Effect of Diane-35, alone or in combination with orlistat or metformin in Chinese polycystic ovary syndrome patients

Arch Gynecol Obstet. 2018 Jun;297(6):1557-1563. doi: 10.1007/s00404-018-4762-0. Epub 2018 Mar 30.

Abstract

Objective: To evaluate the effect of Diane-35, alone or in combination with orlistat or metformin, on androgen and body fat percentage parameters in Chinese overweight and obese polycystic ovary syndrome (PCOS) patients with insulin resistance.

Methods: A total of 240 PCOS women were randomly allocated to receive Diane-35 alone (D group), Diane-35 plus orlistat (DO group), Diane-35 plus metformin (DM group), or Diane-35 plus orlistat plus metformin (DOM group). Serum TT, DHEA-S, androstenedione, SHBG, FT, FAI, body fat, and body fat percentage were assessed at baseline and after 12 weeks of treatment.

Results: Significant changes in serum TT, SHBG, and FAI were observed in all treatment groups compared with baseline. DHEA-S and androstenedione significantly decreased in the DO, DM, and DOM groups after treatment. FT only significantly decreased in the DOM group. Body fat and body fat percentage significantly decreased in the DO and DOM groups. Compared with the D group, DHEA-S significantly decreased in the DO, DM, and DOM groups (F = 4.081, p = 0.008); SHBG significantly increased in the DOM group (F = 3.019, p = 0.031); and FAI significantly decreased in the DO group (χ2 = 12.578, p = 0.006). There were significant differences between groups in body fat percentage (χ2 = 23.590, p < 0.001). Side-effects were less with orlistat than metformin.

Conclusions: Diane-35 in combination with orlistat or metformin is more effective in reducing androgen than Diane-35 alone. Orlistat is more effective in reducing body fat percentage than metformin. In addition, orlistat has mild side-effects and is better tolerated compared with metformin.

Keywords: Diane-35; Metformin; Orlistat; Polycystic ovary syndrome.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adipose Tissue / drug effects*
  • Adult
  • Androgen Antagonists
  • Androgens / blood
  • Cyproterone Acetate / therapeutic use*
  • Drug Combinations
  • Ethinyl Estradiol / therapeutic use*
  • Female
  • Humans
  • Insulin Resistance
  • Metformin / therapeutic use*
  • Obesity / ethnology*
  • Orlistat / therapeutic use*
  • Overweight / ethnology
  • Polycystic Ovary Syndrome / blood
  • Polycystic Ovary Syndrome / drug therapy*
  • Treatment Outcome

Substances

  • Androgen Antagonists
  • Androgens
  • Drug Combinations
  • Ethinyl Estradiol
  • Cyproterone Acetate
  • Cyproterone acetate, ethinyl estradiol drug combination
  • Metformin
  • Orlistat