Glucagon-like peptide-1 receptor agonists and cardiometabolic risk factors in Polycystic Ovary Syndrome: role of race/ethnicity

Abstract

Background: Polycystic Ovary Syndrome (PCOS), the most common endocrine disorder in reproductive-age women, is characterized by androgen excess, polycystic appearance of the ovaries, and ovulatory dysfunction. PCOS women have an increased prevalence of cardiovascular risk factors, such as increased blood pressure, insulin resistance (IR), and obesity. We have previously demonstrated that glucagon-like peptide-1 receptor agonists (GLP1RA) improve IR and obesity in a rat model of PCOS. Recent evidence suggests that Black Women (BW) with PCOS have an increased incidence of cardiometabolic risk factors compared to their White Women (WW) counterparts. We tested the hypothesis that GLP1RA has a differential effect on cardiometabolic risk factors in BW with PCOS versus WW with PCOS. Methods: The University of Mississippi Medical Center de-identified patient data from January 2013 – September 2022 were obtained from electronic medical records (EMR) using UMMC's Research Data Warehouse. Patients with 1) PCOS, 2) type 2 diabetes mellitus (T2DM), 3) documented hemoglobin A1c (HbA1c), and 4) GLP1RA prescription were identified. Cardiometabolic risk factors such as HbA1c, body mass index (BMI), and systolic and diastolic blood pressure (SBP and DBP respectively) were analyzed and compared between BW and WW with PCOS/T2DM. ICD-10 code of PCOS and T2DM: E28.2 and E11.9 respectively. Data are presented as mean ± standard deviation. Results: EMRs of 3756 PCOS patients were obtained. 13.8% of PCOS patients also had a diagnosis of T2DM with documented HbA1c, and 10.4% of them (54 patients) were on a GLP1RA. Of the 54 patients, 35 were BW. In our cohort, BW with PCOS/T2DM had a similar age (38 ± 12 vs 34 ± 11 years of age, p=NS), perimenopausal status, and smoking status as WW with PCOS/T2DM. Compared to WW with PCOS/T2DM on GLP1RA, BW women with PCOS/T2DM had significantly higher HbA1c (8.0 ± 1.0 vs 7.0 ± 0.7 %, p<0.05). There was no difference in BMI, SBP, or DBP between groups. Furthermore, on GLP1RA, there was no difference in the magnitude of change of HbA1c, BMI, SBP, or DBP in BW compared in WW on GLP1RA. Conclusions: BW with PCOS/T2DM had higher HbA1c on GLP1RA compared to WW counterparts. However, there was similar BMI, SBP, and DBP between the two groups. Furthermore, there was no difference in the magnitude of change in cardiometabolic parameters on GLP1RA between the two groups. Race/ethnicity may significantly effect HbA1c, but it does not appear to affect the efficaciousness of GLP1RA on the cardiometabolic profile in women with PCOS. NIGMS P20GM121334 and P20GM104357, NIDDK R21DK11350 and F30DK127527, NHLBI P01HL51971 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.