Objective: To evaluate the effect of orlistat combined with conventional oral contraceptive therapy (OCT) on metabolism and endocrine in patients with polycystic ovary syndrome (PCOS). Methods: We searched PubMed, Web of Science, Cochrane Database of Systematic Reviews,Embase, CNKI and Wanfang databases for trials that assessed orlistat in PCOS patients with OCT from establishment of the database to November 2020. The reviewers selected literature, extracted data and evaluated quality independently, cross-checked, and evaluated the quality of methodological according the inclusion and exclusion criteria. Stata 12.0 software was used for the Mete-analysis. Results: A total of 6 studies involving 547 patients were included. The main endpoint of the study:Among the 5 main outcome indicators, the difference in testosterone (T) levels before and after treatment in the oral contraceptive in combination with orlistat group and the oral contraceptive group was statistically significant[SMD=-0.64, 95% CI (-1.18,-0.10), P=0.021]; among the 10 secondary outcome indicators, the difference in triglyceride (TG) level changes was statistically significant[SMD=-0.40, 95% CI (-0.068,-0.12), P=0.005]. The difference in high-density lipoprotein cholesterol (HDL-C) levels was statistically significant[SMD=0.62, 95% CI (0.32, 0.92), P<0.001]. While orlistat was known as a weight loss drug, compared with single oral contraceptives, before and after combined oral contraceptive treatment, the changes in weight-related indicators were not statistically significant. Conclusion: Comparing with OCT alone, the combination of orlistat and OCT may be of some auxiliary significance in the regulation of testosterone, triglyceride, and high-density lipoprotein-cholesterol levels in PCOS patients.
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