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Pugliese G, de Alteriis G, Muscogiuri G, Barrea L, Verde L, Zumbolo F, Colao A, Savastano S. Liraglutide and polycystic ovary syndrome: is it only a matter of body weight? J Endocrinol Invest 2023:10.1007/s40618-023-02084-6. [PMID: 37093453 PMCID: PMC10372121 DOI: 10.1007/s40618-023-02084-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023]
Abstract
Despite Polycystic Ovary Syndrome (PCOS) is a very prevalent disorder among women of reproductive age, there is widespread agreement that until now, no pharmacological options are available to tackle the entire spectrum of clinical manifestations encountered in the clinical practice. Obesity and insulin resistance, which commonly characterized this syndrome, prompted the design of studies investigating the effects of glucagon-like peptide 1 (GLP-1) receptor agonists (GLP-1RA) in PCOS. Indeed, a very impressive number of randomized controlled clinical trials (RCTs) and systematic reviews provided robust evidence on the effectiveness of GLP-1RA in PCOS as a new, appealing approach, producing both satisfactory and permanent weight loss, and improvement of insulin resistance at the same time. However, most of the subjects included in the RCTs are PCOS patients with obesity/overweight, whereas a portion of PCOS women, which can even reach 50%, might present a lean phenotype. Moreover, some benefits on clinical and metabolic features of PCOS may not have fully emerged due to the low or medium doses employed in the vast majority of the current studies. Thus, pitfalls in the methodology of these studies have led sometimes to misleading results. In addition, some aspects of GLP-1 beyond weight loss, such as preclinical evidence on GLP-1 effects in directly modulating the hypothalamus-pituitary-gonadal axis, or the effects of GLP-1RA on clinical and biochemical expression of hyperandrogenism, still deserve a greater insight, especially in light of a possible therapeutic use in PCOS women independently of obesity. Aim of this review is to further unravel the possible role of GLP-1 in PCOS pathogenesis, tempting to provide additional supports to the rationale of treatment with GLP-1RA in the management of PCOS also independent of weight loss. For this purpose, the outcomes of RCTs investigating in PCOS the anthropometric and metabolic changes have been treated separately to better underpin the effects of GLP-1 RA, in particular liraglutide, beyond weight loss.
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Affiliation(s)
- G Pugliese
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy.
| | - G de Alteriis
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
| | - G Muscogiuri
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
| | - L Barrea
- Department of Humanities, Telematic University Pegaso, Naples, Italy
| | - L Verde
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
| | - F Zumbolo
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
| | - A Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
- Unesco Chair "Education for Health and Sustainable Development", University "Federico II" Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - S Savastano
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University of Naples "Federico II", Naples, Italy
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Mansilla E, Roque G, Sosa YE, Tarditti A, Goya RG. A Rat Treated with Mesenchymal Stem Cells Lives to 44 Months of Age. Rejuvenation Res 2016; 19:318-21. [PMID: 26650400 DOI: 10.1089/rej.2015.1777] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is a growing interest in the potential of mesenchymal stem cells (MSCs) for implementing regenerative medicine. We assessed the effect of intravenous administration of human bone marrow-derived MSC on the life span of a single Sprague-Dawley female rat. The treatment was started when the rat was 6 months old and the cells were administered every 2 weeks afterward. The treatment did not induce any obvious changes in body growth or behavior and the rat showed the typical age changes for this strain, except that, unlike intact counterparts, the animal did not develop mammary tumors or pituitary gland hyperplasia. The more remarkable effect of the treatment was on life span, which was 44 months compared with an average of 36 months for intact laboratory rats. We conclude that despite the low N value, it is likely that the MSC treatment was responsible for the exceptionally long survival of the rat. The potential rewards of confirming the present findings warrant further studies involving higher N values.
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Affiliation(s)
- Eduardo Mansilla
- 1 Tissue Engineering, Regenerative Medicine and Cell Therapies Laboratory, CUCAIBA, Buenos Aires Province Ministry of Public Health , La Plata, Argentina
| | - Gustavo Roque
- 1 Tissue Engineering, Regenerative Medicine and Cell Therapies Laboratory, CUCAIBA, Buenos Aires Province Ministry of Public Health , La Plata, Argentina
| | - Yolanda E Sosa
- 2 Institute for Biochemical Research (INIBIOLP), Histology B & Pathology B, School of Medicine, National University of La Plata , La Plata, Argentina
| | - Adrian Tarditti
- 1 Tissue Engineering, Regenerative Medicine and Cell Therapies Laboratory, CUCAIBA, Buenos Aires Province Ministry of Public Health , La Plata, Argentina
| | - Rodolfo G Goya
- 2 Institute for Biochemical Research (INIBIOLP), Histology B & Pathology B, School of Medicine, National University of La Plata , La Plata, Argentina
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Abstract
Obesity in middle-aged humans is a risk factor for many age-related diseases and decreases life expectancy by about 7 years, which is roughly comparable to the combined effect of all cardiovascular disease and cancer on life span. The prevalence of obesity increases up until late middle age and decreases thereafter. Mechanisms that lead to increased obesity with age are not yet well understood, but current evidence implicates impairments in hypothalamic function, especially impairments in the ability of hypothalamic pro-opiomelanocortin neurons to sense nutritional signals. The rapid increase in the prevalence of obesity at all ages in the past decade suggests that, in the next two or three decades, diseases associated with obesity, especially diabetes, will begin to rise rapidly. Indeed, these trends suggest that for the first time in modern history, the life expectancy of people in developed societies will begin to decrease, unless the rapid increase in the prevalence of obesity can be reversed.
