndrome. Frontiers in endocrinology, 10, https://doi.org/10.3389/fendo.2019.00189
DOI https://doi.org/10.3389/fendo.2019.00189
Publisher URL https://www.frontiersin.org/articles/10.3389/fendo.2019.00189/full

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Copyright Statement
© 2019 Dawson, Sathyapalan, Vince, Coady, Ajjan, Kilpatrick and Atkin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.



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