奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响

doi:10.3969/j.issn.1006-7795.2019.04.015

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (4): 572-577.doi: 10.3969/j.issn.1006-7795.2019.04.015

奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响

闵敏¹, 阮祥燕^1,2, 赵越¹, 王虎生¹, 程姣姣¹, 罗穗豫¹, 许仲婷¹, 李萌¹, 张露平¹, 王月姣¹, Alfred O. Mueck^1,2

1. 首都医科大学附属北京妇产医院内分泌科, 北京 100026;
2. 德国图宾根大学妇产医院妇女健康部与妇女健康研究中心, 图宾根 D-72076, 德国

收稿日期:2019-05-20 出版日期:2019-07-21 发布日期:2019-07-19
通讯作者: 阮祥燕 E-mail:shunashen@126.com
基金资助:
北京市医院管理局"登峰"计划专项经费（DFL20181401），中国国际人才交流促进会医疗健康技术创新与人才培养专项基金（2017041900004，2018042000001），北京市卫生系统高层次卫生技术人才（2014-2-016），首批北京市级妇幼保健专科示范单位"更年期保健专科"（2018/01-2020/12）。

Effect of orlistat combined intervention on androgen and glycolipid metabolism in overweight or obese polycystic ovary syndrome patients

Min Min¹, Ruan Xiangyan^1,2, Zhao Yue¹, Wang Husheng¹, Cheng Jiaojiao¹, Luo Suiyu¹, Xu Zhongting¹, Li Meng¹, Zhang Luping¹, Wang Yuejiao¹, Alfred O. Mueck^1,2

1. Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China;
2. Department for Women's Health, University Women's Hospital and Research Center for Women's Health, University of Tuebingen, Tuebingen D-72076, Germany

Received:2019-05-20 Online:2019-07-21 Published:2019-07-19
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals' Ascent Plan(DFL20181401),China International Talent Exchange Association Medical Health Technology Innovation and Talent training Special Fund(2017041900004,2018042000001),Beijing Municipality Health Technology High-level Talent (2014-2-016),The First Batch of Beijing Maternal and Child Health Specialist Demonstration Units "Menopausal Health Specialist" (2018/01-2020/12).

摘要/Abstract

摘要： 目的探讨奥利司他综合干预对超重或肥胖型多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者人体测量学、雄激素、糖脂代谢的影响。方法选取2018年5月至9月于首都医科大学附属北京妇产医院内分泌科就诊的超重或肥胖型PCOS患者75例［体质量指数（body mass index，BMI）≥24kg/m²］，按照就诊顺序抽取号码，随机分为两组，组1：患者50例，用奥利司他加屈螺酮炔雌醇片（Ⅱ）（优思悦）综合干预；组2：患者25例，单用优思悦，观察并比较两组患者治疗前和治疗3个月后人体测量学、雄激素、糖脂代谢、肝肾功能指标的变化。结果治疗3个月后，奥利司他加优思悦综合干预组及单用优思悦组的体质量、腰围、臀围、BMI均明显下降，但奥利司他加优思悦综合干预组降幅均明显大于单用优思悦组（P<0.05）；激素指标中两组的游离睾酮（free testosterone，FT）、性激素结合球蛋白（sex hormone-binding globulin，SHBG）均明显改变，但改变的程度组间差异无统计学意义（P>0.05）；糖脂代谢及肝肾功能指标均有所变化，变化幅度组间比较差异无统计学意义（P>0.05）。结论奥利司他联合优思悦在改善超重或肥胖型PCOS患者的体质量及腰围方面优于单用优思悦，为临床合理用药选择提供了依据。

关键词: 超重或肥胖, 多囊卵巢综合征, 奥利司他, 屈螺酮炔雌醇片(Ⅱ)(优思悦)

Abstract: Objective To investigate the effect of orlistat combined intervention on anthropometry,androgen,glucose and lipid metabolism in overweight or obese patients with polycystic ovary syndrome (PCOS). Methods Totally 75 overweight or obese PCOS patients[body mass index(BMI) ≥ 24kg/m²]were admitted to the Department of Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,from May to September 2018,numbered according to the order of treatment and randomly divided into two groups.Group 1 included 50 patients,orlistat plus drospirenone and ethinylestradiol tablets(Ⅱ) (Yaz) comprehensive intervention;Group 2 included 25 patients treated with Yaz alone.The changes of anthropometry,androgen,glucose and lipid metabolism,liver and kidney function indexes before and after 3 months of treatment in the two groups were compared. Results After 3 months of treatment,the body weight,waist circumference,hip circumference and BMI of orlistat plus Yaz comprehensive intervention group and Yaz alone group were significantly decreased,but the decrease of orlistat plus Yaz comprehensive intervention group was significantly greater than those Yaz alone group(P<0.05).Among the hormone indicators, free testosterone (FT),sex hormone-binding globulin(SHBG) of the two groups were significantly changed, but there was no statistically significant difference in the degree of change between the two groups (P>0.05).Glucose and lipid metabolism,liver and kidney function were all changed, and there was no statistically significant difference between the two groups (P>0.05). Conclusion Orlistat combined with Yaz was superior to Yaz alone in decreasing the body weight and waist circumference of overweight or obese PCOS patients,providing a basis for clinical rational drug selection.

Key words: overweight or obese, polycystic ovary syndrome, orlistat, drospirenone and ethinylestradiol tablets(Ⅱ) (Yaz)

中图分类号:

R711.75

闵敏, 阮祥燕, 赵越, 王虎生, 程姣姣, 罗穗豫, 许仲婷, 李萌, 张露平, 王月姣, Alfred O. Mueck. 奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响[J]. 首都医科大学学报, 2019, 40(4): 572-577.

Min Min, Ruan Xiangyan, Zhao Yue, Wang Husheng, Cheng Jiaojiao, Luo Suiyu, Xu Zhongting, Li Meng, Zhang Luping, Wang Yuejiao, Alfred O. Mueck. Effect of orlistat combined intervention on androgen and glycolipid metabolism in overweight or obese polycystic ovary syndrome patients[J]. Journal of Capital Medical University, 2019, 40(4): 572-577.

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奥利司他综合干预对超重或肥胖型PCOS患者雄激素及糖脂代谢的影响

Effect of orlistat combined intervention on androgen and glycolipid metabolism in overweight or obese polycystic ovary syndrome patients

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