Sahebkar Amirhossein, Simental-Mendía Luis E, Reiner Željko, Kovanen Petri T, Simental-Mendía Mario, Bianconi Vanessa, Pirro Matteo
Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran.
Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.
Pharmacol Res. 2017 Aug;122:53-65. doi: 10.1016/j.phrs.2017.05.022. Epub 2017 May 27.
Orlistat, an inhibitor of intestinal lipase, promotes body weight reduction. The lipid-lowering efficacy of orlistat is controversial and the effect of orlistat-induced body weight reduction on lipid changes has not been explored in meta-regression analyses. A systematic literature search was conducted to identify randomized controlled trials investigating the efficacy of orlistat on plasma total, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides and lipoprotein(a) levels. Thirty-three studies were included in the meta-analysis (5522 and 4210 participants in the orlistat therapy and control groups, respectively). Orlistat reduced body weight (weighted mean difference: -2.12, p <0.001), total-cholesterol (weighted mean difference: -0.30mmol/L, p <0.001), low-density lipoprotein cholesterol (weighted mean difference: -0.27mmol/L, p <0.001), high-density lipoprotein cholesterol (weighted mean difference: -0.034mmol/L, p <0.001) and triglyceride (weighted mean difference: -0.09mmol/L, p <0.001) concentrations, while no effect on lipoprotein(a) was observed. Total- and low-density lipoprotein cholesterol-lowering were associated negatively with duration of orlistat treatment and positively with body weight changes. In conclusion, Orlistat treatment slightly reduces cholesterol and triglyceride levels, but not lipoprotein(a) levels. Total- and low-density lipoprotein cholesterol levels reductions are more consistent in patients with greater body weight reduction and shorter duration of orlistat treatment.
奥利司他是一种肠道脂肪酶抑制剂，可促进体重减轻。奥利司他的降脂疗效存在争议，且在荟萃回归分析中尚未探讨奥利司他诱导的体重减轻对血脂变化的影响。我们进行了一项系统的文献检索，以确定研究奥利司他对血浆总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯和脂蛋白(a)水平疗效的随机对照试验。荟萃分析纳入了33项研究（奥利司他治疗组和对照组分别有5522名和4210名参与者）。奥利司他降低了体重（加权平均差：-2.12，p<0.001）、总胆固醇（加权平均差：-0.30mmol/L，p<0.001）、低密度脂蛋白胆固醇（加权平均差：-0.27mmol/L，p<0.001）、高密度脂蛋白胆固醇（加权平均差：-0.034mmol/L，p<0.001）和甘油三酯（加权平均差：-0.09mmol/L，p<0.001）浓度，而未观察到对脂蛋白(a)有影响。总胆固醇和低密度脂蛋白胆固醇的降低与奥利司他治疗持续时间呈负相关，与体重变化呈正相关。总之，奥利司他治疗可轻微降低胆固醇和甘油三酯水平，但对脂蛋白(a)水平无影响。体重减轻更多且奥利司他治疗持续时间较短的患者，总胆固醇和低密度脂蛋白胆固醇水平的降低更为一致。
