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首页> 外文期刊>Current therapeutic research, clinical and experimental. >Effects of orlistat plus diet on postprandial lipemia and brachial artery reactivity in normolipidemic, obese women with normal glucose tolerance: A prospective, randomized, controlled Study
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Effects of orlistat plus diet on postprandial lipemia and brachial artery reactivity in normolipidemic, obese women with normal glucose tolerance: A prospective, randomized, controlled Study

机译：奥利司他加饮食对正常糖耐量正常，肥胖的肥胖妇女餐后血脂和肱动脉反应性的影响：一项前瞻性，随机对照研究

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Background: Postprandial lipemia (PPL) is an independent predictor of earlyatherosclerosis and coronary artery disease. It is defined as a postprandial triglyceride (TG) level ≥80% higher than the fasting level. Brachial arterial reactivity (BAR) is used to identify early-phase atherosclerosis. Data concerning whether orlistat improves PPL and endothelial function are lacking. Objective: The aim of this study was to determine the effects of orlistat on PPL and BAR in normolipidemic, obese women with normal glucose tolerance. Methods: This prospective, randomized, controlled study was conducted at Baskent University, Ankara, Turkey. Normolipidemic, obese women aged 18 to 65 years with normal glucose tolerance were eligible for screening. On screening, demographic information, anthropomorphic parameters (body mass index [BMI], waist circumference [WC], hip circumference, waist-hip ratio), BAR, laboratory test results (level of insulin resistance assessed using the homeostasis model assessment-insulin resistance [HOMA-IR] index, serum lipid profile, fasting plasma levels of glucose and insulin [FPI]), and oral fat-loading test results were recorded as baseline values. The primary end points were the effects of orlistat + diet on PPL (assessed using the AUC of TG) and BAR. Women found on screening to be PPL positive were randomly assigned in a 2:1 ratio to treatment with orlistat 120 mg TID plus low-calorie diet (600-kcal/d deficit; minimum, 1200 kcal/d) or low-calorie diet only (control) for 12 weeks. After 12 weeks, all of the above assessments were repeated, and AUC values for lipid parameters were calculated as secondary outcome measures. To assess tolerability and compliance, women were monitored by telephone each week and instructed to return every 4 weeks for clinic visits. Results: Twenty-seven women were identified as PPL positive and assigned to the orlistat + diet group (18 subjects) or the control group (9) (mean [SD] age, 45.9 [2.3] years; mean [SD] weight, 87.4 [2.5] kg; mean [SD] BMI, 36.0 [0.8] kg/m2). Treatment with orlistat + diet was associated with significantly greater changes from baseline compared with controls in WC (P= 0.003), fasting and postprandial serum TG levels (P = 0.012 and P < 0.001, respectively), FPI level (P 0.001), and HOMA-IR index (P < 0.001). Logistic regression analysis found that 12 weeks of treatment with orlistat + diet was associated with a numeric, but statistically non-significant, 4.1-fold change in PPL, which was independent of reductions from baseline in weight and WC. Neither treatment was associated with significant changes from baseline in BAR. The prevalences of gastrointestinal symptoms previously found to be related to orlistat use were statistically similar between the orlistat + diet and control groups (9 [50.0%] vs 3 [33.3%] subjects). Conclusions: The results of this small study in normolipidemic, obesewomen with normal glucose tolerance suggest that 12 weeks of treatment with orlistat 120 mg/d plus low-calorie diet was associated with a numeric, but statistically nonsignificant, 4.1-fold change from baseline in PPL, which was independent of reductions from baseline in weight and WC. Treatment with orlistat + diet was associated with significant effects on WC, TG, and level of insulin resistance, but not BAR. 2006 Excerpta Medica, Inc.
机译：背景：餐后血脂（PPL）是早期动脉粥样硬化和冠状动脉疾病的独立预测因子。定义为餐后甘油三酯（TG）水平比禁食水平高≥80％。肱动脉反应性（BAR）用于识别早期动脉粥样硬化。缺乏关于奥利司他是否改善PPL和内皮功能的数据。目的：本研究的目的是确定奥利司他对正常血脂，肥胖且糖耐量正常的肥胖妇女的PPL和BAR的影响。方法：这项前瞻性，随机对照研究在土耳其安卡拉的Baskent大学进行。年龄正常且糖耐量正常的18岁至65岁肥胖女性，可以进行筛查。筛查，人口统计学信息，拟人化参数（体重指数[BMI]，腰围[WC]，臀围，腰臀比），BAR，实验室检查结果（使用体内稳态模型评估的胰岛素抵抗水平-胰岛素抵抗将[HOMA-IR]指数，血清脂质谱，空腹血浆葡萄糖和胰岛素水平[FPI]和口服脂肪负荷测试结果记录为基线值。主要终点是奥利司他+饮食对PPL（使用TG的AUC评估）和BAR的影响。被筛查为PPL阳性的女性以2：1的比例随机分配至奥利司他120 mg TID加低热量饮食（600 kcal / d缺乏症;最低1200 kcal / d）或仅低热量饮食治疗（对照）12周。 12周后，重复上述所有评估，并计算血脂参数的AUC值作为次要结局指标。为了评估耐受性和依从性，每周都要通过电话对妇女进行监视，并指示每4周返回一次以进行门诊。结果：27名女性被确认为PPL阳性，并被分为奥利司他+饮食组（18名受试者）或对照组（9名）（平均[SD]年龄为45.9 [2.3]岁;平均[SD]体重为87.4） [2.5]公斤;平均[SD] BMI，36.0 [0.8]公斤/平方米。与对照组相比，奥利司他+饮食治疗与基线相比，与基线相比有显着更大的变化（P = 0.003），空腹和餐后血清TG水平（分别为P = 0.012和P <0.001），FPI水平（P 0.001）和HOMA-IR指数（P <0.001）。 Logistic回归分析发现，奥利司他+饮食治疗12周与PPL的数值变化（但统计上无显着意义）相关，为4.1倍，与体重和WC的基线下降无关。两种治疗均与BAR的基线水平发生明显变化无关。先前发现与奥利司他使用有关的胃肠道症状的患病率在奥利司他+饮食与对照组之间在统计学上相似（9 [50.0％] vs 3 [33.3％]个受试者）。结论：这项对正常血脂，葡萄糖耐量正常的肥胖妇女的小型研究的结果表明，奥利司他120 mg / d加上低热量饮食的12周治疗与基线时的数字（但无统计学意义）相比有4.1倍的变化PPL，与体重和WC的基线降低无关。奥利司他+饮食治疗对WC，TG和胰岛素抵抗水平有显着影响，但对BAR无效。 2006 Excerpta Medica，Inc.

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