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Effect of long‐term orlistat treatment on serum levels of advanced glycation end‐products in women with polycystic ovary syndrome
Author(s) -
DiamantiKandarakis Evanthia,
Katsikis Ilias,
Piperi Christina,
Alexandraki Krystallenia,
Panidis Dimitrios
Publication year - 2007
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2006.02693.x
Subject(s) - orlistat , polycystic ovary , medicine , endocrinology , body mass index , insulin , estrone , obesity , estrogen , insulin resistance , weight loss
Summary 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. Objective 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. Design A clinical trial of 6 months of orlistat administration with an energy‐restricted diet [basic metabolic rate (BMR) 600 kcal/day] in all subjects. 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 ). Measurements Serum AGE levels (U/ml), hormonal and metabolic profile. Results 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. Conclusions 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.