***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: We prospect ively estimated the prevalence of the polycystic ovary syndrome ( PCOS ) , as defined by the NIH/NICHHD 1990 endocrine criteria , in a population of 154 Caucasian women of reproductive age reporting spontaneously for blood donation .  Anthropometric data ; the presence of hirsutism , acne , and and rogenic alopecia ; and the menstrual history were recorded by a single investigator . In 145 women , blood sample s were also obtained for measurement of serum and rogen levels .  PCOS was defined by the presence of 1 ) oligomenorrhea , 2 ) clinical and /or biochemical hyper and rogenism , and 3 ) exclusion of hyperprolactinemia , thyroid disorders , and nonclassic 21-hydroxylase deficiency . Hirsutism was defined by a modified Ferriman-Gallwey score of 8 or more , acne was considered as a sign of hyper and rogenism when persistent after the second decade of life , and hyper and rogenemia was defined by an increase in circulating testosterone or dehydroepi and rosterone sulfate or an increase in the free and rogen index above the 95th percentile of the control values derived from the nonhirsute , nonacneic women having regular menses who were not receiving hormonal therapy . PCOS was present in 10(6.5 % ) , hirsutism was present in 11 ( 7.1 % ) , and acne was present in 19 ( 12.3 % ) of the 154 women . Our results demonstrate a 6.5 % prevalence of PCOS , as defined , in a minimally biased population of Caucasian women from Spain . The polycystic ovary syndrome , hirsutism , and acne are common endocrine disorders in women OBJECTIVE : Polycystic ovary syndrome ( PCOS ) is characterized by obesity and insulin resistance ( IR ) , which result in elevated plasminogen activator inhibitor-1 ( PAI-1 ) levels . We aim ed to assess the changes in PAI-1 levels in PCOS during treatment with metformin and during weight loss . DESIGN : Twenty-three normal weight women with PCOS were given metformin 850 mg bid for 6 months . Fifty overweight/obese women with PCOS were prescribed an energy-restricted diet , were instructed to exercise and were r and omized to orlistat 120 mg tid or sibutramine 10 mg qd for 6 months . RESULTS : In normal weight women , treatment with metformin reduced the body mass index ( BMI ) and circulating and rogens , improved markers of IR and lowered PAI-1 levels . In overweight/obese women , sibutramine and orlistat yielded comparable reductions in BMI and markers of IR . In contrast , the effects on the free and rogen index ( FAI ) differed ( p=0.027 ) : sibutramine reduced the FAI ( p=0.005 ) , whereas orlistat had no effect . The effects of sibutramine and orlistat on PAI-1 levels also differed ( p=0.042 ) : sibutramine  reduced PAI-1 levels ( p<0.001 ) , whereas orlistat had no effect . CONCLUSIONS : Metformin and sibutramine , but not orlistat , reduce PAI-1 levels in PCOS . The reduction in circulating and rogens during metformin and sibutramine treatment might be implicated in this decline BACKGROUND This prospect i ve study evaluated the effect of weight reduction on anthropometric indices and ovarian morphology in anovulatory overweight patients with polycystic ovary syndrome ( PCOS ) . METHODS Thirty-three anovulatory overweight patients with PCOS were enrolled in the study . All had patent Fallopian tubes and chronic anovulation : 27 of them were oligo-amenorrhoeic . The partners were normospermic . Patients were prescribed a 1200 kcal/day diet , and physical exercise was recommended .  Anthropometric indices and ovarian imaging parameters were assessed at baseline and after weight loss of 5 and 10 % . RESULTS Twenty-five patients ( 76 % ) lost at least 5 % of their body weight . Eleven of these patients ( 33 % ) reached a 10 % decrease in weight . Waist circumference at the umbilical level , hip circumference , four skin folds , body mass index and fatty mass ratio were significantly reduced after 5 and 10 % weight loss . Ovarian morphology changed during the diet : we observed a significant reduction in ovarian volume and in the number of microfollicles per ovary . Among the 27 patients with oligo-amenorrhoea , 18 had a resumption of regular cycles and 15 experienced