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Article: Orlistat maintains biliary lipid composition and hepatobiliary function in obese subjects undergoing moderate weight loss

TitleOrlistat maintains biliary lipid composition and hepatobiliary function in obese subjects undergoing moderate weight loss
Authors
Issue Date2001
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.html
Citation
American Journal Of Gastroenterology, 2001, v. 96 n. 6, p. 1888-1894 How to Cite?
AbstractOBJECTIVES: Orlistat, an intestinal lipase inhibitor, has recently been approved by the US Food and Drug Administration for treatment of obesity. The effects of orlistat on hepatobiliary function have not been previously defined. A 4 wk study was performed involving modest weight loss in obese subjects to observe any short-term hepatobiliary responses that occur after initiating treatment with orlistat and a hypocaloric diet. METHODS: A total of 23 obese (BMI 30-41 kg/m 2) subjects were randomized to a double blind t.i.d. treatment with 120 mg of orlistat or a placebo in conjunction with a hypocaloric diet (1200-1500 kcal/day). The study was designed to achieve similar modest weight loss in both groups in order to be able to directly assess the effects of orlistat. Cholesterol saturation, bile composition, and gallbladder motility were measured. RESULTS: At the end of the treatment period, mean weight loss of 3.8 kg was achieved in the orlistat group (vs 2.3 kg with placebo, p = NS). Total bile acid concentration decreased significantly with placebo (-18.57 ± 6.99 mmol/L; 95% CI = -32.26 to -4.87), but not with orlistat. Biliary phospholipid concentration decreased significantly with placebo (-4.38 ± 1.91 mmol/L; 95% CI = -8.13 to -0.64) but not with orlistat. Mean changes from the baseline in cholesterol saturation index and gallbladder motility were similar in both groups. Microscopy of bile failed to reveal cholesterol microcrystals before or after treatment in either group. CONCLUSIONS: Our findings indicate a primary initial effect of weight loss is a reduction in biliary bile acids and phospholipids. Orlistat blocks these adverse changes in biliary lipid composition and maintains hepatobiliary function. We speculate that the risk of formation of gallstones during weight loss may actually be lowered with orlistat. © 2001 by Am. Coll. of Gastroenterology.
Persistent Identifierhttp://hdl.handle.net/10722/148227
ISSN
2015 Impact Factor: 10.383
2015 SCImago Journal Rankings: 3.946
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorChu, KMen_HK
dc.contributor.authorYuen, STen_HK
dc.contributor.authorLeung, SYen_HK
dc.contributor.authorLam, SKen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-05-29T06:11:38Z-
dc.date.available2012-05-29T06:11:38Z-
dc.date.issued2001en_HK
dc.identifier.citationAmerican Journal Of Gastroenterology, 2001, v. 96 n. 6, p. 1888-1894en_HK
dc.identifier.issn0002-9270en_HK
dc.identifier.urihttp://hdl.handle.net/10722/148227-
dc.description.abstractOBJECTIVES: Orlistat, an intestinal lipase inhibitor, has recently been approved by the US Food and Drug Administration for treatment of obesity. The effects of orlistat on hepatobiliary function have not been previously defined. A 4 wk study was performed involving modest weight loss in obese subjects to observe any short-term hepatobiliary responses that occur after initiating treatment with orlistat and a hypocaloric diet. METHODS: A total of 23 obese (BMI 30-41 kg/m 2) subjects were randomized to a double blind t.i.d. treatment with 120 mg of orlistat or a placebo in conjunction with a hypocaloric diet (1200-1500 kcal/day). The study was designed to achieve similar modest weight loss in both groups in order to be able to directly assess the effects of orlistat. Cholesterol saturation, bile composition, and gallbladder motility were measured. RESULTS: At the end of the treatment period, mean weight loss of 3.8 kg was achieved in the orlistat group (vs 2.3 kg with placebo, p = NS). Total bile acid concentration decreased significantly with placebo (-18.57 ± 6.99 mmol/L; 95% CI = -32.26 to -4.87), but not with orlistat. Biliary phospholipid concentration decreased significantly with placebo (-4.38 ± 1.91 mmol/L; 95% CI = -8.13 to -0.64) but not with orlistat. Mean changes from the baseline in cholesterol saturation index and gallbladder motility were similar in both groups. Microscopy of bile failed to reveal cholesterol microcrystals before or after treatment in either group. CONCLUSIONS: Our findings indicate a primary initial effect of weight loss is a reduction in biliary bile acids and phospholipids. Orlistat blocks these adverse changes in biliary lipid composition and maintains hepatobiliary function. We speculate that the risk of formation of gallstones during weight loss may actually be lowered with orlistat. © 2001 by Am. Coll. of Gastroenterology.en_HK
dc.languageengen_US
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/ajg/index.htmlen_HK
dc.relation.ispartofAmerican Journal of Gastroenterologyen_HK
dc.subject.meshAdulten_US
dc.subject.meshAnti-Obesity Agents - Adverse Effects - Pharmacokinetics - Pharmacologyen_US
dc.subject.meshBile - Chemistryen_US
dc.subject.meshBile Acids And Salts - Chemistryen_US
dc.subject.meshCholesterol - Metabolismen_US
dc.subject.meshDouble-Blind Methoden_US
dc.subject.meshEnergy Intakeen_US
dc.subject.meshEnzyme Inhibitors - Adverse Effects - Pharmacokinetics - Pharmacologyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGallbladder - Drug Effects - Physiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshLactones - Adverse Effects - Pharmacokinetics - Pharmacologyen_US
dc.subject.meshLipase - Antagonists & Inhibitorsen_US
dc.subject.meshLipids - Analysisen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshObesity - Drug Therapy - Metabolismen_US
dc.subject.meshWeight Lossen_US
dc.titleOrlistat maintains biliary lipid composition and hepatobiliary function in obese subjects undergoing moderate weight lossen_HK
dc.typeArticleen_HK
dc.identifier.emailChu, KM: chukm@hkucc.hku.hken_HK
dc.identifier.emailLeung, SY: suetyi@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityChu, KM=rp00435en_HK
dc.identifier.authorityLeung, SY=rp00359en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/S0002-9270(01)02346-2en_HK
dc.identifier.pmid11421247-
dc.identifier.scopuseid_2-s2.0-0034976310en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034976310&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume96en_HK
dc.identifier.issue6en_HK
dc.identifier.spage1888en_HK
dc.identifier.epage1894en_HK
dc.identifier.isiWOS:000169201000034-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChan, AOO=7403167965en_HK
dc.identifier.scopusauthoridChu, KM=7402453538en_HK
dc.identifier.scopusauthoridYuen, ST=7103160927en_HK
dc.identifier.scopusauthoridLeung, SY=7202044886en_HK
dc.identifier.scopusauthoridLam, SK=7402279800en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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