分析奥利司他单药治疗或与非诺贝特联合治疗对超重和肥胖代谢综合征患者富含甘油三酯脂蛋白代谢的 6 个月疗效。

Analysis of 6-month effect of orlistat administration, alone or in combination with fenofibrate, on triglyceride-rich lipoprotein metabolism in overweight and obese patients with metabolic syndrome.

机构信息

Department of Internal Medicine, School of Medicine, University of Ioannina, 45 110 Ioannina, Greece.

出版信息

J Clin Lipidol. 2008 Aug;2(4):279-84. doi: 10.1016/j.jacl.2008.06.001. Epub 2008 Jun 13.

DOI:10.1016/j.jacl.2008.06.001

PMID:21291744

Abstract

BACKGROUND

Orlistat significantly reduced serum triglycerides (TG) in most clinical trials. Orlistat-induced TG reduction has not been studied to determine the factors contributing to TG alterations in clinical settings.

OBJECTIVE

We examined the factors influencing TG reduction during orlistat administration, alone or in combination with fenofibrate, and we investigated the effects of these treatments on apolipoprotein C-II (ApoC-II) and C-III (ApoC-III) levels.

METHODS

Patients with the metabolic syndrome were randomly allocated to receive orlistat 120 mg three times daily (n = 28, O group), micronized fenofibrate 200 mg/day (n = 28, F group), or both (n = 27, OF group) for 6 months. Plasma ApoC-II and ApoC-III were determined by an immunoturbidimetric assay.

RESULTS

In the O group, we observed reductions of plasma ApoC-III (P < 0.05) and ApoC-II (P = NS) levels. Fenofibrate administration significantly reduced concentrations of ApoC-II and ApoC-III, whereas the combination of orlistat and fenofibrate had an additive effect on these apolipoproteins. There were significant in-group reductions in serum TG levels in all treatment groups. Multivariate analysis showed that in O group's baseline TG levels were independently positively correlated, whereas the baseline ApoC-II levels were negatively correlated with TG-lowering. In the F group, baseline TG levels and ApoC-III reduction were significantly and independently correlated with TG reduction. OF group's baseline TG levels and ApoC-III reduction were independently positively correlated and baseline ApoC-II levels were negatively correlated with TG-lowering.

CONCLUSIONS

Orlistat-mediated TG-lowering is independently associated with baseline TG and ApoC-II levels. When orlistat is combined with fenofibrate, ApoC-III reduction is another independent contributor to TG alterations.

摘要

背景

奥利司他在大多数临床试验中显著降低血清三酰甘油（TG）。尚未研究奥利司他诱导的 TG 降低，以确定在临床环境中导致 TG 改变的因素。

目的

我们检查了单独使用奥利司他或与非诺贝特联合使用期间影响 TG 降低的因素，并研究了这些治疗对载脂蛋白 C-II（ApoC-II）和 C-III（ApoC-III）水平的影响。

方法

代谢综合征患者被随机分配接受奥利司他 120 mg 每日三次（n = 28，O 组）、微粒化非诺贝特 200 mg/天（n = 28，F 组）或两者联合（n = 27，OF 组）治疗 6 个月。通过免疫比浊法测定血浆 ApoC-II 和 ApoC-III。

结果

在 O 组中，我们观察到血浆 ApoC-III（P < 0.05）和 ApoC-II（P = NS）水平降低。非诺贝特给药显著降低 ApoC-II 和 ApoC-III 的浓度，而奥利司他和非诺贝特联合使用对这些载脂蛋白具有附加作用。所有治疗组的血清 TG 水平均有显著的组内降低。多变量分析显示，在 O 组中，基线 TG 水平呈独立正相关，而基线 ApoC-II 水平与 TG 降低呈负相关。在 F 组中，基线 TG 水平和 ApoC-III 降低与 TG 降低显著且独立相关。OF 组的基线 TG 水平和 ApoC-III 降低与 TG 降低独立正相关，而基线 ApoC-II 水平与 TG 降低呈负相关。