The effect of exenatide on cardiovascular risk markers in women with polycystic ovary syndrome

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

Research output: Contribution to journalArticle

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.

Original languageEnglish
Article number189
JournalFrontiers in Endocrinology
Volume10
Issue numberAPR
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Polycystic Ovary Syndrome
Selectins
Biomarkers
Intercellular Adhesion Molecule-1
Inflammation
Weights and Measures
Weight Loss
P-Selectin
E-Selectin
Vascular Cell Adhesion Molecule-1
Hyperemia
Manometry
Fibrin
Insulin Resistance
exenatide

Keywords

  • Blood clot function
  • Cardiovascular risk
  • Endothelial function
  • Exenatide
  • GLP-1 receptor agonists
  • Inflammation
  • Polycystic ovary syndrome

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Dawson, A. J., Sathyapalan, T., Vince, R., Coady, A. M., Ajjan, R. A., Kilpatrick, E. S., & Atkin, S. (2019). The effect of exenatide on cardiovascular risk markers in women with polycystic ovary syndrome. Frontiers in Endocrinology, 10(APR), [189]. https://doi.org/10.3389/fendo.2019.00189

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.

In: Frontiers in Endocrinology, Vol. 10, No. APR, 189, 01.01.2019.

Research output: Contribution to journalArticle

Dawson, Alison J. ; Sathyapalan, Thozhukat ; Vince, Rebecca ; Coady, Anne Marie ; Ajjan, Ramzi A. ; Kilpatrick, Eric S. ; Atkin, Stephen. / The effect of exenatide on cardiovascular risk markers in women with polycystic ovary syndrome. In: Frontiers in Endocrinology. 2019 ; Vol. 10, No. APR.
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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.",
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