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Endocrine Abstracts (2019) 63 S23.3 | DOI: 10.1530/endoabs.63.S23.3

ECE2019 Symposia PCOS: can we personalise treatment? (3 abstracts)

Treatment options in cardiometabolic pcos phenotype

Mojca Jensterle


Slovenia.


Background: Cardiometabolic polycystic ovary syndrome (PCOS) phenotype is predominantly characterized by obesity. It is clearly associated with impaired metabolic and reproductive health, whereas implications on cardiac health are mostly limited with the exploration of cardiovascular risk factors without actual cardiovascular endpoints. There is a relative lack of systematic prospective studies investigating long-term effects of different treatment options that include phenotype specific outcomes.

Aim: We will cover different treatment interventions available for cardiometabolic PCOS phenotype. The treatment goals will include weight reduction, improvements of metabolic health, decrease of cardiovascular risk and increase in the fertility potential.

Results: Multicomponent lifestyle modification (LSM) is crucial intervention for this phenotype. Metformin in addition to LSM should be considered for managemnent of weight and metabolic outcomes. In clinical practice, LSM and metformin are often insufficient, by means of decreasing weight, preventing conversion rate from normal glucose tolerance to prediabetes and to type 2 diabetes and improving reproductive outcomes. Potential new modifiable risk factors should be addressed in this high-risk population. Some limited data from preclinical and clinical studies support an adjunct management with agents mediating through glucagon-like peptide-1 (GLP-1) axis, including GLP-1 receptor agonists and dipeptidyl peptidase-4 inhibitors. GLP-1 receptor agonists have shown a beneficial effect on weight loss, some cardiometabolic risk factors and some reproductive outcomes. In severly affected individuals, bariatric surgery can be effective in achieving significant weight loss, reduction of cardiovascular risk and might result in a striking PCOS resolution rate.

Conclusions: Management of patients with cardiometabolic PCOS phenotype should aim to reduce weight, improve metabolic derangemnets, decrease risk for cardiovascular diseases and increase fertility potential. There exist some unsolved questions that implicate an exciting new research field with potential wider clinical implications. All this will be put in perspective in this talk.

Volume 63

21st European Congress of Endocrinology

Lyon, France
18 May 2019 - 21 May 2019

European Society of Endocrinology 

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