奥利司他在初始饮食/行为治疗后的应用：睡眠呼吸障碍患者的体重变化和饮食维持。

Orlistat after initial dietary/behavioural treatment: changes in body weight and dietary maintenance in subjects with sleep related breathing disorders.

机构信息

Preventive Cardiology, Oslo University Hospital, Ullevål Hospital, N-0407 Oslo, Norway.

出版信息

Nutr J. 2011 Mar 8;10:21. doi: 10.1186/1475-2891-10-21.

DOI:10.1186/1475-2891-10-21

PMID:21385420

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3060836/

Abstract

BACKGROUND

Sleep related breathing disorders (SRBD) are associated with increased morbidity and mortality and weight loss is recommended to overweight or obese patients with SRBD. However, maintenance of weight loss is difficult to achieve and strategies for weight loss maintenance is needed. Orlistat is a pharmacological agent that reduces the intestinal absorption of fat and may favour long-term weight maintenance.

OBJECTIVE

To examine the change in body weight and dietary intake during a 1-year treatment with orlistat after an initial weight loss in obese subjects with SRBD. Furthermore, to explore the dietary determinants of weight maintenance during treatment with orlistat.

METHODS

Men and women with SRBD aged 32-62 years (n=63) participated in a 3-month dietary intervention to increase intake of vegetables and fruit. After an initial weight loss of 3.4 kg they achieved a mean body mass index of 34.3±4.7 kg/m2. Subsequently they were treated with orlistat for 1 year. During this year, dietary and behavioural interventions to attain weight loss were provided in the course of 14 group sessions. Dietary intake, energy density and food choices were assessed with a food frequency questionnaire before and after orlistat treatment.

RESULTS

With orlistat, body weight decreased by a mean of 3.5 kg (95% CI 1.5, 5.5). The dietary E% from saturated fat, intake of fatty dairy products and energy density increased after 1 year while intakes of oils, fish and vegetables decreased (all P<0.05). After multivariate adjustments, weight loss was associated with E% protein (R2adj=0.19 [95% CI 0.10, 0.46]), and inversely associated with E% saturated fat (R2adj=0.20 [95% CI 0.12, 0.47]) and fatty dairy products (R2adj=0.23 [95% CI 0.12, 0.49]).

CONCLUSIONS

Orlistat induced further weight loss, but dietary compliance declined with time. Increasing dietary protein and restricting saturated fat and fatty dairy products may facilitate weight loss with orlistat.

摘要

背景

睡眠相关呼吸障碍（SRBD）与发病率和死亡率增加有关，超重或肥胖的 SRBD 患者建议减肥。然而，减肥维持是难以实现的，需要有减肥维持的策略。奥利司他是一种减少脂肪肠道吸收的药物，可能有利于长期体重维持。

目的

在肥胖的 SRBD 患者经过初始减肥后，用奥利司他治疗 1 年，观察体重和饮食摄入的变化。此外，探讨奥利司他治疗期间体重维持的饮食决定因素。

方法

32-62 岁的男性和女性 SRBD 患者（n=63）参加了为期 3 个月的饮食干预，增加蔬菜和水果的摄入量。经过 3.4 公斤的初始减肥后，他们的平均体重指数达到 34.3±4.7kg/m2。随后，他们接受了 1 年的奥利司他治疗。在这一年中，通过 14 次小组会议提供了达到减肥目标的饮食和行为干预。在接受奥利司他治疗前后，使用食物频率问卷评估饮食摄入、能量密度和食物选择。

结果

用奥利司他治疗后，体重平均下降了 3.5 公斤（95%CI 1.5，5.5）。1 年后，饮食中的饱和脂肪 E%、脂肪乳制品的摄入量和能量密度增加，而油、鱼和蔬菜的摄入量减少（均 P<0.05）。经过多变量调整后，体重减轻与蛋白质 E%（R2adj=0.19[95%CI 0.10，0.46]）呈正相关，与饱和脂肪 E%（R2adj=0.20[95%CI 0.12，0.47]）和脂肪乳制品（R2adj=0.23[95%CI 0.12，0.49]）呈负相关。