spontaneous ovulation ; 10 spontaneous pregnancies occurred in patients who lost at least 5 % of their weight . CONCLUSIONS Weight loss through a controlled low-calorie diet improves anthropometric indices in obese PCOS patients , reduces ovarian volume and microfollicle number and can restore ovulatory cycles , allowing spontaneous pregnancy The effect of orlistat , a nonabsorbed inhibitor of gastric and pancreatic lipases , was examined in patients with primary hyperlipidaemia ( serum cholesterol ≥6.2 mmol·l−1 and triglycerides ≤5.0 mmol·l−1 ) not responsive to dietary change alone . In a multicentre , r and omised , double-blind study , 103 men and 70 women received 30 , 90 , 180 , or 360 mg of orlistat or placebo for 8 weeks . Total and low-density lipoprotein cholesterol levels were reduced by 4 % and 5 % with 30 mg orlistat , by 7 % and 8 % with 90 mg orlistat , by 7 % and 7 % with 180 mg orlistat and by 11 % and 10 % with 360 mg orlistat  compared to placebo . High density lipoprotein cholesterol levels significantly decreased in the 360 mg  orlistat group . Triglyceride levels significantly increased in the placebo group but not in the drug groups . Body weight decreased by 1.2 kg with 360 mg orlistat , despite a weight maintenance diet . Decreases in vitamin E and D levels occurred , although both vitamins remained within the normal range . Adverse effects from the gastrointestinal tract were frequent , but led to discontinuation of therapy in only seven patients . Orlistat is a new therapeutic drug for the treatment of hyperlipidaemia that may be particularly useful among overweight patients . Its potential place in therapy will await long-term studies . Vitamin supplementation should be considered during treatment CONTEXT The polycystic ovary syndrome ( PCOS ) is the commonest endocrine abnormality in women of reproductive age . OBJECTIVE To determine the rate of hospital admissions for women with PCOS in Western Australian population in comparison to women without PCOS . DESIGN A population -based retrospective cohort study using data linkage in a statewide hospital morbidity data base system . SETTING All hospitals within Western Australia . PARTICIPANTS A total of 2566 women with PCOS hospitalized from 1997 - 2011 and 25 660 r and omly selected age-matched women without a PCOS diagnosis derived from the electoral roll . MAIN OUTCOME MEASURES Hospitalizations by ICD-10-M diagnoses from 15 years were compared . RESULTS Hospitalizations were followed until a median age of 35.8 years ( interquartile range , 31.0 - 39.9 ) . PCOS was associated with more nonobstetric and non-injury-related hospital admissions ( median , 5 vs 2 ; P < .001 ) , a diagnosis of adult-onset diabetes ( 12.5 vs 3.8 % ) , obesity ( 16.0 vs 3.7 % ) , hypertensive disorder ( 3.8 vs 0.7 % ) , ischemic heart disease ( 0.8 vs 0.2 % ) , cerebrovascular disease ( 0.6 vs 0.2 % ) , arterial and venous disease ( 0.5 vs 0.2 % and 10.4 vs 5.6 % , respectively ) , asthma ( 10.6 vs 4.5 % ) , stress/anxiety ( 14.0 vs 5.9 % ) , depression ( 9.8 vs 4.3 % ) , licit/illicit drug-related admissions ( 8.8 vs 4.5 % ) , self-harm ( 7.2 vs 2.9 % ) , l and transport accidents ( 5.2 vs 3.8 % ) , and mortality ( 0.7 vs 0.4 % ) ( all P < .001 ) . Women with PCOS had a higher rate of admissions for menorrhagia ( 14.1 vs 3.6 % ) , treatment of infertility ( 40.9 vs 4.6 % ) , and miscarriage ( 11.1 vs 6.1 % ) and were more likely to require in vitro fertilization ( 17.2 vs 2.0 % ) . CONCLUSION PCOS has profound medical implication s for the health of women , and health care re sources should be directed accordingly Purpose : To implement an evidence ‐based lifestyle modification intervention , guided by motivational interviewing , among a sample of infertile overweight and obese women with polycystic ovary syndrome to increase chances of conception while improving overall health . Data sources : A prospect i ve quantitative design was utilized ( n = 12 ) . Infertile overweight and obese women with polycystic ovary syndrome at an infertility practice completed question naires to assess diet and exercise practice s at study onset and completion . Body mass index and weight measurements were