These results are consistent with previous studies by Metwally et al. The best predictor of ovulation according to the present and the previous study is percentage weight loss and a low concentration of baseline LH.
Our study demonstrated a statistically significant fall in total serum testosterone levels and improvements in the FAI in both drug arms. Similar to the results of present study Metwally et al. In the current study, none of the groups showed improvement in any of the biochemical parameters for assessing insulin resistance.
Nevertheless, there was fall in levels of fasting blood sugar, fasting insulin and HOMA-IR in the metformin group but it did not reach the level of significance. When plasminogen activator-1 PAI-1 levels were analyzed in a study, orlistat did not show any reduction in PAI-1, compared with metformin. The reduction in circulating androgens during Metformin treatment might be implicated in this decline. However, all these studies including our study have given substantial evidence that both orlistat and metformin are more efficacious in reducing weight, and ovulation in obese PCOS patients compared to control thereby demonstrating the therapeutic potential of orlistat in PCOS.
In addition, subjects in orlistat group showed significant improvement in lipid profile. However, orlistat has minimal side-effects and is better tolerated compared to metformin. Though there was no statistically significant difference in term of reduction of BMI, waist circumference and waist-hip ratio between orlistat and metformin groups, ovulation rates in both groups were comparable.
The significant improvements observed in lipid profile including LDL, Triglycerides and total cholesterol at the end of 3 months, is an observation for reducing cardiovascular problems on long-term intake of orlistat.
The authors would like to acknowledge Dr. Lavanya Rai who participated in literature search. Preetha from Department of Physiotherapy, for training subjects physiotherapy exercises.
Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U.
J Hum Reprod Sci. Pratap Kumar and Shweta Arora. Author information Article notes Copyright and License information Disclaimer. Address for correspondence: Dr. E-mail: ude. This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.
This article has been cited by other articles in PMC. METHODS: A total of 90 eligible PCOS women were randomly assigned to receive either of the two drugs orlistat or metformin in combination with lifestyle interventions or as controls where they received lifestyle interventions alone. RESULTS: The levels of fasting blood sugar, fasting insulin and homeostatic model assessment insulin resistance were comparable in three treatment groups. Study population The study population consisted of 90 overweight and obese women who fulfilled the criteria mentioned below were enrolled with 30 in each, orlistat, and metformin and control group.
Exclusion criteria Male factor Untreated hypothyroidism Renal or hepatic impairment Malabsorption syndrome Diabetes type 2 or type 1. Study design This was a randomized controlled clinical trial. Drug formulation Patients in the metformin arm received the drug with fertility fitness program.
The control arm patients underwent fertility fitness program only. Fertility fitness program All subjects in the three arms were given specific hypocaloric dietary advice according to their weight and fertility fitness program was part of the treatment in all the groups. Dietetic treatment Dietary management was targeted for gradual weight loss 0.
Physiotherapy Exercise was advised by a physiotherapiest. Ethical committee Ethical committee clearance was done. Methodology At the first visit following were performed History Menstrual cyclicity and the presence or absence of hirsutism and acne. Physical examination Body mass index was taken as the adapted version for Asian people , waist circumference, waist-hip ratio. Transvaginal ultrasonography Follow-up visits The following were recorded at 4 weekly intervals for 3 months-history and physical examination, especially anthropometric evaluation.
At study conclusion At 12 weeks follow-up, androgen profile, serum LH and FSH, lipid profile, fasting insulin, and fasting blood sugar were repeated. Outcome measures Primary outcome measures Ovulation Weight loss.
Secondary outcome measures Change in the BMI and waist circumference, predictors of response to treatment ovulation, detected by ultrasound for the three arms. Primary outcome Ovulation rates Subjects in orlistat and metformin arms had similar ovulation rates which were significantly better than that of the control group with P - 0. Table 1 Comparison of ovulation rate in three groups.
Open in a separate window. Table 2 Comparison of conception rates in three groups. Figure 1. Figure 3. Graph showing waist circumference in the three arms at follow-up visits. Figure 2. Graph showing body mass index in the three arms at follow-up visits. Between groups comparisons Both drug arms have similar efficacy in reducing weight, BMI, waist circumference and waist-hip ratio as highlighted in Table 3. Table 3 Percentage change in parameters for measuring weight loss at follow-up between the groups.
Table 4 Percentage change in androgen profile at follow-up between three groups. Dieting or use of products to lose weight during pregnancy is not recommended.
Experience of orlistat use in pregnancy is limited. Where exposure in the first trimester has occurred, a detailed fetal anomaly scan should be considered in addition to any other antenatal investigations relating to the maternal obesity, and the drug discontinued as soon as pregnancy is diagnosed.
Women and health professionals should be aware that antenatal detection of fetal anomalies is compromised with increasing BMI and that a normal scan is not informative with respect to neurodevelopmental outcomes. Other risk factors which independently increase the risk of adverse pregnancy outcome may be present in individual cases. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.
This document is regularly reviewed and updated. This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation.
Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise.
Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides.
The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Updated visitor guidelines. Top of the page. What is the most important information I should know about orlistat? What is orlistat? Orlistat blocks some of the fat that you eat, keeping it from being absorbed by your body. Orlistat may also be used for purposes not listed in this medication guide.
What should I discuss with my healthcare provider before taking orlistat? How should I take orlistat? What happens if I miss a dose? What happens if I overdose? Seek emergency medical attention or call the Poison Help line at What should I avoid while taking orlistat? What are the possible side effects of orlistat? Stop using orlistat and call your doctor at once if you have:.
What other drugs will affect orlistat? Ask a doctor or pharmacist if it is safe for you to use orlistat if you are also using any of the following drugs: amiodarone; insulin or oral diabetes medicine; HIV or AIDS medications; seizure medicine especially if your seizures get worse while taking orlistat ; a vitamin or mineral supplement that contains beta-carotene or vitamin E; or a blood thinner --warfarin, Coumadin, Jantoven.
Where can I get more information? Your pharmacist can provide more information about orlistat. Copyright Cerner Multum, Inc.
0コメント