Fondazione IRCCS Policlinico S. Matteo, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, P.le C. Golgi, 2-27100 Pavia, Italy.
Fundam Clin Pharmacol. 2011 Oct;25(5):642-51. doi: 10.1111/j.1472-8206.2010.00888.x. Epub 2010 Nov 16.
To evaluate the effects of 1-year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight, glycemic and lipid control, and inflammatory parameters in obese type 2 diabetic patients. Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus (T2DM) [glycated hemoglobin (HbA(1c)) > 8.0%] in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomized to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day. We evaluated the following parameters at baseline and after 3, 6, 9, and 12 months: body weight, body mass index (BMI), glycated hemoglobin (HbA(1c) ), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (Tg), adiponectin (ADN), leptin, tumor necrosis factor-α (TNF-α), vaspin, and high-sensitivity C-reactive protein (Hs-CRP). We observed a better decrease in body weight, glycemic profile, HOMA-IR, LDL-C, and ADN and a faster improvement in FPI, TC, Tg, leptin, TNF-α, Hs-CRP with orlistat plus L-carnitine compared to orlistat alone. We also recorded an improvement in vaspin with orlistat plus l-carnitine not reached with orlistat alone. Orlistat plus L-carnitine gave a better improvement in body weight, glycemic and lipid profile compared to orlistat alone; furthermore, a faster and better improvement in inflammatory parameters was observed with orlistat plus L-carnitine compared to orlistat alone.
评估奥利司他联合左旋肉碱治疗 1 年与单独应用奥利司他治疗相比，对肥胖 2 型糖尿病患者体重、血糖和血脂控制及炎症参数的影响。
共纳入 258 例接受不同口服降糖药或胰岛素治疗但血糖控制不佳的 2 型糖尿病（T2DM）患者（糖化血红蛋白（HbA1c）＞8.0%），将其随机分为奥利司他 120mg 每日 3 次联合左旋肉碱 2g 每日 1 次组（联合治疗组）和奥利司他 120mg 每日 3 次组（单独治疗组）。于治疗前及治疗 3、6、9、12 个月时检测以下参数：体重、体质量指数（BMI）、糖化血红蛋白（HbA1c）、空腹血糖（FPG）、餐后 2h 血糖（PPG）、空腹血浆胰岛素（FPI）、稳态模型评估胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、三酰甘油（TG）、脂联素（ADN）、瘦素、肿瘤坏死因子-α（TNF-α）、内脂素（vaspin）和高敏 C 反应蛋白（Hs-CRP）。
联合治疗组体重、血糖谱、HOMA-IR、LDL-C、ADN 下降更明显，FPI、TC、TG、瘦素、TNF-α、Hs-CRP 改善更快；与单独治疗组相比，联合治疗组 vaspin 也有改善，但单独治疗组无此作用。
与单独应用奥利司他相比，奥利司他联合左旋肉碱可更明显改善肥胖 T2DM 患者的体重、血糖和血脂谱，且能更快更好地改善炎症参数。
