奥利司他对多囊卵巢综合征患者的影响

2016-10-28 11:50:08

所属分类:专业学术

 

作者: Kumar P, Arora S.

【摘自】生殖生物学杂志, 2014年第7卷4期。

【摘要】

目的研究奥利司他与二甲双胍和运动相比,对PCOS的疗效。

方法:90PCOS肥胖女性患者随机均分为实验组(接受奥利司他或二甲双胍其中一种药物,同时结合生活方式的干预)和对照组(单纯生活方式的干预),评估人体测量指标的基线水平,在3个月的试验期间,每4周测量一次人体测量指标。在研究结束时,对雄激素水平,胰岛素抵抗,排卵受孕率和血脂水平进行评估。

结果:三组患者的空腹血糖、空腹胰岛素水平、胰岛素抵抗是相似的。平均总睾酮、血清激素结合球蛋白、游离雄激素指数、硫酸脱氢雄酮水平再所有组中也是相似的,没有统计学差异。但是,奥利司他和二甲双胍在减重、减少体重指数、腰围和腰臀比方面更有效。然而,奥利司他的副作用更小。奥利司他和二甲双胍组的排卵率分别是33.3%23.35%,但无统计学差异。在3个月的试验结束时,奥利司他组的血脂水平有了显著改善。奥利司他、二甲双胍和对照组的受孕率分别是40%16.7%3.3%P=0.003)。减肥是排卵的一个最有效的预测指标,具有较高的灵敏度。

结论奥利司他与二甲双胍在降低体重和改善PCOS肥胖患者排卵率方面的效果相当。但是,与二甲双胍相比,奥利司他具有更小的副作用和更好的耐受性。

关键词】控制,二甲双胍,奥利司他,多囊卵巢综合征

原文:

Orlistat in polycystic ovarian syndrome reduces weight with improvement in lipid profile and pregnancy rates.

Author: Kumar P, Arora S.

Author information:

Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

Quote From: J Hum Reprod Sci. 2014 Oct-Dec; 7(4): 255–261.

【ABSTRACT】

 

BACKGROUND:

The effects of exercise, metformin, and orlistat on anthropometric parameters, lipid profile, endocrine parameters, and ovulation in polycystic ovarian syndrome (PCOS) women were compared.

  AIM:

The aim was to study the efficacy of orlistat compared with metformin and exercise in PCOS.

  DESIGN:

Randomized control trial.

  METHODS:

A total of 90 eligible PCOS women were randomly assigned to receive either of the two drugs (orlistat or metformin) in combination with lifestyle interventions or as controls where they received lifestyle interventions alone. Anthropometric parameters were assessed at baseline and 4 weekly intervals for 3 months. Androgen levels, insulin resistance, ovulation and conception rates and lipid profile were also assessed at the end of study.

  STATISTICAL ANALYSIS:

Statistical analysis was performed using the SPSS version 17.0.

  RESULTS:

The levels of fasting blood sugar, fasting insulin and homeostatic model assessment insulin resistance were comparable in three treatment groups. Mean total testosterone, serum hormone binding globulin, free androgen index, dehydroepiandrosterone sulfate in all arms were comparable and statistically nonsignificant. However, orlistat and metformin were more effective in reducing weight, body mass index, waist circumference and waist-hip ratio. However, side-effects were less with orlistat. Ovulation rate was 33.3%, 23.35% with orlistat and metformin group respectively, but were not statistically significant. In orlistat group, significant improvement was observed in lipid profile at the end of 3 months. Conception rates were 40% and 16.7% and 3.3% in orlistat, metformin group and control group respectively (P - 0.003). Weight loss was found to be the best predictor of ovulation with sensitivity with good sensitivity.

  CONCLUSION:

Orlistat is as effective as metformin in reducing weight and achieves similar ovulation rates in obese PCOS patients. However, orlistat has minimal side-effects and is better tolerated compared with metformin.


 

文献详情:http://www.ncbi.nlm.nih.gov/pubmed/?term=Orlistat+in+polycystic+ovarian+syndrome+reduces+weight+with+improvement+in+lipid+profile+and+pregnancy+rates