作者： Kumar P, Arora S.
【摘自】生殖生物學(xué)雜志， 2014年第7卷4期。
【摘要】
目的：研究奧利司他與二甲雙胍和運(yùn)動(dòng)相比，對(duì)PCOS的療效。
方法：共90例PCOS肥胖女性患者隨機(jī)均分為實(shí)驗(yàn)組（接受奧利司他或二甲雙胍其中一種藥物，同時(shí)結(jié)合生活方式的干預(yù)）和對(duì)照組（單純生活方式的干預(yù)），評(píng)估人體測(cè)量指標(biāo)的基線水平，在3個(gè)月的試驗(yàn)期間，每4周測(cè)量一次人體測(cè)量指標(biāo)。在研究結(jié)束時(shí)，對(duì)雄激素水平，胰島素抵抗，排卵受孕率和血脂水平進(jìn)行評(píng)估。 結(jié)果：三組患者的空腹血糖、空腹胰島素水平、胰島素抵抗是相似的。平均總睪酮、血清激素結(jié)合球蛋白、游離雄激素指數(shù)、硫酸脫氫雄酮水平再所有組中也是相似的，沒有統(tǒng)計(jì)學(xué)差異。但是，奧利司他和二甲雙胍在減重、減少體重指數(shù)、腰圍和腰臀比方面更有效。然而，奧利司他的副作用更小。奧利司他和二甲雙胍組的排卵率分別是33.3%和23.35%，但無統(tǒng)計(jì)學(xué)差異。在3個(gè)月的試驗(yàn)結(jié)束時(shí)，奧利司他組的血脂水平有了顯著改善。奧利司他、二甲雙胍和對(duì)照組的受孕率分別是40%、16.7%和3.3%（P=0.003）。減肥是排卵的一個(gè)最有效的預(yù)測(cè)指標(biāo)，具有較高的靈敏度。 結(jié)論：奧利司他與二甲雙胍在降低體重和改善PCOS肥胖患者排卵率方面的效果相當(dāng)。但是，與二甲雙胍相比，奧利司他具有更小的副作用和更好的耐受性。 【關(guān)鍵詞】控制，二甲雙胍，奧利司他，多囊卵巢綜合征 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.