Endocrinology, Diabetes & Metabolism

Real-World Metabolic Improvements in Women With and Without Polyendocrine Metabolic Syndrome via a Multidisciplinary Telehealth Care Platform

Graphical abstract from Endocrinology, Diabetes & Metabolism
Open the figure at full size
Graphical abstract. Huddleston et al.
Cohort study of 919 peopleInterventions
Follow

Abstract

OBJECTIVE: To evaluate metabolic outcomes in women with and without Polyendocrine Metabolic Ovarian Syndrome (PMOS, formerly Polycystic Ovary Syndrome (PCOS))) receiving multidisciplinary care through a women's health telehealth platform that combines physician and registered dietitian support. METHODS: Retrospective cohort analysis of 919 women with BMI ≥ 25 initiating care in 2024, with ≥ 6 months follow-up (mean 9.6 months). Participants included 557 with PMOS and 362 without. Outcomes extracted from the electronic health record (EHR) included change in weight, HbA1c, HOMA-IR, fasting insulin, fasting glucose, ALT, AST and total cholesterol between baseline and last measured value. Linear regression models adjusted for baseline values of each outcome, age, BMI, race/ethnicity and follow-up time. RESULTS: Significant improvements were observed across all metabolic markers for the group overall: HOMA-IR (-14.0%), fasting insulin (-15.6%), fasting glucose (-13.0%), HbA1c (-6.2%), ALT (-21.2%), AST (-25.5%), total cholesterol (-8.0%) and weight (-4.9%). PCOS status was not associated with differential improvement in any outcome after adjustment. GLP-1 receptor agonist use was associated with greater weight loss; however, improvements were also observed in the no-medication group. CONCLUSIONS: Women with PCOS achieved metabolic improvements equivalent to those without PMOS through a multidisciplinary telehealth model despite presenting with a more adverse metabolic profile at baseline.

From the paper

Participants

A total of 3117 women initiated care between 1 January and 31 December 2024.

Results, 3.1 Study Population and Baseline Characteristics

Follow-up

Retrospective cohort analysis of 919 women with BMI ≥ 25 initiating care in 2024, with ≥ 6 months follow-up (mean 9.6 months).

Methods

Result

Compared to no pharmacologic weight loss support, GLP-1 RA use was significantly associated with greater weight loss in adjusted models, whether prescribed alone (−10.1 lbs, 95% CI −14.0, −6.2) or in combination with metformin (−7.1 lbs, 95% CI −10.4, −3.9).

Results, 3.3 Association Between Change in Outcome Values, Exposures and Covariates

Limitation

With a retrospective observational design, causation cannot be assigned and unmeasured confounding cannot be excluded.

4 Discussion

Quoted word for word from the full text on onlinelibrary.wiley.com.