obtained on participants at study onset and completion of intervention . Menstrual history was assessed by interview . Conclusions : There was a mean weight loss ( p = .005 ) of 7(±5 ) pounds although a 5 % weight reduction did not occur . Mean daily calorie ( p = .005 ) , fat ( p = .006 ) , and carbohydrate intake ( p = .014 ) were significantly reduced . Frequency in brisk walking exercise significantly increased ( p = .024 ) . Frequency in home or gym exercise increased ( p = .050 ) . Menstrual cyclicity improved by 50 % among prior amenorrheic subjects . Implication s for practice : An evidence ‐based lifestyle modification guideline could prove to be a cost effective intervention for infertile women with polycystic ovary syndrome ( PCOS ) who desire pregnancy . This intervention could be integrated into the primary care and reproductive medicine visits as sole therapy or in conjunction with infertility treatment Obesity can affect ovulation and the chances of pregnancy . In this prospect i ve study , a weight loss programme was assessed to determine whether it could help infertile overweight anovulatory women to establish ovulation and assist in achieving pregnancy , ideally without further medical intervention . The subjects acted as their own historical controls . They underwent a weekly programme of behavioural change in relation to exercise and diet over 6 months ; those who did not complete the 6 months were treated as the comparison group . Women in the study group lost an average of 6.3 kg , with 12 of the 13 subjects resuming ovulation and 11 becoming pregnant , five of these spontaneously . Fitness , diet and psychometric measurements all improved . Fasting insulin and testosterone concentrations dropped significantly , while sex hormone binding globulin concentrations rose . None of these changes occurred in the comparison group . Thus , weight loss with a result ant improvement in ovulation , pregnancy outcome , self-esteem and endocrine parameters is the first therapeutic option for women who are infertile and overweight Purpose Comparing the effects of metformin or orlistat on hormone , lipid profile and ovulation status in obese women with polycystic ovary syndrome . Methods A total of 80 women were prospect ively recruited to receive either metformin ( n = 40 ) or orlistat ( n = 40 ) . Weight , BMI , waist , serum LH , total serum testosterone and lipid profile were assessed at baseline and after 3 months . The subjects ’ ovulatory status was assessed after 3 months . Results There was no significant difference in ovulation between the two treatment groups ( 30 % vs 15 % ) . Treatment with either drug showed a significant decline in body weight , BMI ( Body Mass Index ) , and waist circumference , but the degree of decline in both groups was the same . Patients who were treated with orlistat , showed a significant reduction in total testosterone and serum lipid . Women in metformin group showed a significant reduction in serum LH . Conclusions Both metformin and orlistat showed a similar effect on weight loss and ovulation rates OBJECTIVE It is well established that the risk of developing type 2 diabetes is closely linked to the presence and duration of overweight and obesity . A reduction in the incidence of type 2 diabetes with lifestyle changes has previously been demonstrated . We hypothesized that adding a weight-reducing agent to lifestyle changes may lead to an even greater decrease in body weight , and thus the incidence of type 2 diabetes , in obese patients . RESEARCH DESIGN AND METHODS In a 4-year , double-blind , prospect i ve study , we r and omized 3,305 patients to lifestyle changes plus either orlistat 120 mg or placebo , three times daily . Participants had a BMI > /=30 kg/m2 and normal ( 79 % ) or impaired ( 21 % ) glucose tolerance ( IGT ) . Primary endpoints were time to onset of type 2 diabetes and change in body 
    Output:
    
( S ) The present results suggest that orlistat leads to significant reduction in BMI /body weight in PCOS .
In addition , the available evidence indicates that orlistat and metformin have similar effects in reducing BMI , HOMA , testosterone and insulin in overweight/obese PCOS women .