奥利司他综合干预对超重或肥胖多囊卵巢综合征患者脂蛋白（a）、糖脂代谢及肝、肾功能的影响

doi:10.3969/j.issn.1006-7795.2023.04.007

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (4): 544-549.doi: 10.3969/j.issn.1006-7795.2023.04.007

• 妇科内分泌绝经与生育力保护 • 上一篇下一篇

奥利司他综合干预对超重或肥胖多囊卵巢综合征患者脂蛋白（a）、糖脂代谢及肝、肾功能的影响

张明珍¹, 阮祥燕^1*, 闵敏¹, Alfred O.Mueck^1,2

1.首都医科大学附属北京妇产医院/北京妇幼保健院内分泌科，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:2023-05-09 出版日期:2023-08-21 发布日期:2023-07-26
通讯作者: 阮祥燕 E-mail:ruanxiangyan@ccmu.edu.cn
基金资助:
北京市医院管理中心“登峰”人才培养计划项目(DFL20181401)

Effect of Orlistat comprehensive intervention on lipoprotein(a) and glycolipid metabolism and hepatorenal function in overweight or obese patients with polycystic ovary syndrome

Zhang Mingzhen¹, Ruan Xiangyan^1*, Min Min¹, Alfred O. Mueck^1,2

1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University / Beijing Maternal and Child Health Care Hospital, Beijing 100026, China;2.Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University Hospitals of Tuebingen, Tuebingen D-72076, Germany

Received:2023-05-09 Online:2023-08-21 Published:2023-07-26
Supported by:
This study was supported by Beijing Municipal Administration of Hospitals Ascent Plan (DFL20181401).

摘要/Abstract

摘要： 目的比较奥利司他联合屈螺酮炔雌醇片(drospirenone/ethinylestradiol tablets, DRSP/EE)与单用DRSP/EE对超重或肥胖多囊卵巢综合征（polycystic ovary syndrome, PCOS）患者心血管病危险因素脂蛋白（a）［lipoprotein（a）, Lp（a）］、糖脂代谢及肝、肾功能的影响。方法本研究为随机对照试验，共纳入69例超重或肥胖PCOS患者。在组间基线特征可比的原则上，所有研究对象按1∶2的比例随机分为两组：对照组(n=23)接受DRSP/EE；观察组(n=46)接受DRSP/EE+奥利司他，治疗12周。两组患者饮食和体力活动均在首都医科大学附属北京妇产医院进行相同的规范化综合干预。观察不同方案治疗前后患者Lp（a）、体质量、腰围（waist circumference, WC）、血清总胆固醇(total cholesterol, TC)、三酰甘油(triglyceride, TG)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol, LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol, HDL-C)、空腹血糖(fasting plasma glucose, FPG)、空腹胰岛素（fasting insulin, FINS）、同型半胱氨酸(homocysteine, HCY)、尿酸(uric acid, UA)的变化。结果治疗12周后，与对照组相比，观察组Lp（a）、LDL-C、FPG及体质量水平下降显著（P<0.05）；观察组患者WC、TC、FINS、UA、HCY下降，对照组FINS上升，但差异无统计学意义（P>0.05）；两组患者HDL-C、TG较治疗前升高，差异无统计学意义（P>0.05）。结论奥利司他联合DRSP/EE可以降低超重或肥胖PCOS患者的Lp（a）及LDL-C、FPG、体质量水平，为临床合理用药提供依据。

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

Abstract: Objective To access the effect of Orlistat combined with drospirenone/ethinylestradiol tablets (DRSP/EE) on the lipoprotein(a), glycolipid metabolism and hepatorenal function compared to DRSP/EE-alone in overweight or obese patients with polycystic ovary syndrome (PCOS). Methods We conducted a randomized controlled trial involving 69 overweight or obese PCOS patients. In principle of comparable baseline characteristics between groups, all participants were randomly assigned into two groups in a 1∶2 ratio, who received DRSP/EE alone as the control group(n=23) and DRSP/EE plus Orlistat as the observation group(n=46) for 12 weeks. Both groups got the same comprehensive intervention regarding diet and physical activities, which is standardized in Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Changes in cardiovascular risk factors including lipoprotein(a)［Lp(a)］, weight, waist circumference (WC), total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), fasting plasma glucose (FPG), fasting insulin (FINS), homocysteine (HCY), and uric acid (UA) were observed before and after different regiments. Results After 12 weeks of treatment, the Lp(a), LDL-C, FPG, and body weight levels of the observation group decreased significantly compared with the control group (P<0.05). The levels of WC, TC, FINS, UA, and HCY in the observation group decreased, and the FINS level increased in the control group, but there was no significant statistical significance (P>0.05). HDL-C and TG in the two groups were higher than those before treatment, and the difference was not statistically significant (P>0.05). Conclusions Olistat combined with DRSP/EE can reduce the levels of Lp(a), LDL-C, FPG, and body weight in overweight or obese PCOS patients, which provides evidence for the choice of rational drug use in clinical practice.

Key words: polycystic ovary syndrome, overweight or obesity, lipoprotein(a), Orlistat, drospirenone/ethinylestradiol tablets

中图分类号:

张明珍, 阮祥燕, 闵敏, Alfred O.Mueck. 奥利司他综合干预对超重或肥胖多囊卵巢综合征患者脂蛋白（a）、糖脂代谢及肝、肾功能的影响[J]. 首都医科大学学报, 2023, 44(4): 544-549.

Zhang Mingzhen, Ruan Xiangyan, Min Min, Alfred O. Mueck. Effect of Orlistat comprehensive intervention on lipoprotein(a) and glycolipid metabolism and hepatorenal function in overweight or obese patients with polycystic ovary syndrome[J]. Journal of Capital Medical University, 2023, 44(4): 544-549.

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奥利司他综合干预对超重或肥胖多囊卵巢综合征患者脂蛋白（a）、糖脂代谢及肝、肾功能的影响

Effect of Orlistat comprehensive intervention on lipoprotein(a) and glycolipid metabolism and hepatorenal function in overweight or obese patients with polycystic ovary syndrome

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