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Affiliation(s)
- Tooru Mizuno
- Fishberg Center for Neurobiology, Neurobiology of Aging Laboratories, Department of Geriatrics, Mt. Sinai School of Medicine, New York, NY 10029, USA
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Roe FJ, Lee PN, Conybeare G, Kelly D, Matter B, Prentice D, Tobin G. The Biosure Study: influence of composition of diet and food consumption on longevity, degenerative diseases and neoplasia in Wistar rats studied for up to 30 months post weaning. Food Chem Toxicol 1995; 33 Suppl 1:1S-100S. [PMID: 7713457 DOI: 10.1016/0278-6915(95)80200-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The 1200-rat Biosure Study had six interrelated aims: (1) To see whether dietary restriction (80% ad lib.) reduces the age-standardized incidence of fatal or potentially fatal neoplasia before the age of 30 months. (2) To see whether the beneficial effects of diet restriction can be achieved by (a) limiting the daily period of access to food to 6 hr, or by (b) limiting the energy value of the diet. (3) To see whether reduced calorie intake between weaning and age 4 months influences survival and/or incidence of non-neoplastic and neoplastic diseases. (4) To compare effects of food consumption, energy intake and protein intake on survival and disease. (5) To study the relationships between body weight at different ages with eventual survival and disease incidence. (6) To provide a database for studying relationships between various in-life measurements and eventual survival and disease incidence in individual animals. Twelve groups of SKF Wistar rats consisting of 50 animals of each sex were fed according to different dietary regimens from when they were weaned at the age of 3 wk until they died, or had to be killed because they were sick, or until the experiment was terminated at 30 months. For five of the 12 dietary regimens, satellite groups consisting of 30 animals per sex were maintained in parallel and used to supply information on the effect of diet on circulating hormone levels during the course of the study. During the 13 wk post weaning a Standard Breeder diet (SB) was provided either ad lib. (four groups), 80% ad lib. (three groups), or with access to food limited to 6 hr per day (one group). During this same period two other groups were fed a Low Nutrient Breeder diet (LB) ad lib. A further group was fed a Low Nutrient Maintenance (high fibre) diet (LM) ad lib. Finally, one group was fed the high protein Porton Rat diet (PR) ad lib.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- F J Roe
- Sandoz Pharma Ltd., Basle, Switzerland
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Abstract
In organs other than the brain, cell activation seems to increase "wear and tear," e.g., by increased free-radical formation, and so to cause an increased rate of aging. However, activation of nerve cells within the physiological range seems to lead to maintenance of neurons during aging and in Alzheimer's disease, possibly by preferentially stimulating the action of protective mechanisms such as DNA repair. This "use it or lose it" principle might explain why certain neurons degenerate in aging or Alzheimer's disease while others do not, and why recovery of various neuronal systems during aging has been obtained by restoration of the missing stimulus. Consequently, neuronal activation might provide a means of prolonging its optimal function for the full length of our natural life span.
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Affiliation(s)
- D F Swaab
- Netherlands Institute for Brain Research, Amsterdam, The Netherlands
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Quigley K, Goya R, Nachreiner R, Meites J. Effects of underfeeding and refeeding on GH and thyroid hormone secretion in young, middle-aged, and old rats. Exp Gerontol 1990; 25:447-57. [PMID: 2257891 DOI: 10.1016/0531-5565(90)90033-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The effects of a 50% reduction in normal food intake for a period of 10 weeks were measured on secretion of growth hormone (GH), thyroxine (T4), and triiodothyronine (T3) in 5 1/2-6 1/2-month old, 13 1/2-month-old, and 17 1/2-18 1/2-month-old male rats. In full-fed controls, GH, T3, and T4 were lower in the old and middle-aged than in the young rats. By the 10th week of underfeeding, GH, T3, and T4 were reduced in all age groups, but the decrease in T3 and T4 in the middle-aged and old rats was greater than in the young rats. Pulses of GH ceased in all the underfed groups. Upon refeeding for 5 days, pulses of GH and levels of GH returned to full-fed control values in the young and middle-aged but not in the old rats. T3 values in the young and middle-aged rats returned to full-fed control levels, but remained below control levels in the old rats. T4 values reached control levels in all age groups upon refeeding. The differences in the response to underfeeding and refeeding by the middle-aged and old rats as compared to the young rats may be due to their initially lower secretion of GH and thyroid hormones and to the age-related decrease in neuroendocrine function.
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Affiliation(s)
- K Quigley
- Department of Physiology, Michigan State University, East Lansing 48824-1101
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Abstract
The genome and environmental agents are believed to regulate aging processes mainly via the homeostatic and integrative mechanisms of the body, which consist primarily of the neuroendocrine, immune and cell-to-cell communicating systems. Of these, the neuroendocrine system is considered to be the most important since it regulates to a greater or lesser degree all body functions, in old age as well as in early and mature life. We have studied mainly three aging events in the rat: the reproductive decline, development of numerous mammary and pituitary tumors and the decrease in GH secretion and protein synthesis. We have found that all three are caused primarily by faults that develop in hypothalamic function, particularly the decline in norepinephrine (NE) and dopamine (DA) activity. This decline appears to be caused largely by damage to hypothalamic neurons as a result of the chronic action of hormones, toxins, free radicals, cross linkages, lipofuscin accumulation and "wear and tear". Administration of drugs that increase hypothalamic NE and DA activity can delay or reverse all three aging events. Changes in hormone secretion, estrous cycles, tumor development and protein synthesis can be measured and used as "biomarkers of aging" in the rat.
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Affiliation(s)
- J Meites
- Department of Physiology, Michigan State University, East Lansing 48824-1101
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