***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : The aim of this study was to determine the cardiometabolic risk factors in different polycystic ovary syndrome ( PCOS ) phenotypes . Subjects and Methods : This cross-sectional study was performed between 2010 and 2011 . Eighty-nine patients with PCOS and 25 age- and weight-matched healthy controls were included in the study . Patients were grouped using the Rotterdam 2003 criteria as : group 1 ,  oligomenorrhea and /or anovulation ( ANOV  ) and hyper and rogenemia  ( HA ) and /or hyper and rogenism ( n = 23 ) ; group 2 , ANOV and polycystic ovaries ( PCO ; n = 22 ) ; group 3 , HA and PCO ( n = 22 ) ; group 4 , ANOV , HA and PCO ( n = 22 ) ; group 5 ,  controls  ( n = 25 ) . Laboratory blood tests for diagnosis and cardiometabolic risk assessment s were performed . Insulin resistance ( IR ) was calculated in all patients with the homeostasis model assessment of IR ( HOMA-IR ) formula . An euglycemic hyperinsulinemic clamp test was performed on 5 r and omly selected cases in each subgroup , making 25 cases in total , and indicated as the ‘ M ' value ( mg/kg/min ) , which is the total body glucose disposal rate . Results : The mean BMl values of the groups were : group 1 , 26.1 ± 5.3 ; group 2 , 27.9 ± 5.2 ; group 3 , 24.3 ± 4.2 ; group 4 , 27.9 ± 7.5 ; group 5 , 24.7 ± 5.2 ( p > 0.05 ) . There were no differences in the lipid profile , plasma glucose , HOMA-IR , insulin and M values between the groups ( p > 0.05 ) . Phenotypes with oligomenorrhea/anovulation ( groups 1 , 2 and 4 ) were more obese than group 3 ( p = 0.039 ) . Conclusions : The cardiometabolic risk profile was similar among the PCOS subgroups . This finding could be attributed to the mean BMl values , which , being below 30 , were not within the obesity range . Obesity appeared to be an important determinant of high cardiovascular risk in PCOS Abstract Aim : Glucagon-like peptide 1 receptor agonists ( GLP-1 RA ) stimulate satiety leading to reductions in food intake and body weight . The effects of long- acting GLP-1 RA liraglutide on eating behavior of women with PCOS have not been investigated yet . Methods : Thirty-six obese women with PCOS ( mean ± SD , aged 31.2 ± 7.8 years , with BMI 38.7 ± 0.1 kg/m2 ) , pretreated with metformin ( 1000 mg BID ) were switched to liraglutide 1.2 mg QD sc for 12 weeks . Adiposity parameters and eating behavior as assessed by Three-Factor Eating Question naire ( TFEQ-R18 ) were examined at baseline and after 12 weeks . Results : Subjects treated with liraglutide lost on average 3.8 ± 0.1 kg ( p < 0.001 ) . Significant reductions of waist circumference and visceral adipose tissue ( VAT ) mass , volume and area were demonstrated from liraglutide induction to the end of the study . TFEQ-R18 scores were significantly different pre- and post-liraglutide intervention . After treatment with liraglutide  the uncontrolled eating ( UE ) score decreased from 36.8 ± 24.5 to 19.6 ± 18.4 ( p < 0.001 ) and emotional eating ( EE ) score decreased from 49.9 ± 33.3 to 28.5 ± 26.9 ( p < 0.001 ) . Scores for cognitive restraint ( CR ) were not changed . Conclusions : Short-term liraglutide treatment was associated with weight loss and significantly improved eating behavior in obese women with PCOS Background This study was design ed to investigate the effect of metformin and flutamide alone or in combination with anthropometric indices and laboratory tests of obese/overweight PCOS women under hypocaloric diet . Methods This single blind clinical trial was performed on 120 PCOS women . At the beginning , hypocaloric diet was recommended for the patients . After one month while they were on the diet , the patients were r and omly divided in 4 groups ; metformin ( 500 mg , 3/day ) , flutamide ( 250 mg , 2/day ) , combined , metformin ( 500 mg , 3/day ) with flutamide ( 250 mg , 2/day ) and finally placebo group . The patients