Department of Endocrinology & Metabolic Disease, Firat University Hospital, Elazig, Turkey.
J Physiol Biochem. 2009 Sep;65(3):215-23. doi: 10.1007/BF03180574.
Obesity, characterized by hyperleptinemia and hypoghrelinemia, has become a major health problem all over the world and is associated with an increased risk of complications including insulin resistance, hypertension, dyslipidemia, diabetes mellitus and atherosclerosis. The use of the pancreatic lipase inhibitor Orlistat can help seriously overweight people to achieve and maintain weight loss. The aim of our study was to compare the serum leptin and ghrelin levels in obese subjects who take orlistat with those receiving only dietary treatment. Twenty-one obese patients and 10 control subjects participated. The obese patients were divided into two groups; one group (n=11) took orlistat (120 mg, 3 times daily) and received dietary treatment and the other (n=10) only received the dietary treatment. The study lasted twelve weeks. The concentrations of serum ghrelin, leptin, insulin and C-peptide, and routine biochemical parameters, were measured in both groups. The serum ghrelin level was higher in control (183+/-62 fmol/ml) than obese (59+/-30 fmol/ml) subjects while the plasma leptin level was lower in control (8.7+/-12 microg/L) than obese (36.7+/-19 microg/L) subjects (all p<0.001). BMI and the total blood cholesterol, LDL and triglyceride levels fell significantly after both orlistat and dietary treatment in the obese subjects (all p<0.01), and the plasma ghrelin level rose (p<0.01). The leptin level demonstrated the opposite trend in both groups but only the patients taking orlistat showed a significant change (p<0.05).Taken together, these results show that orlistat has no effect on body weight in obese subjects additional to that conferred by a non-pharmacological life-style intervention. We therefore conclude that weight lost rather than type of treatment might be more valuable in obesity.
肥胖症的特点是血瘦素水平升高和血 ghrelin 水平降低，现已成为全世界范围内的一个主要健康问题，并且与包括胰岛素抵抗、高血压、血脂异常、糖尿病和动脉粥样硬化在内的多种并发症的风险增加相关。使用胰脂肪酶抑制剂奥利司他可以帮助严重超重的人群实现并维持体重减轻。本研究的目的是比较服用奥利司他和仅接受饮食治疗的肥胖患者的血清瘦素和 ghrelin 水平。21 名肥胖患者和 10 名对照受试者参与了本研究。肥胖患者分为两组；一组（n=11）服用奥利司他（120mg，每日 3 次）并接受饮食治疗，另一组（n=10）仅接受饮食治疗。研究持续 12 周。两组均检测血清 ghrelin、瘦素、胰岛素和 C 肽浓度以及常规生化参数。对照组（183±62fmol/ml）的血清 ghrelin 水平高于肥胖组（59±30fmol/ml），而对照组（8.7±12μg/L）的血浆瘦素水平低于肥胖组（36.7±19μg/L）（均 P<0.001）。肥胖患者在接受奥利司他和饮食治疗后，BMI 以及总胆固醇、LDL 和甘油三酯水平均显著下降（均 P<0.01），且血浆 ghrelin 水平升高（P<0.01）。两组的瘦素水平均呈相反趋势，但仅服用奥利司他的患者出现显著变化（P<0.05）。综上所述，这些结果表明，奥利司他除了通过非药物生活方式干预之外，对肥胖患者的体重没有额外影响。因此，我们得出结论，体重减轻而不是治疗类型可能在肥胖症中更有价值。
