Orlistat Is as Beneficial as Metformin in the Treatment of Polycystic Ovarian Syndrome (ฉบับที่ 1 ปี 2548)

          Department of Medicine, University of Hull, Michael White Centre for Diabetes and Endocrinology, Hull Royal Infirmary, Hull, U.K.; Department of Clinical Biochemistry and Immunology, Hull Royal Infirmary, Hull, U.K.; and Department of Medicine, York Hospital, York, U.K. Insulin resistance is increased in women with polycystic ovary syndrome (PCOS), and it may increase the risk of type 2 diabetes. In addition, hyperinsulinemia may contribute to androgen excess and could be a factor in the infertility associated with PCOS. This prospective, randomized, open-label study compared metformin therapy with orlistat in 21 women with PCOS. Orlistat reportedly produces significant, sustained weight loss and improves carbohydrate metabolism. After an 8-week period of dietary change, the women were randomized to receive either 500 mg metformin 3 times daily (n = 11) or 120 mg orlistat 3 times daily (n = 10) for 3 months.Compliance with assigned medication approximated 90% in both treatment groups. None of the women required dose reduction because of side effects. Treatment with orlistat for 3 months led to a 4.7% reduction in body weight, a more significant loss than was observed in metformin-treated women (1.0%). Serum testosterone levels declined significantly in both groups (). There was no change in levels of sex hormone-binding globulin. Fasting insulin concentrations did not decrease significantly in either treatment group. Lipid levels failed to improve significantly in either group and did not differ substantially in the 2 groups.(Figure is included in full-text article.)Orlistat appears to effectively reduce body weight in women with PCOS and it also, like metformin, decreases serum testosterone levels. This agent has potential as an adjunct to the treatment of PCOS. PMID: 15995557 [PubMed – as supplied by publisher]