Diamanti-Kandarakis Evanthia, Katsikis Ilias, Piperi Christina, Alexandraki Krystallenia, Panidis Dimitrios
Laiko Hospital, Medical School, University of Athens, Endocrine Section, First Department of Medicine, Athens, Greece.
Clin Endocrinol (Oxf). 2007 Jan;66(1):103-9. doi: 10.1111/j.1365-2265.2006.02693.x.
BACKGROUND Women with polycystic ovary syndrome (PCOS) exhibit elevated serum advanced glycation end-products (AGE) compared with healthy subjects. Short-term administration of orlistat has been shown to reduce the postmeal increase in serum AGE levels in women with PCOS and in controls.
To evaluate the long-term effect of orlistat and a low-calorie diet on serum AGE levels, and on the hormonal and metabolic profile of obese PCOS and normal women.
A clinical trial of 6 months of orlistat administration with an energy-restricted diet [basic metabolic rate (BMR) 600 kcal/day] in all subjects.
Twenty-nine women with PCOS [aged 27.52 +/- 5.77 years; body mass index (BMI) 35.43 +/- 5.31 kg/m(2)] and 18 controls (aged 32.06 +/- 5.64 years; BMI 36.39 +/- 6.47 kg/m(2)).
Serum AGE levels (U/ml), hormonal and metabolic profile.
PCOS and controls did not differ in BMI (P = 0.58), waist-to-hip ratio (WHR) (P = 0.44), fasting insulin concentration (P = 0.45) and glucose-to-insulin ratio (GIR) (P = 0.34). PCOS women exhibited statistically higher AGE (P < 0.001) and testosterone levels (P < 0.001) compared with controls. After 6 months of orlistat treatment, AGE levels showed a statistically significant decrease in both groups (PCOS: baseline 9.08 +/- 1.84, post-orlistat 8.56 +/- 1.95, P = 0.001; controls: baseline 5.02 +/- 0.62, post-orlistat 4.91 +/- 0.69, P = 0.03), independently of the BMI reduction in the PCOS group. A significant reduction was observed in BMI (PCOS: P < 0.001; controls: P < 0.001), WHR (PCOS: P = 0.002; controls: P = 0.04), fasting insulin (PCOS: P < 0.001; controls: P = 0.008), and testosterone concentrations in PCOS (P < 0.001). SHBG concentration (PCOS: P = 0.004; controls: P = 0.008) and GIR (PCOS: P < 0.001; controls: P = 0.03) were significantly increased. A significant improvement was also observed in insulin resistance indices post-treatment in both groups.
Our data suggest that orlistat has a beneficial effect in reducing elevated AGE levels and improving the hormonal and metabolic profile in women with PCOS after 6 months of treatment, independently of BMI changes.
背景 与健康受试者相比，多囊卵巢综合征（PCOS）女性的血清晚期糖基化终产物（AGE）水平升高。已证明短期服用奥利司他可降低PCOS女性和对照组女性餐后血清AGE水平的升高。
评估奥利司他和低热量饮食对肥胖PCOS女性和正常女性血清AGE水平以及激素和代谢状况的长期影响。
对所有受试者进行为期6个月的奥利司他给药及能量限制饮食[基础代谢率（BMR）600千卡/天]的临床试验。
29名PCOS女性[年龄27.52±5.77岁；体重指数（BMI）35.43±5.31千克/米²]和18名对照组女性（年龄32.06±5.64岁；BMI 36.39±6.47千克/米²）。
血清AGE水平（单位/毫升）、激素和代谢状况。
PCOS组和对照组在BMI（P = 0.58）、腰臀比（WHR）（P = 0.44）、空腹胰岛素浓度（P = 0.45）和葡萄糖-胰岛素比值（GIR）（P = 0.34）方面无差异。与对照组相比，PCOS女性的AGE（P < 0.001）和睾酮水平（P < 0.001）在统计学上显著更高。奥利司他治疗6个月后，两组的AGE水平均有统计学意义的下降（PCOS组：基线9.08±1.84，奥利司他治疗后8.56±1.95，P = 0.001；对照组：基线5.02±0.62，奥利司他治疗后4.91±0.69，P = 0.03），且与PCOS组BMI的降低无关。BMI（PCOS组：P < 0.001；对照组：P < 0.001）、WHR（PCOS组：P = 0.002；对照组：P = 0.04）、空腹胰岛素（PCOS组：P < 0.001；对照组：P = 0.008）以及PCOS组的睾酮浓度（P < 0.001）均显著降低。性激素结合球蛋白（SHBG）浓度（PCOS组：P = 0.004；对照组：P = 0.008）和GIR（PCOS组：P < 0.001；对照组：P = 0.03）显著升高。两组治疗后胰岛素抵抗指数也有显著改善。
我们的数据表明，治疗6个月后，奥利司他在降低PCOS女性升高的AGE水平以及改善其激素和代谢状况方面具有有益作用，且与BMI变化无关。