were treated for 6 months . Anthropometric indices and laboratory tests ( fasting and glucose-stimulated insulin levels , lipid profile and and rogens ) were measured . A one-way ANOVA ( Post Hoc ) and paired t-test were performed to analyze data . A p ≤ 0.05 was considered statistically significant . Results After treatment , reduction in weight , BMI , hip circumference was significantly greater in the metformin group in comparison to other groups ( p<0.05 ) . In addition , the fasting insulin was significantly greater in metformin group and flutamide group in comparison to metformin+flutamide and placebo groups after treatment ( p<0.05 ) . Within groups , insulin level showed significant changes ( before and after treatment ) in metformin+flutamide group and LDL reduction was significant in flutamide group before and after treatment . Post hoc tukey and two-tailed with p≤0.05 were used to define statistical significance . Conclusion Using combination of metformin and flutamide improves anthropometric indices and laboratory tests in obese/overweight PCOS women under hypocaloric diet OBJECTIVE Development of these guidelines is m and ated by the American Association of Clinical Endocrinologists ( AACE ) Board of Directors and the American College of Endocrinology ( ACE ) Board of Trustees and adheres to published AACE protocol s for the st and ardized production of clinical practice guidelines ( CPGs ) . METHODS Recommendations are based on diligent review of clinical evidence with transparent incorporation of subjective factors . RESULTS There are 9 broad clinical questions with 123 recommendation numbers that include 160 specific statements ( 85 [ 53.1 % ] strong [ Grade A ] ; 48 [ 30.0 % ] intermediate [ Grade B ] , and 11 [ 6.9 % ] weak [ Grade C ] , with 16 [ 10.0 % ] based on expert opinion [ Grade D ] ) that build a comprehensive medical care plan for obesity . There were 133 ( 83.1 % ) statements based on strong ( best evidence level [ BEL ] 1 = 79 [ 49.4 % ] ) or intermediate ( BEL 2 = 54 [ 33.7 % ] ) levels of scientific substantiation . There were 34 ( 23.6 % ) evidence -based recommendation grade s ( Grade s A-C = 144 ) that were adjusted based on subjective factors . Among the 1,790 reference citations used in this CPG , 524 ( 29.3 % ) were based on strong ( evidence level [ EL ] 1 ) , 605 ( 33.8 % ) were based on intermediate ( EL 2 ) , and 308 ( 17.2 % ) were based on weak ( EL 3 ) scientific studies , with 353 ( 19.7 % ) based on review s and opinions ( EL 4 ) . CONCLUSION The final recommendations recognize that obesity is a complex , adiposity-based chronic disease , where management targets both weight-related complications and adiposity to improve overall health and quality of life . The detailed evidence -based recommendations allow for nuanced clinical decision-making that addresses real-world medical care of patients with obesity , including screening , diagnosis , evaluation , selection of therapy , treatment goals , and individualization of care . The goal is to facilitate high- quality care of patients with obesity and provide a rational , scientific approach to management that optimizes health outcomes and safety . ABBREVIATIONS A1C = hemoglobin A1c AACE = American Association of Clinical Endocrinologists ACE = American College of Endocrinology ACSM = American College of Sports Medicine ADA = American Diabetes Association ADAPT = Arthritis , Diet , and Activity Promotion Trial ADHD = attention-deficit hyperactivity disorder AHA = American Heart Association AHEAD = Action for Health in Diabetes AHI = apnea-hypopnea index ALT = alanine aminotransferase AMA = American Medical Association ARB = angiotensin receptor blocker ART = assisted reproductive technology AUC = area under the curve BDI = Beck Depression Inventory BED = binge eating disorder BEL = best evidence level BLOOM = Behavioral Modification and Lorcaserin for Overweight and