The aim of this study was to assess the effects of orlistat or metformin treatment on lipid and glucose metabolism, and gonadal function in obese/overweight women with polycystic ovary syndrome (PCOS). A total of 39 patients diagnosed with PCOS were randomly (digital table method) divided into orlistat treatment group (20 cases) and metformin treatment group (19 cases). Compared with those before, treatment with either orlistat or metformin significantly reduced body weight, body mass index (BMI), hip circumferences, and serum insulin levels of the PCOS patients both at the end of 3 months and 6 months (P<0.05). No significant differences could be viewed between orlistat and metformin treated subjects. Moreover, orlistat treatment significantly lowered the levels of low-density lipoprotein cholesterol, total cholesterol, fasting blood glucose, and homeostasis model assessment-insulin resistance (HOMA-IR) (P<0.05), while there were no significant changes in above parameters with metformin treatment. The improvement of menstrual cycle was observed after 6-month treatment in both groups (P<0.05). However, changes in polycystic ovarian morphology by ultrasound were only observed in orlistat treated group. In conclusion, orlistat is comparable with metformin in weight loss and improvement of insulin resistance and menstrual cycle, and is superior to metformin in improvement of lipid metabolism in overweight/obese PCOS patients.
为比较奥利司他及二甲双胍治疗对超重/肥胖的多囊卵巢综合征（PCOS）患者代谢及性腺功能的影响，将诊断PCOS的超重或肥胖育龄期女性按数字表法随机分为奥利司他组（20例）及二甲双胍组（19例），在治疗3个月及6个月后，两组PCOS患者体重、体重指数（BMI）、臀围、胰岛素均有显著下降（P<0.05），且两组改善程度差异无统计学意义。奥利司他组低密度脂蛋白胆固醇、总胆固醇、空腹血糖、稳态模型法评估的胰岛素抵抗指数（HOMA-IR）较治疗前显著降低（P<0.05），但二甲双胍组治疗前后变化不显著；两组患者治疗后月经紊乱均有改善；奥利司他组治疗后卵巢多囊样改变较治疗前改善。在超重/肥胖的PCOS患者治疗中，奥利司他与二甲双胍在减重、改善胰岛素抵抗及月经改善方面疗效相当，奥利司他对脂代谢改善更有优势。.