Short-term Administration of Orlistat Reduced Daytime Triglyceridemia in Obese Women With the Metabolic Syndrome

Abstract

The objective of this prospective, controlled, randomized study was to evaluate the effect of orlistat administration for 10 days on daytime capillary triglyceridemia in obese women with metabolic syndrome (MetSyn). Thirty-two obese, nondiabetic women with MetSyn were evaluated. The presence of MetSyn was defined according to the National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATP III) criteria. Patients were randomized into 2 similar groups: group A (orlistat), mean age 50.1 ∓8.2 years, received a low-calorie diet combined with orlistat 120 mg tid for 10 days and group B (control), mean age 51.2 ∓9.1 years, received only the low-calorie diet for the same period of time. Anthropometric, lipids, and parameters of insulin resistance were measured before and after 10 days of intervention. Capillary triglycerides (TG_c) were measured at 6 different time points during the day and daytime triglyceridemia was expressed as area under the curve of TG_c (AUC-TG_c). Most anthropometric measurements (body weight, body mass index, waist circumference, and percentage of fat mass) and most metabolic parameters (total cholesterol [TC], fasting venous triglycerides [TG_fv], high-density lipoprotein cholesterol [HDL-C] levels, fasting glucose [FG], fasting insulin [FI], and homeostasis model for assessment [HOMA] for insulin resistance index) decreased significantly in both groups, while waist-to-hip ratio (WHR) and systolic (SBP) and diastolic blood pressure (DBP) did not change significantly in both groups and low-density lipoprotein cholesterol (LDL-C) levels decreased only in the orlistat group. Following minimal weight loss, TG_c at most time points and AUC-TG_c were significantly reduced only in group A. In group A, AUG-TG_c decreased by 17% from 36.4 ∓11.8 to 30.2 ∓9.9 mmol/Lxh^-1 (p<0.001), and this reduction was significantly greater compared with the control group (p<0.05) and remained significant after percentage of weight loss was taken into account. This decrease of AUC-TG_c significantly correlated with the decrease of HOMA index (p<0.05, r =0.39) and the decrease of TG_fv (p<0.001, r =0.62). The tolerability of orlistat was very good and side effects were transient and of minimal intensity. In conclusion, short-term administration of orlistat significantly reduced daytime triglyceridemia in obese, nondiabetic women with MetSyn. This reduction could offer cardiovascular benefits in these high-risk patients. Long-term studies with more patients are needed to reach definite conclusions.