Clinical efficacy of liraglutide combined with pioglitazone in obese polycystic ovary syndrome and its effects on the serum chemerin/visfatin ratio.

OBJECTIVE

To evaluate the clinical efficacy and safety of liraglutide combined with pioglitazone in obese patients with polycystic ovary syndrome (PCOS), and to explore the predictive value of serum chemerin, visfatin and their ratio for the improvement of insulin resistance (IR).

METHODS

A total of 338 obese PCOS women enrolled in this retrospective study were divided into two groups. The control group (n=168) received pioglitazone alone (15-30 mg/day), while the combination group (n=170) received liraglutide (0.6-1.8 mg/day) plus pioglitazone for 24 weeks. Anthropometric, metabolic, hormonal and adipokine-related indicators were compared before and after treatment. Correlation analysis, ROC curve analysis and multivariate logistic regression analysis were subsequently performed.

RESULTS

After treatment, the combination group exhibited significantly better improvements in multiple anthropometric, metabolic, hormonal and adipokine parameters than the control group (all P<0.001). The overall clinical response rate was markedly higher in the combination group (92.35% vs. 78.57%, P<0.001), whereas the incidence of adverse events showed no significant between-group difference (P=0.628). Baseline HOMA-IR was positively correlated with chemerin (r=0.569), visfatin (r=0.360) and chemerin/visfatin ratio (r=0.580) (all P<0.001). The chemerin/visfatin ratio yielded the highest predictive efficiency for IR improvement, with an AUC of 0.703. Multivariate logistic regression identified treatment regimen (OR=4.858), baseline chemerin/visfatin ratio (OR=1.281), BMI (OR=1.169), triglycerides (OR=1.874) and testosterone (OR=2.997) as independent influencing factors for IR improvement (all P<0.05). No significant interaction was observed between treatment regimen and baseline chemerin/visfatin ratio or BMI.

CONCLUSION

Liraglutide combined with pioglitazone can effectively ameliorate body mass, glucose and lipid metabolism, reproductive hormone levels and IR in obese PCOS patients, without increasing the risk of adverse events. The serum chemerin/visfatin ratio is closely correlated with IR and may serve as a promising biomarker for predicting treatment response in obese PCOS.