Effect of liraglutide on atrial natriuretic peptide, adrenomedullin, and copeptin in PCOS
Context: Women with polycystic ovary syndrome (PCOS) have an increased risk of cardiovascular disease (CVD), and biomarkers can be used to detect early subclinical CVD. Midregional-pro-adrenomedullin (MR-proADM), midregional-pro-atrial natriuretic peptide (MR-proANP) and copeptin are all associat...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Bioscientifica
2018-01-01
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| Series: | Endocrine Connections |
| Subjects: | |
| Online Access: | http://www.endocrineconnections.com/content/7/1/115.full |
| Summary: | Context: Women with polycystic ovary syndrome (PCOS) have an increased risk of
cardiovascular disease (CVD), and biomarkers can be used to detect early subclinical
CVD. Midregional-pro-adrenomedullin (MR-proADM), midregional-pro-atrial natriuretic
peptide (MR-proANP) and copeptin are all associated with CVD and part of the delicate
system controlling fluid and hemodynamic homeostasis through vascular tonus and
diuresis. The GLP-1 receptor agonist liraglutide, developed for treatment of type 2
diabetes (T2D), improves cardiovascular outcomes in patients with T2D including a
decrease in particular MR-proANP.
Objective: To investigate if treatment with liraglutide in women with PCOS reduces
levels of the cardiovascular biomarkers MR-proADM, MR-proANP and copeptin.
Methods: Seventy-two overweight women with PCOS were treated with 1.8 mg/
day liraglutide or placebo for 26 weeks in a placebo-controlled RCT. Biomarkers,
anthropometrics, insulin resistance, body composition (DXA) and visceral fat (MRI) were
examined.
Results: Baseline median (IQR) levels were as follows: MR-proADM 0.52 (0.45–0.56) nmol/L,
MR-proANP 44.8 (34.6–56.7) pmol/L and copeptin 4.95 (3.50–6.50) pmol/L. Mean
percentage differences (95% CI) between liraglutide and placebo group after treatment
were as follows: MR-proADM −6% (−11 to 2, P = 0.058), MR-proANP −25% (−37 to −11,
P = 0.001) and copeptin +4% (−13 to 25, P = 0.64). Reduction in MR-proANP concentration
correlated with both increased heart rate and diastolic blood pressure in the liraglutide
group. Multiple regression analyses with adjustment for BMI, free testosterone, insulin
resistance, visceral fat, heart rate and eGFR showed reductions in MR-proANP to be
independently correlated with an increase in the heart rate.
Conclusion: In an RCT, liraglutide treatment in women with PCOS reduced levels of
the cardiovascular risk biomarkers MR-proANP with 25% and MR-proADM with 6%
(borderline significance) compared with placebo. The decrease in MR-proANP was
independently associated with an increase in the heart rate. |
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| ISSN: | 2049-3614 2049-3614 |