| Objective: This study was designed to evaluate and compare the weight loss effects and glycolipid metbolic effects of orlistat and antidiabetic agents,combined with lifestyle change or not.Methods: Retrieved from PubMed,Embase,Ovid,Web of Science,Cochrane Library,CJFF,Wanfang database and VIP,randomized controlled trials(RCTs)about orlistat and antidiabetic agents,alone or combined with lifestyle change were collected.Two reviewers independently screened studies,extracted data,and assessed the methodological quality.Meta-analysis was performed by RevMan 5.3 software and network meta-analysis was performed by Stata 14.0 software.Results: A total of 43 RCTs involving 2416 PCOS patients were included.The results of network meta-analysis showed that: in patients with BMI?25 Kg/m2,GLP-1 receptor agonist combing with lifestyle intervention was better than other interventions on weight reduction and glycometabolism improvement,while orlistat plus lifestyle change was good at weight reduction and improving the lipid metabolism.And the intervention of medicine combing lifestyle change were superior to intervention of medicine or lifestyle alone.Conclusion: For PCOS patients with overweight or obesity,lifestyle change played a vital role in improving anthropometric index(BMI,weight,waist and WHR)and indices of glycometabolism,and the GLP-1 receptor agonist or orlistat combing with lifestyle change might be the best choice to improve metabolic disturbance for PCOS patients. |
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