Obesity Management BLOSSOM = Behavioral Modification and Lorcaserin Second Study for Obesity Management BMI = body mass index BP = blood pressure C-SSRS = Columbia Suicidality Severity Rating Scale CAD = coronary artery disease CARDIA = Coronary Artery Risk Development in Young Adults CBT = cognitive behavioral therapy CCO = Consensus Conference on Obesity CHF = congestive heart failure CHO = carbohydrate CI = confidence interval COR-I = Contrave Obesity Research I CPG = clinical practice guideline CV = cardiovascular CVD = cardiovascular disease DASH = Dietary Approaches to Stop Hypertension DBP = diastolic blood pressure DEXA = dual-energy X-ray absorptiometry DPP = Diabetes Prevention Program DSE = diabetes support and education EL = evidence level ED  = erectile dysfunction  ER = extended release EWL = excess weight loss FDA = Food and Drug Administration FDG = 18F-fluorodeoxyglucose GABA = gamma-aminobutyric acid GERD = gastroesophageal reflux disease GI = gastrointestinal GLP-1 = glucagon-like peptide 1 HADS = Hospital Anxiety and Depression Scale HDL-c = high-density lipoprotein cholesterol HR = hazard ratio HTN = hypertension HUNT = Nord-Trøndelag Health Study ICSI = intracytoplasmic sperm injection IFG = impaired fasting glucose IGT = impaired glucose tolerance ILI = intensive lifestyle intervention IVF = in vitro fertilization LAGB = laparoscopic adjustable gastric b and ing LDL-c = low-density lipoprotein cholesterol LES = lower esophageal sphincter LSG = laparoscopic sleeve gastrectomy LV = left ventricle LVH = left ventricular hypertrophy LVBG = laparoscopic vertical b and ed gastroplasty MACE = major adverse cardiovascular events MAOI = monoamine oxidase inhibitor MI = myocardial infa rct ion MN RCT = meta- analysis of non-r and omized prospect i ve or case-controlled trials MRI = magnetic resonance imaging MUFA = monounsaturated fatty acid NAFLD = nonalcoholic fatty liver disease NASH = nonalcoholic steatohepatitis NES = night eating syndrome NHANES = National Health and Nutrition Examination Surveys NHLBI = National Heart , Lung , and Blood Institute NHS = Nurses ' Health Study NICE = National Institute for Health and Care Excellence OA = osteoarthritis OGTT = oral glucose tolerance test OR = odds ratio OSA = obstructive sleep apnea PHQ-9 = Patient Health Question naire PCOS = polycystic ovary syndrome PCP = primary care physician POMC = pro-opiomelanocortin POWER = Practice -Based Opportunities for Weight Reduction PPI = proton pump inhibitor PRIDE = Program to Reduce Incontinence by Diet and Exercise PSA = prostate specific antigen QOL = quality of life RA = receptor agonist RCT = r and omized controlled trial ROC = receiver operator characteristic RR = relative risk RYGB = Roux-en-Y gastric bypass  SAD = sagittal abdominal diameter SBP = systolic blood pressure SCOUT = Sibutramine Cardiovascular Outcome Trial SG = sleeve gastrectomy SHBG = sex hormonebinding globulin SIEDY = Structured Interview on Erectile Dysfunction SNRI = serotonin-norepinephrine reuptake inhibitors SOS = Swedish Obese Subjects SS = surveillance study SSRI = selective serotonin reuptake inhibitors STORM = Sibutramine Trial on Obesity Reduction and Maintenance TCA = tricyclic antidepressant TONE = Trial of Nonpharmacologic Intervention in the Elderly TOS = The Obesity Society T2DM = type 2 diabetes mellitus UKPDS = United Kingdom Prospect i ve Diabetes Study U.S = United States VAT = visceral adipose tissue VLDL = very low-density lipoprotein WC = waist circumference WHO = World Health Organization WHR = waist-hip ratio WHtR = waist-to-height ratio WMD = weighted mean difference WOMAC = Western Ontario and McMaster Universities 
    Output:
    
Liraglutide alone , liraglutide/metformin and metformin alone significantly reduced waist circumference , but no change was found with orlistat .
Liraglutide appears superior to the other drugs in reducing weight and waist circumference