Effects Of Exenatide On Insulin Resistance And Epicardial Fat Thickness In Obese Polycystic Ovary Syndrome Patients

Objective:polycystic ovary syndrome is the most common gynecological endocrine disorder among women of reproductive age,the main pathophysiological basis of which is insulin resistance.Obesity patients with polycystic ovary syndrome are often complicated by cardiovascular metabolic disorders,which greatly increase the risk of atherosclerosis and cardiovascular disease,and the Epicardium adipose thickness(EAT)is closely related to the risk of cardiovascular disease in patients with polycystic ovary.This study was to investigate the effects of GLP-1 receptor agonist--exenatide on insulin resistance and Epicardium adipose thickness for obesity patients with polycystic ovary syndrome.methods:A total of 88 obese patients with polycystic ovary syndrome diagnosed in our Department of Endocrinology between December 2015 and June 2017 were selected as subjects.They were randomly divided into two groups according to time and random number tables,46 patients in the test group and 42 in the control group.The control group was treated with metformin orally,0.5 g each time,3 times a day the test group was treated with metformin,0.5g each time,3 times a day,plus Exenatide Injection 30 minutes before breakfast and dinner,subcutaneous injection,5ug each time,2 times a day,after 4 weeks,exenatide dose increased to 10ug each time,2 times a day.The whole treatment cycle lasted for 24 weeks.Observe the changes of each index respectively at baseline and twenty-fourth weeks,the index include body weight,BMI,abdominal circumference,low density lipoprotein,triglyceride,blood glucose and insulin levels after 75g oral glucose tolerance test(OGTT)after Oh,1h,2h,3h,insulin resistance index(HOMA-IR),ultrasound measured Epicardium adipose thickness.Statistical methods were used for statistical analysis to compare the average body weight,abdominal circumference,BMI,low-density lipoprotein,triglyceride between the test group and the control group before and after treatment and between the two groups,and to compare the differences of blood glucose,insulin levels,Insulin resistance index,and Epicardium adipose thickness at the corresponding time after OGTT,so as to investigate how exenatide affects Insulin resistance and Epicardium adipose thickness in obesity patients with polycystic ovary syndrome.Results:After treatment in the experimental group,the average body weight,abdominal circumference,BMI,low density lipoprotein,triglyceride,blood glucose,insulin levels,insulin resistance index,and Epicardium adipose thickness after OGTT was significantly lower than before treatment,the difference was statistically significant(P<0.05);after treatment in control group,average body weight,abdominal circumference,BMI,blood glucose,insulin levels,insulin resistance index after OGTT were lower,the difference was statistically significant(P<0.05),picardium adipose thickness had no obvious change,the difference was not statistically significant(P>0.05).After treatment,compared to control group,average body weight,abdominal circumference,BMI,low density lipoprotein,triglyceride,blood glucose,insulin levels,insulin resistance index and Epicardium adipose thickness after OGTT decreased more obviously,the difference was statistically significant(P<0.05).Conclusion:Exenatide can significantly reduce body weight,improve insulin resistance and reduce blood lipids in obese patients with polycystic ovary syndrome,which obviously decrease their Epicardium adipose thickness,and reduce the risk of concurrent metabolic syndrome and cardiovascular disease.