O'Donovan Deirdre, Feinle-Bisset Christine, Wishart Judith, Horowitz Michael
Department of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace, South Australia 5000, Australia.
Br J Nutr. 2003 Nov;90(5):849-52. doi: 10.1079/bjn2003971.
The lipase inhibitor, orlistat, is used in the treatment of obesity and reduces fat absorption by about 30%. However, the mean weight loss induced by orlistat is less than expected for the degree of fat malabsorption. It was hypothesised that lipase inhibition with orlistat attenuates the suppressive effects of oral fat on subsequent energy intake in normal-weight subjects. Fourteen healthy, lean subjects (nine males, five females; aged 25 +/- 1.3 years) were studied twice, in a double-blind fashion. The subjects received a high-fat yoghurt 'preload' (males 400 g (2562 kJ); females 300 g (1923 kJ)), containing orlistat (120 mg) on one study day (and no orlistat on the other 'control' day), 30 min before ad libitum access to food and drinks; energy intake was assessed during the following 8 h. Blood samples were taken at regular intervals for the measurement of plasma cholecystokinin (CCK). Each subject performed a 3 d faecal fat collection following each study. Energy intake during the day was greater following orlistat (10,220 (SEM 928) kJ) v. control (9405 (SEM 824) kJ) (P=0.02). On both days plasma CCK increased (P<0.05) after the preload. Plasma CCK 20 min following ingestion of the preload was less after orlistat (4.1 (SEM 0.9) pmol/l) v. control (5.3 (SEM 0.9) pmol/l (P=0.028); however there was no difference in the area under the curve 0-510 min between the two study days. Fat excretion was greater following orlistat (1017 (SEM 168) kJ) v. control (484 (SEM 90) kJ) (P=0.004). In conclusion, in healthy, lean subjects the acute inhibitory effect of fat on subsequent energy intake is attenuated by orlistat and the increase in energy intake approximates the energy lost due to fat malabsorption.
脂肪酶抑制剂奥利司他被用于治疗肥胖症，可使脂肪吸收减少约30%。然而，奥利司他所致的平均体重减轻低于因脂肪吸收不良程度所预期的数值。据推测，奥利司他抑制脂肪酶会减弱正常体重受试者口服脂肪对后续能量摄入的抑制作用。14名健康、体型偏瘦的受试者（9名男性，5名女性；年龄25±1.3岁）以双盲方式接受了两次研究。受试者在一个研究日（另一个“对照”日不服用奥利司他）随意进食和饮水前30分钟，摄入一份含奥利司他（120毫克）的高脂酸奶“预负荷”（男性400克（2562千焦）；女性300克（1923千焦））；在接下来的8小时内评估能量摄入情况。定期采集血样以测定血浆胆囊收缩素（CCK）。每次研究后，每位受试者进行为期3天的粪便脂肪收集。服用奥利司他后当天的能量摄入（10220（标准误±928）千焦）高于对照组（9405（标准误±824）千焦）（P = 0.02）。在两天中，预负荷后血浆CCK均升高（P<0.05）。服用预负荷后20分钟，奥利司他组的血浆CCK（4.1（标准误±0.9）皮摩尔/升）低于对照组（5.3（标准误±0.9）皮摩尔/升）（P = 0.028）；然而，两个研究日之间0至510分钟曲线下面积并无差异。奥利司他组的脂肪排泄量（1017（标准误±168）千焦）高于对照组（484（标准误±90）千焦）（P = 0.004）。总之，在健康、体型偏瘦的受试者中，奥利司他会减弱脂肪对后续能量摄入的急性抑制作用，且能量摄入的增加量近似于因脂肪吸收不良而损失的能量。
