Effect of orlistat or metformin in overweight and obese polycystic ovary syndrome patients with insulin resistance

Abstract

The aim of this study was to evaluate the effect of orlistat or metformin combined with Diane-35 on anthropometric, hormonal and metabolic parameters in overweight and obese polycystic ovary syndrome (PCOS) patients with insulin resistance (fasting insulin > 10 mIU/L). A total of 240 PCOS women were randomly allocated to orlistat plus Diane-35(OD group), metformin plus Diane-35(MD group), orlistat plus metformin plus Diane-35(OMD group) or Diane-35 (D group). Body weight, BMI, waist and hip circumference, blood pressure, endocrine profile, lipid profile and insulin resistance were assessed at baseline and after 3 months. Significant reductions in waist and hip circumference, serum LH, total testosterone and uric acid were observed in all groups compared with baseline. TG and TC significantly decreased in the OD group. Homeostasis model assessment insulin resistance (HOMA-IR) index was reduced in the OD (p = .015), MD (p = .001) and OMD (p = .004) groups. Body weight, BMI, systolic BP and HDL-C significantly changed in the OD and OMD group compared with the D group (p < .05). Side effects were less with orlistat than metformin. This study demonstrated that orlistat is more effective in reducing weight and lipid profile than metformin. Besides, orlistat has mild side-effects and is better tolerated compared with metformin.

Chinese abstract

研究目的为评价奥利司他或二甲双胍联合达英-35治疗超重/肥胖伴胰岛素抵抗(空腹胰岛素>10 mIU/L)的多囊卵巢综合征(PCOS)患者的疗效, 包括人体测量、性激素和糖脂代谢指标。240名PCOS妇女随机分为4组：奥利司他+达英-35组(OD组), 二甲双胍+达英-35组(MD组), 奥利司他+二甲双胍+达英-35组 (OMD组)和达英-35组(D组)。在治疗前和3个月治疗后, 分别测量体重、BMI、腰围、臀围、血压、内分泌激素、血脂和胰岛素抵抗。与治疗前相比, 4组腰围、臀围、血清LH、总睾酮和尿酸水平均显著降低。TG和 TC在OD组显著减少。稳态模型胰岛素抵抗(HOMA-IR)指数在OD (p=.015)、MD(p=.001)和OMD(p=.004)组显著降低。与D组相比, 体重、BMI、收缩压和HDL-C在OD和OMD组显著变化。与二甲双胍相比, 奥利司他不良反应少。本研究表明奥利司他较二甲双胍减轻体重和降低血脂的效果更显著。而且奥利司他不良反应轻微, 较二甲双胍更易被患者接受。

Keywords:

• Orlistat
• metformin
• polycystic ovary syndrome
• obesity
• insulin resistance

Acknowledgements

The authors especially thank Prof. Xingming Li for his assistance in statistical analysis of the data.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study was supported by Capital Characteristic Clinic Project of China (Z161100000516143); Beijing Capital Foundation for Medical Science Development and Research (2016-2-2113); Clinical Technique Innovation Project of Beijing Municipal Administration of Hospitals (XMLX201710); Beijing Municipality Health Technology High-level Talent (2014-2-016); Foreign technical and administrative talent introduction project in 2017, State Administration of Foreign Experts Affairs, the P. R. of China (20171100004).