Svendsen M, Helgeland M, Tonstad S
Department of Preventive Cardiology, Ullevål University Hospital, Oslo, Norway.
J Hum Nutr Diet. 2009 Feb;22(1):55-63. doi: 10.1111/j.1365-277X.2008.00920.x.
Orlistat is a lipase inhibitor that reduces the intestinal absorption of fat and may enhance the effects of dietary and behavioural therapy on weight loss and maintenance. The present study examined the effect of orlistat on dietary intake, especially fat intake, during long-term weight maintenance.
Subjects comprised 44 men and women (aged 18-63 years; body mass index 37.5 +/- 4.3 kg m(-2)) included in the Scandinavian Multicenter study of Obese subjects with the metabolic syndrome, a 3-year clinical trial of orlistat or placebo following an 8-week, very low energy diet (VLED). Two months after the end of the trial when the use of orlistat was optional, 33 subjects remained in the study. A dietary interview based on a validated food frequency questionnaire was conducted before the VLED, after 1 year of treatment with orlistat or placebo and 2 months after the end of the trial.
At 1 year, dietary intake did not differ between the orlistat and placebo group. Energy percent (E%) fat was reduced and E% carbohydrate was increased within both groups. Two months after the end of the trial, E% fat was 32.6% (SD 6.2%) in subjects that chose to take orlistat and 27.7% (SD 5.5%) in subjects not taking orlistat [between group difference -5.0% (95% confidence interval -9.2 to -0.7); P = 0.021].
The use of orlistat compared with placebo in a lifestyle modification programme does not appear to influence dietary intake. Subjects that chose to take orlistat after the end of the programme did not comply with dietary recommendations and this may hamper the effect of the drug.
奥利司他是一种脂肪酶抑制剂，可减少肠道对脂肪的吸收，并可能增强饮食和行为疗法对体重减轻及维持的效果。本研究探讨了奥利司他在长期体重维持期间对饮食摄入，尤其是脂肪摄入的影响。
受试者包括44名男性和女性（年龄18 - 63岁；体重指数37.5±4.3 kg/m²），参与了斯堪的纳维亚肥胖代谢综合征多中心研究，这是一项在8周极低能量饮食（VLED）后进行的为期3年的奥利司他或安慰剂临床试验。试验结束两个月后，奥利司他使用为可选项，33名受试者仍留在研究中。在VLED前、使用奥利司他或安慰剂治疗1年后以及试验结束后2个月进行了基于有效食物频率问卷的饮食访谈。
在1年时，奥利司他组和安慰剂组的饮食摄入量没有差异。两组内脂肪能量百分比（E%）均降低，碳水化合物E%均升高。试验结束两个月后，选择服用奥利司他的受试者脂肪E%为32.6%（标准差6.2%），未服用奥利司他的受试者为27.7%（标准差5.5%）[组间差异 -5.0%（95%置信区间 -9.2至 -0.7）；P = 0.021]。
在生活方式改变计划中，与安慰剂相比，使用奥利司他似乎不会影响饮食摄入。在计划结束后选择服用奥利司他的受试者未遵守饮食建议，这可能会妨碍药物的效果。
