Insulin Resistance and Weight Loss in Obese Women with Polycystic Ovary Syndrome Treated with Liraglutide—Single Institution Experience

Abstract

Background: Insulin resistance contributes to the pathogenesis of polycystic ovary syndrome (PCOS) in obese women, but its predictive value for weight loss with liraglutide treatment is unknown. Methods: Retrospective cohort study of 16 obese (BMI ≥30 kg/m2), nondiabetic women aged 18-42 with PCOS who were seen in a weight loss clinic between November 2014 and November 2016 and prescribed liraglutide (either 1.8 mg/day or 3.0 mg/day based on insurance coverage) and metformin. Maximum weight loss achieved from baseline until 2 to 13 months post-liraglutide initiation was compared. Spearman’s rank correlation was used to establish the relationship between pre-treatment Homeostatic Model for Insulin Resistance (HOMA-IR) and % weight loss. The University of Pennsylvania Institutional Review Board approved the study. Results: Overall median weight loss was 4.4 kg (-3.4% of initial weight). Median weight loss was -4.7 kg (-3.7%) in women treated with 3.0 mg daily (n=6) and -2.5 kg (-2.0%) in women treated with 1.8 mg (n=10). 6/16 (37.5%) of women experienced >5% weight loss: 2/6 women treated with 3.0 mg daily dosing, and 4/10 women treated with 1.8 mg daily. HOMA-IR at baseline was not associated strongly with % weight loss achieved for all subjects (rs= -0.31, p=0.24), or when stratified to examine those subjects receiving 3.0 mg daily (rs= -0.20; p=0.70) or 1.8 mg daily (rs= -0.36, p=0.31). Conclusions: In this small study, our findings suggest that insulin resistance at baseline does not strongly correlate with maximum weight loss achieved using liraglutide. Furthermore, our study suggests that liraglutide is an effective tool for weight loss. Overall, 37.5% of women achieved >5% weight loss from baseline, meeting the FDA’s categorical efficacy target for weight loss medications. Disclosure A. Crawford: None. L.G. Cooney: None. N. Jochym: None. A. Dokras: Consultant; Self; Fractyl Laboratories, Inc. A. Amaro: Consultant; Self; Novo Nordisk Inc., Andrew Technologies, LLC.