4. Discussion
T2D, PCOS, weight reduction, overweight, Diabetes, weight loss
ADVERSE EVENTS, EVENTS, OBESE, DIABETES
Participants in the dulaglutide + CRD group took a shorter time to achieve a 7% weight loss goal than those in the CRD group, which suggests that dulaglutide could favor high efficiency in achieving the target weight loss. This finding was generally supported by the results of previous studies that have demonstrated that GLP-1 RA was effective in weight reduction in overweight and obese women with PCOS [There were no significant differences in visceral fat reduction between the groups after equivalent weight loss. The significant reduction in VAT in the CRD group was consistent with previous studies’ results that have shown that weight reduction induced by CRD was associated with a significant improvement in WC and reduced fat mass [In this trial, we found that dulaglutide combined with CRD provided additional benefits respecting HbA1c and PPG as compared with CRD after equivalent weight loss, which was consistent with earlier clinical trial findings showing that GLP-1 RAs could result in significant improvements in HbA1c and post-OGTT glucose levels in women with PCOS [There was no discernible between-group difference, despite the improved menstrual frequencies from baseline to the achievement of target weight loss being comparable between the groups. This phenomenon may be explained by the fact that the short time frame in the present study was not sufficient for evaluating changes in menstrual frequency. Moreover, the CRD group showed a significant decrease in TT and AD levels. Levels of LH, FSH, PRL, FT, DHEAS, and SHBG did not alter significantly in either group after moderate reductions in body weight, which was consistent with previous studies’ findings [Concerning adverse events, GI events are common side effects of GLP1 RAs. In our study, 37.14% of the PCOS participants with dulaglutide treatment reported at least one GI TEAE, which was comparable with those observed in individuals with T2D receiving 1.5 mg once-weekly dulaglutide as described in the Assessment of Weekly AdministRation of LY2189265 in Diabetes (AWARD) trials [Our study has certain limitations. First, the intervention period was comparatively short and different in the two groups, which may weaken the observed usefulness of GLP-1 RA in treating PCOS. However, long-term efficacy of dulaglutide combined with CRD remains to be studied. Second, different durations to attain the target weight loss or the implications of the trial being unblinded may have introduced bias. Third, in our experiment, physical exercise was not mandated, since our aim was to determine whether the dietary regimen in isolation or in combination with medication would act on VAT reduction. Fourth, since the endpoints of the study occurred when the targeted weight loss was reached, not all reproductive hormones were measured during menstruation. Lastly, although VAT was not measured using magnetic resonance imaging (MRI) or computed tomography (CT), DXA-VAT has been validated against either MRI or CT [