专业学术

奥利司他-选择性抑制脂肪可长期服用

2016-04-20

所属分类:专业学术


作者:

Hauptman J.

【摘自】内分泌杂志,2000年10月第13刊第2期。

【摘要】

奥利司他是一种新的非中枢神经作用的减肥药,可选择性的抑制胃肠道脂肪酶的活性,可减少膳食中约1/3的脂肪吸收。在一系列1年和2年的肥胖患者的随机对照试验中,奥利司他结合轻度低热量饮食减重效果比单纯饮食控制更好。奥利司他治疗1年和2年后,治疗组患者获得有临床意义的体重减轻的数量高于安慰剂组。奥利司他可明显降低长期减肥的反弹。此外,奥利司他治疗可明显改善几个心血管风险因子,包括血清总胆固醇和低密度脂蛋白胆固醇,血清胰岛素水平,收缩压和舒张压以及腰围。而且,与安慰剂组比较,肥胖伴2型糖尿病的患者服用奥利司他体重下降非常明显,同时可明显改善糖化血红蛋白和空腹血糖水平。与安慰剂组比较,奥利司他可降低糖耐量异常患者发展成2型糖尿病的比例。奥利司他在胃肠道发挥作用,很少吸收入血。长期的临床试验发现,奥利司他在糖尿病和非糖尿病个体中都有很好的耐受性。

 [关键词] 奥利司他、减肥药、限制脂肪的饮食、减重、冠状动脉风险

文献原文:

Orlistat: selective inhibition of caloric absorption can affect long-term body weight

AuthorHauptman J.

Author informationHoffmann-La Roche Inc., Nutley, NJ 07110-1199, USA.

QuoteEndocrine. 2000 Oct;13(2):201-6.

ABSTRACT】

Orlistat is a novel, noncentrally acting antiobesity agent that selectively inhibits gastrointestinal lipase activity, thereby reducing the absorption of dietary fat by approximately one-third. In a series of 1- and 2-yr randomized, placebo-controlled trials of obese subjects, treatment with orlistat in combination with a mildly calorie-restricted diet consistently produced significantly greater mean weight loss than diet alone. More orlistat-treated subjects than placebo recipients achieved clinically meaningful weight reduction (> or =5% or > or =10% of initial body weight) after 1 and 2 yr. Orlistat was also associated with a significant reduction in the regain of lost weight during long-term treatment. In addition, orlistat therapy resulted in significant improvements in several cardiovascular risk factors including serum total and low-density lipoprotein-cholesterol, serum insulin levels, systolic and diastolic blood pressure, and waist circumference. Furthermore, obese subjects with type 2 diabetes achieved a significantly greater decrease in body weight with orlistat compared with placebo, as well as significant improvements in HbA1c and fasting glucose levels. Among subjects with impaired glucose tolerance, orlistat compared with placebo reduced the proportion who developed type 2 diabetes. Conversely, orlistat increased the proportion of subjects who achieved a normalization of glucose tolerance. Orlistat acts locally in the gastrointestinal tract and is only minimally absorbed. In long-term clinical trials, orlistat was well tolerated by both diabetic and nondiabetic subjects.

文献详情:http://www.ncbi.nlm.nih.gov/pubmed/?term=Selective+Inhibition+of+Caloric+Absorption+Can+Affect+Long-Term+Body+Weight

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