Hartavi M, Kizilgul M, Koca F I, Takir M
Nizip State Hospital, Department of Internal Medicine, Gaziantep.
Kilis State Hospital, Department of Endocrinology and Metabolism, Kilis.
Acta Endocrinol (Buchar). 2024 Jul-Sep;20(3):341-348. doi: 10.4183/aeb.2024.341. Epub 2025 May 23.
Up to this point, individual or population-based approaches for treating and preventing obesity have not yielded lasting success. We assessed the impact of orlistat with or without metformin on anthropometric and laboratory measurements as well as cardiovascular risk factors in patients suffering from severe obesity.
A total of 116 patients with morbid obesity, consisting of 105 females and 11 males, were involved in the study. Of these, 30 patients (29 females and 1 male) underwent treatment with orlistat, while 86 patients (70 females and 10 males) were given a combination of orlistat and metformin. The effects of orlistat treatment, either 360 mg/day alone or orlistat plus metformin at a dose of 1700 mg/day, were retrospectively examined in patients who had been compliant with therapy for at least three months and had also made adjustments to their diet and lifestyle.
The mean age in the orlistat group was 46.26 ± 11.30 years, and 43.13 ± 11.37 years in the orlistat plus metformin group. Significant reductions in weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (BP), total cholesterol, LDL-cholesterol, and carotid intima media thickness (CIMT) resulted from three months of orlistat treatment (p < 0.01). The combination of orlistat and metformin produced substantial reductions in weight, BMI, WC, systolic BP, diastolic BP, CIMT, fasting blood glucose, total cholesterol levels, homeostatic model assessment for insulin resistance (HOMA-IR), and HbA1c levels (p < 0.01). The groups showed comparable weight, BMI, and WC. Neither group experienced notable side effects.
Treatments with orlistat and orlistat in combination with metformin led to a significant reduction in body weight. Similar body weight changes were observed between the groups, whereas the alterations in fasting plasma glucose, HOMA-IR, and HbA1c levels were greater with orlistat combined with metformin treatment.
到目前为止,针对肥胖症的个体或基于人群的治疗和预防方法尚未取得持久成功。我们评估了奥利司他联合或不联合二甲双胍对重度肥胖患者人体测量学指标、实验室检查结果以及心血管危险因素的影响。
本研究共纳入116例病态肥胖患者,其中女性105例,男性11例。其中,30例患者(29例女性和1例男性)接受奥利司他治疗,而86例患者(70例女性和10例男性)接受奥利司他与二甲双胍联合治疗。对至少三个月依从治疗且已调整饮食和生活方式的患者,回顾性研究单独使用360mg/天奥利司他治疗或奥利司他联合1700mg/天二甲双胍治疗的效果。
奥利司他组的平均年龄为46.26±11.30岁,奥利司他联合二甲双胍组为43.13±11.37岁。三个月的奥利司他治疗使体重、体重指数(BMI)、腰围(WC)、收缩压(BP)、总胆固醇、低密度脂蛋白胆固醇和颈动脉内膜中层厚度(CIMT)显著降低(p<0.01)。奥利司他与二甲双胍联合使用使体重、BMI、WC、收缩压、舒张压、CIMT、空腹血糖、总胆固醇水平、胰岛素抵抗稳态模型评估(HOMA-IR)和糖化血红蛋白(HbA1c)水平大幅降低(p<0.01)。两组的体重、BMI和WC具有可比性。两组均未出现明显副作用。
奥利司他以及奥利司他联合二甲双胍治疗均导致体重显著降低。两组观察到相似的体重变化,而奥利司他联合二甲双胍治疗使空腹血糖、HOMA-IR和HbA1c水平的变化更大。