{"id":300,"title":"Next-generation incretin therapeutics for polyendocrine metabolic ovarian syndrome: navigating current pipeline and clinical considerations","title_zh":"下一代肠促胰素疗法用于多内分泌代谢性卵巢综合征：在研管线与临床考量","url":"https://pubmed.ncbi.nlm.nih.gov/42978208","doi":"10.1080/14656566.2026.2760042","pmid":"42978208","journal":"Expert Opin Pharmacother","kind":"paper","lang":"en","published_at":"2026-11-03T00:00:00+00:00","fetched_at":"2026-11-08T03:44:04+00:00","authors":["Ozgen Saydam B","Yıldız BO"],"primary_topic":"oocyte","topics":[{"slug":"oocyte","score":5.0,"hits":["ovarian","ovary"]},{"slug":"repro-endo","score":2.0,"hits":["pcos","polycystic ovary"]},{"slug":"repro-tox","score":1.0,"hits":["lifestyle"]}],"topic_score":5.0,"preference_score":0.0,"preference_labels":[],"llm_score":72.0,"final_score":72.0,"score_dims":{"novelty":68,"rigor":62,"impact":70,"relevance":74,"translation":66},"recommend_reason":"系统梳理肠促胰素类药物从单靶点到多靶点的演进及其在PMOS（原PCOS）中的代谢与生殖证据缺口，对生殖内分泌临床决策与后续试验设计有参考价值；但为叙述性综述、缺乏原始数据，PMOS生殖结局证据仍薄弱。","keywords":["多囊卵巢综合征","肠促胰素","GLP-1受体激动剂","替尔泊肽","生殖内分泌","表型分层"],"selected":1,"story_id":139,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-endo-genetics","source_name":"PubMed · 生殖内分泌/遗传/保存","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"本文为叙述性综述，评估从单一GLP-1受体激动剂到替尔泊肽（GIP/GLP-1双受体激动）及瑞他鲁肽（GIP/GLP-1/胰高血糖素三受体激动）的演进，检索PubMed 2023年1月至2026年10月文献并补充ClinicalTrials.gov与参考文献筛查，从代谢、激素与生殖结局三方面评价证据。结果显示，司美格鲁肽等单激动剂可改善体重、脂肪分布与胰岛素抵抗，并初现生殖获益；多肠促胰素疗法在减重、内脏与异位脂肪及胰岛素抵抗方面可能更优，但PMOS专属生殖证据有限，生殖获益是否独立于减重、停药后能否维持、是否因表型而异均不明确。作者呼吁开展按表型分层的随机试验，以标准化生殖、代谢、心血管与安全性终点。","summary":"INTRODUCTION: Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a complex metabolic-reproductive disorder managed with lifestyle interventions, metformin, and symptom-directed therapies. Incretin-based therapies offer substantial metabolic benefits, but their reproductive efficacy, durability, and phenotypic safety remain incompletely defined. AREAS COVERED: This narrative review examines the therapeutic evolution from single glucagon-like peptide-1 (GLP-1) receptor agonists to dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonism with tirzepatide and triple GIP/GLP-1/glucagon receptor agonism with retatrutide. A structured PubMed search of studies published from January 2023 to October 2026 was supplemented by ClinicalTrials.gov and reference-list screening. Evidence was evaluated across metabolic, hormonal, and reproductive outcomes. EXPERT OPINION: Single GLP-1 receptor agonists, particularly semaglutide, improve weight, adiposity, and insulin resistance, with emerging evidence of reproductive benefits. Multi-incretin therapies may provide greater reductions in body weight, visceral and ectopic fat, and insulin resistance. However, PMOS-specific reproductive evidence remains limited. Whether reproductive benefits are independent of weight loss, persist after treatment withdrawal, or differ across PMOS phenotypes is uncertain. Phenotype-stratified randomized trials with standardized reproductive, metabolic, cardiovascular and safety endpoints are needed to determine whether multi-incretins provide durable benefits beyond weight control while maintaining reproductive safety and accessibility.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}