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口服避孕药联合奥利司他治疗多囊卵巢综合征伴超重/肥胖患者的效果:一项荟萃分析。

Effects of oral contraceptives plus orlistat in patients with polycystic ovary syndrome and overweight/obesity: A meta-analysis.

机构信息

Department of Reproductive Health and Infertility, Gaozhou Hospital of Traditional Chinese Medicine, Gaozhou City, Guangdong Province, China.

Reproductive Center, SSL Central Hospital of Dongguan, Dongguan City, Guangdong Province, China.

出版信息

J Obstet Gynaecol Res. 2022 Jun;48(6):1399-1408. doi: 10.1111/jog.15211. Epub 2022 Mar 18.

Abstract

AIM

This meta-analysis was conducted to compare the effect and safety of oral contraceptive pills (OCP) plus orlistat with OCP alone in clinical, hormonal, and lipid metabolism outcomes in patients with polycystic ovary syndrome (PCOS) and overweight/obesity.

METHODS

Pubmed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and SinoMed were systematically reviewed. A random-effects or fixed-effects model was used to pool the estimate.

RESULTS

Eight studies were included in this meta-analysis. Significant reductions in BMI, WHR, and waist circumference were observed in combination group as compared with OCP alone group. Regarding the hormonal outcome, T, SHBG, FAI, LH, DHEAS, FSH, and E2 levels were significantly improved in combination group compared with OCP alone group. However, the TT and FT did not change significantly between the two groups. Regarding the lipid metabolism outcomes, TC, LDL-C, and TG levels were reduced and HDL-C level was increased in the combination group. Regarding the insulin metabolism outcomes, FINS and HOMA-IR levels were reduced in combination group than in OCP group. The ovulation rate, pregnancy rate, and overall effective rate were significantly higher in combination group than in OCP alone group. Fewer complications were observed in the combination group than in OCP group, and the difference between them was significant.

CONCLUSION

This combination treatment of OCP and orlistat was more effective than OCP alone in reducing the weight, hormonal, lipid, and insulin metabolism profiles, as well as improving the ovulation rate, pregnancy rate, and overall effective rate, as compared with OCP alone.

摘要

目的

本荟萃分析旨在比较口服避孕药 (OCP) 加奥利司他与单独使用 OCP 治疗多囊卵巢综合征 (PCOS) 合并超重/肥胖患者的临床、激素和脂代谢结局的疗效和安全性。

方法

系统检索 Pubmed、Embase、Web of Science、中国知网 (CNKI) 和中国生物医学文献数据库 (SinoMed)。采用固定效应或随机效应模型对估计值进行合并。

结果

本荟萃分析纳入了 8 项研究。与单独使用 OCP 组相比,联合组的 BMI、WHR 和腰围显著降低。在激素结局方面,与单独使用 OCP 组相比,联合组的 T、SHBG、FAI、LH、DHEAS、FSH 和 E2 水平显著改善。然而,两组 TT 和 FT 无显著变化。在脂代谢结局方面,联合组的 TC、LDL-C 和 TG 水平降低,HDL-C 水平升高。在胰岛素代谢结局方面,联合组的 FINS 和 HOMA-IR 水平低于 OCP 组。与单独使用 OCP 组相比,联合组的排卵率、妊娠率和总有效率显著提高。联合组的并发症发生率低于 OCP 组,差异有统计学意义。

结论

与单独使用 OCP 相比,OCP 加奥利司他联合治疗在降低体重、激素、脂代谢和胰岛素代谢谱方面更为有效,同时提高排卵率、妊娠率和总有效率,优于单独使用 OCP。

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