الفهرس 
Endocrinological causes of PCOSOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Obesity is frequently present in women with polycystic ovary syndrome (PCOS) and appears to play an important role in the manifestations of this syndrome. Obesity contributes to the pathogenesis of the pivotal characteristics of PCOS, including infertility, hyperandrogenemia and insulin resistance (IR). In addition, weight reduction has beneficial effects on the metabolic and endocrine abnormalities of PCOS.
In overweight and obese patients with PCOS, lifestyle changes represent first-line treatment. However, weight reduction is frequently small with lifestyle changes alone and many women eventually regain weight. In these women, the combination of lifestyle changes with antiobesity agents might represent a useful option.
The only currently available antiobesity agent in most countries is orlistat, which does not have systemic adverse effects and appears to exert beneficial effects not only on body weight but also on other cardiovascular risk factors, including type 2 diabetes mellitus (T2DM), hypertension and dyslipidemia.
However, there are limited data on the effects of orlistat in women with PCOS, there is increased risk of both T2DM and cardiovascular disease in 7-10 of population. Orlistat is a potent and irreversible inhibitor of gastric and pancreatic carboxylester lipase, inhibiting the digestion of dietary triglycerides and decreasing the absorption of lipids.
Previous studies have shown that it produces significant and sustained weight reduction with associated improvement in lipid parameters and carbohydrate metabolism .Weight reducing agents such as orlistat and sibutramine have additionally been shown to augment the