{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T13:03:11Z","timestamp":1779195791941,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Polycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive\u2010age women, often accompanied by insulin resistance, obesity, and increased metabolic risk. While Metformin (MET) is commonly used to improve insulin sensitivity, its limited effect on postprandial glucose has led to interest in combination therapies. Exenatide (EX), a glucagon\u2010like peptide\u20101 receptor agonist, may offer complementary benefits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effectiveness of EX combined with MET (EX\u2009+\u2009MET) versus MET alone (MET) in improving insulin resistance and metabolic outcomes in overweight and obese women with PCOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This systematic review and meta\u2010analysis included five randomized controlled trials (<jats:italic>n<\/jats:italic>\u2009=\u2009339) and followed Preferred Reporting Items for Systematic reviews and Meta\u2010Analysis Extension guidelines. The primary outcome was the change in insulin resistance (Homeostatic Model Assessment of Insulin Resistance [HOMA\u2010IR]). Secondary outcomes included body mass index (BMI), 2\u2010h oral glucose tolerance test (OGTT), lipid profile, and reproductive hormones.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Pooled analysis revealed that EX\u2009+\u2009MET significantly reduced HOMA\u2010IR (mean difference [MD]: \u20130.9; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), improved 2\u2010h OGTT values (MD: \u20131.78; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), reduced BMI (MD: \u20130.4; <jats:italic>p<\/jats:italic>\u2009=\u20090.03), with low heterogeneity. Combination therapy also improved triglyceride and total cholesterol levels. However, no significant effects were observed on reproductive hormones or low\u2010density lipoprotein and high\u2010density lipoprotein cholesterol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While hormonal and some lipid changes were not significant, their inclusion highlights the multifaceted impact of PCOS and the need for longer\u2010term studies. By improving insulin sensitivity and weight\u2010related outcomes, EX\u2009+\u2009MET may be a valuable clinical option for metabolically high\u2010risk PCOS patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.16296","type":"journal-article","created":{"date-parts":[[2025,4,30]],"date-time":"2025-04-30T02:41:29Z","timestamp":1745980889000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Exenatide plus Metformin versus Metformin alone on insulin resistance in women with Polycystic Ovary Syndrome: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-7733-7774","authenticated-orcid":false,"given":"Abd\u2010alrahman","family":"Al\u2010Qudah","sequence":"first","affiliation":[{"name":"Faculty of Medicine University of Jordan  Amman Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5683-1630","authenticated-orcid":false,"given":"Mohammad","family":"Al\u2010Hanaktah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Jordan  Amman Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reham","family":"Albadaineh","sequence":"additional","affiliation":[{"name":"Jordanian Royal Medical Services  Amman Jordan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Office on Women's Health.Polycystic ovary syndrome.https:\/\/womenshealth.gov\/a-z-topics\/polycystic-ovary-syndrome. 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