Abstract 4368319: Effects of Glucagon-Like Peptide-1 Receptor Agonists on Endothelial Function and Cardiometabolic Outcomes in Polycystic Ovary Syndrome: A Systematic Review
Bibliographic record
Abstract
Background: Polycystic ovary syndrome (PCOS) is associated with early-onset cardiometabolic dysfunction, including insulin resistance and vascular impairment. Although glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved for metabolic disorders, their potential to improve both endocrine and endothelial parameters in PCOS remains under-investigated. Objective: To systematically assess the effects of GLP-1RAs on endothelial function and cardiometabolic risk markers in reproductive-age women with PCOS. Methods: Following PRISMA 2020 guidelines, we searched four databases (Embase, PubMed, Cochrane, Web of Science) for studies published from 2000 to May 31, 2025. Seven independent reviewers screened 631 records using Rayyan (450 after deduplication). Full-text assessment identified 18 eligible trials. Inclusion criteria: randomized or prospective cohort design, women aged 18–45 with diagnosed PCOS, and a GLP-1RA intervention of ≥12 weeks. Data were extracted on study design, drug type, duration, outcomes, and adverse events. Risk of bias was evaluated using RoB 2.0 for RCTs and the Newcastle–Ottawa Scale (NOS) for cohorts. A narrative synthesis was conducted due to heterogeneity in design and outcome reporting. Results: Eighteen trials (715 GLP-1RA-treated, 399 control participants; mean age 26 ± 4 y, BMI 33 ± 5 kg/m2) evaluated liraglutide (11), exenatide (5), or semaglutide (2). HOMA-IR decreased in 6/16 trials (typical absolute drop ≈ 1 unit); 9 were neutral, 1 increased. Systolic BP declined in 5/15 trials (≈ 2–6 mm Hg); 9 were neutral, 1 increased. LDL-C dropped in 7/13 trials (median ≈ 10 mg/dL); 5 were neutral, 1 increased. Endothelial function improved in both trials that assessed FMD (+2%, +3%). Adverse events were mild: transient nausea (15%) and injection-site discomfort (9%); no reports of pancreatitis or severe hypoglycemia. Risk-of-bias summary: two low-risk, 13 some-concerns, and three high-risk studies, as assessed by RoB 2.0 and the Newcastle–Ottawa Scale (NOS). Conclusions: GLP-1RAs show consistent signals of benefit across insulin sensitivity, lipid metabolism, and vascular outcomes in women with PCOS, with favorable safety profiles. Clinical Perspective: Targeting early endothelial and metabolic dysfunction with GLP-1RAs may reduce long-term cardiovascular risk in PCOS; high-quality, longer-duration trials are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.024 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.008 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".