Effect of long-term orlistat treatment on serum levels of advanced glycation end-products in women with polycystic ovary syndrome.
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.


METHODS
A clinical trial of 6 months of orlistat administration with an energy-restricted diet [basic metabolic rate (BMR) 600 kcal/day] in all subjects.


METHODS
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)).


METHODS
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.
Diamanti-Kandarakis
Evanthia
E
Laiko Hospital, Medical School, University of Athens, Endocrine Section, First Department of Medicine, Athens, Greece. akandara@otenet.gr
Katsikis
Ilias
I
Piperi
Christina
C
Alexandraki
Krystallenia
K
Panidis
Dimitrios
D
D000328:Adult; D019440:Anti-Obesity Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D016022:Case-Control Studies; D004032:Diet; D004334:Drug Administration Schedule; D005260:Female; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D007783:Lactones / Q000008:administration & dosage* / Q000627:therapeutic use; D016014:Linear Models; D008049:Lipase / Q000037:antagonists & inhibitors; D009765:Obesity / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy; D000077403:Orlistat; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D049629:Waist-Hip Ratio
D019440:Anti-Obesity Agents; D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D007328:Insulin; D007783:Lactones; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000077403:Orlistat; D008049:Lipase