A Clinical Study on the Metabolic and Hormonal Effects of Terzepate in Women With Polycystic Ovary Syndrome and Obesity
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Background: Polycystic ovary syndrome (PCOS) is an endocrine and metabolic dysfunction common in pre-menopausal women. Often linked to obesity, insulin resistance, hyperandrogenism, menstrual irregularities, and the risk for metabolic comorbidities. Relationship of obesity and insulin resistance in the pathophysiology and clinical presentation of PCOS is important. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist that has been shown to have significant weight and glycemic lowering effects. But there is very little evidence about its metabolic and hormonal effects specifically in women with PCOS. Hypothesis: The purpose of this study was to assess the effects of Tirzepatide treatment on women with PCOS and obesity, on their anthropometric, metabolic, hormonal and clinical parameters. Design: A retrospective observational study was carried out in 56 women with PCOS and obesity. The dose of Tirzepatide was initiated at 2.5 mg weekly, progressed to 5 mg weekly and then to 7.5 mg weekly as maintenance treatment. Baseline and post-treatment data included body weight, body mass index (BMI), fasting blood glucose (FBG), levels of glycated hemoglobin (HbA1c), insulin resistance, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), as well as certain clinical symptoms of PCOS. Paired statistical tests were used to analyze the continuous variables and the chi-square test was used to analyze the categorical variables. The p-value was determined and considered statistically significant at < 0.05. Results: It was observed that treatment was associated with significant reductions in body weight, BMI, fasting blood glucose and HbA1c. Mean body weight decreased from 84.80 ± 12.74 kg to 76.71 ± 10.84 kg (p=0.0004), while BMI decreased from 36.51 ± 6.14 to 32.49 ± 4.68 kg/m² (p=0.0002). Mean fasting blood glucose decreased from 6.89 ± 0.78 to 5.57 ± 0.42 mmol/L (p<0.0001), and HbA1c decreased from 5.7 ± 0.6% to 4.9 ± 0.4% (p<0.0001). Among respondents, 75.0% reported hormonal normalization for LH, 80.36% for FSH and 82.14% for testosterone. In 78.57% of patients, insulin resistance improved or normalized. There was also a significant reduction in other symptoms associated with PCOS such as acne, acanthosis nigricans, depression/anxiety, difficulty losing weight, ovarian cysts, sleep apnea and irregular menstruation. Conclusions: There was a marked improvement in anthropometric and glycemic parameters and in selected hormonal and clinical parameters in women with PCOS and obesity after treatment with tirzepatide. These results indicate that Tirzepatide has potential metabolic and clinical benefits in this population. The study was retrospective, small in size and followed patients for a relatively short duration, however, to validate the results and establish long-term reproductive and safety outcomes, larger prospective, randomized controlled studies are needed.
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