司美格鲁肽联合二甲双胍治疗肥胖型PCOS的研究进展
Research Progress on the Combination of Semaglutide and Metformin in the Treatment of Obese PCOS

肥胖型多囊卵巢综合征(PCOS)是一种严重影响女性生殖代谢状态和生活质量的疾病，指南中也明确提出了减轻体重的重要性。近年来，胰高糖素样肽-1受体激动剂(GLP-1RA)类药物司美格鲁肽与二甲双胍的联合使用在治疗肥胖型PCOS中逐渐受到关注。司美格鲁肽通过刺激胰岛素分泌、降低胰高血糖素分泌以及提高胰岛素敏感性等多重机制，展现出显著的降糖和减重效果。二甲双胍则主要通过抑制肝糖原输出、改善外周组织对葡萄糖的利用以及减轻体重等作用机制来降低血糖水平，并在PCOS治疗中广泛应用。由此可见，司美格鲁肽联合二甲双胍为肥胖型PCOS患者提供了一种全新的治疗选择，具有广阔的临床应用前景和研究价值。本文将近年对司美格鲁肽联合二甲双胍治疗肥胖型PCOS的研究进展进行讨论，包括研究背景、主要研究成果、存在的争议和未来研究方向等，以期为临床治疗提供一定的参考。
Obese polycystic ovary syndrome (PCOS) is a disease that seriously affects women’s reproductive and metabolic status as well as their quality of life, and guidelines have also clearly emphasized the importance of weight reduction. In recent years, the combined use of glucagon-like peptide-1 receptor agonist (GLP-1RA) semaglutide and metformin has gradually gained attention in the treatment of obese PCOS. Semaglutide exhibits significant glucose-lowering and weight-reducing effects through multiple mechanisms, including stimulating insulin secretion, reducing glucagon secretion, and enhancing insulin sensitivity. Metformin, on the other hand, primarily lowers blood glucose levels by inhibiting hepatic glucose output, improving peripheral tissue utilization of glucose, and reducing body weight, and is widely used in the treatment of PCOS. Therefore, the combination of semaglutide and metformin provides a novel therapeutic option for patients with obese PCOS, with broad clinical application prospects and research value. This article discusses the recent research progress on the use of semaglutide combined with metformin in the treatment of obese PCOS, including the research background, main findings, existing controversies, and future research directions, aiming to provide a reference for clinical treatment.