Abstract
INTRODUCTION: Obesity is associated with impaired microvascular endothelial
function. We aimed to determine the effects of orlistat and sibutramine treatment on
microvascular endothelial function, anthropometric and lipid profile, blood pressure (BP),
and heart rate (HR). METHODS: 76 subjects were recruited and randomized to
receive orlistat 120 mg three times daily or sibutramine 10 mg daily for 9 months.
Baseline weight, BMI, BP, HR and lipid profile were taken. Microvascular endothelial
function was assessed using laser Doppler fluximetry and iontophoresis process. Maximum
change (max), percent change (% change) and peak flux (peak) in perfusion to acetylcholine
(ACh) and sodium nitroprusside (SNP) iontophoresis were used to quantify endothelium
dependent and independent vasodilatations. RESULTS: 24 subjects in both
groups completed the trial. After treatment, weight and BMI were decreased for both
groups. AChmax, ACh % change and ACh peak were increased in orlistat-treated
group but no difference was observed for sibutramine-treated group. BP and total
cholesterol (TC) were reduced for orlistat-treated group. HR was reduced for
orlistat-treated group but was increased in sibutramine-treated group.
CONCLUSION: 9 months treatment with orlistat significantly improved
microvascular endothelial function. This was associated with reductions in weight, BMI,
BP, HR, TC and low density lipoprotein cholesterol. No effect was seen in microvascular
endothelial function with sibutramine.
