Effect on the cardiovascular independent risk factor lipoprotein(a) in overweight or obese PCOS patients with ethinyl-estradiol/drospirenone alone or plus orlistat

Abstract

Objective

This study aimed to assess the effect on the cardiovascular independent risk factor Lipoprotein(a) [Lp(a)] in overweight or obese polycystic ovary syndrome (PCOS) patients with ethinyl-estradiol/drospirenone (EE/DRSP) alone or plus orlistat.

Methods

In this randomized controlled prospective study, 66 PCOS patients with overweight or obesity were matched according to age and BMI. All participants were randomly divided into two groups to receive EE/DRSP plus Orlistat (n = 33) or EE/DRSP alone (n = 33) for 3 months. Changes in cardiovascular risk factors including Lp(a), CRP, LDL-C, anthropometric assessments, variations in sex hormones related parameters, and in glucolipid metabolic index were evaluated after the intervention.

Results

Lp(a) and CRP were significantly decreased at 3 months only in the EE/DRSP plus Orlistat group. There were significant reductions in LDL-C, weight, BMI, waist circumference (WC), body fat percentage (BFP), FT in both groups compared to baseline. However, these reductions were significantly greater in EE/DRSP plus Orlistat group. The levels of HDL-C, TG, and SHBG significantly increased, while TT and LH significantly decreased in both groups over time. TC, FINS, FPG were not significantly changed in both groups after the intervention.

Conclusions

This is the first study found that EE/DRSP plus Orlistat could significantly decrease Lp(a) in overweight or obese PCOS patients. This result can be assessed as particularly important, because Lp(a) is well-known as an independent risk factor predicting an increased risk of cardiovascular diseases (CVDs).

摘要

目的:本研究旨在评价屈螺酮炔雌醇(EE/DRSP)单独或联合奥利司他对超重或肥胖型多囊卵巢综合征(PCOS)患者心血管疾病独立危险因素脂蛋白(a) [Lp(a)]的影响。

方法:采用前瞻性随机对照研究, 对66例超重或肥胖型PCOS患者根据年龄和BMI进行配对。所有参与者被随机分为两组, 分别接受EE/DRSP联合奥利司他(n = 33)或单用EE/DRSP (n = 33)治疗共3个月。干预后评估心血管疾病危险因素包括Lp(a)、CRP、LDL-C变化、人体测量学、性激素相关指标及糖脂代谢指标的变化。

结果:EE/DRSP联合奥利司他组Lp(a)和CRP在3个月时明显降低。与基线数据相比, 两组患者的LDL-C、体重、BMI、腰围(WC)、体脂率(BFP)、FT均明显降低, 但EE/DRSP联合奥利司他组降幅更明显。随着时间的推移, 两组HDL-C、TG、SHBG水平均显著升高, TT、LH水平均显著降低。干预后两组TC、FINS、FPG无明显改变。

结论:本研究首次发现EE/DRSP联合奥利司他可显著降低超重或肥胖型PCOS患者的Lp(a), 这一结果可以被认为是特别重要的, 因为众所周知Lp(a)是预测心血管疾病(CVDs)风险增加的独立危险因素。

Keywords:

• PCOS
• Lp(a)
• ethinyl-estradiol/drospirenone
• Orlistat
• obesity

关键词:

• 多囊卵巢综合征
• 脂蛋白(a)
• 屈螺酮炔雌醇
• 奥利司他
• 肥胖

Acknowledgments

Especially thank Prof. Xingming Li of Capital Medical University (Beijing, China) for his assistance with the statistical analysis.

Disclosure statement

The authors report there are no competing interests to declare.

Additional information

Funding

This work was supported by Beijing Municipal Administration of Hospitals’ Ascent Plan [No. DFL20181401].