Endocrine Abstracts

Objective: Accumulating data suggests that post-prandial hypertriglyceridemia is important in the pathogenesis and progression of atherosclerosis, and thus cardiovascular diseases. We aimed to assess the acute effect of the orlistat vs placebo on post-prandial triglyceride (TG) level in diabetic and non-diabetic obese patients.

Research Design and Methods: Study population consisted of 49 patients with obesity (25 non-diabetics, 24 diabetic). Patients were randomized to take either single dose of orlistat 120 mg (26 patients) or placebo (23 patients) before a standard mixed meal containing 50 g of fat. Plasma TG, glucose and insulin levels were measured at baseline and post-prandially at 2-h interval for 6–h. Post-prandial curves were calculated as the total area under curve (AUC) for TG. The incremental area under the curves (d AUC) for TG was also calculated.

Results: There were no statistically significant difference between the orlistat and placebo groups with regard to age, sex, BMI, A1c, basal triglyceride and basal total cholesterol. Post-prandial glucose and insulin responses to test meal were not significant between the orlistat and the placebo groups. Significant post-prandial TG reduction in TG 4-h (202.2±103.1 vs 297.5±121 mg/dl, P=0.005) and in TG 6-h (151.9±78.7 vs 233.9±93.1 mg/dl, P=0.002) were achieved with orlistat, which resulted in a significant lower TG AUC (1163.3±566.2 vs 1475.6±561.7, P=0.042) and TG dAUC (269. 7±250.7 vs 571.8±296.2 P<0.001) compared to the placebo group.

The effect of orlistat on time course of the change in postprandial TG concentrations (except TG at 6-h), TG AUC, TG dAUC during 6-h postprandial period were not different between diabetic and non-diabetic obese.

Conclusion: Orlistat improves postprandial TG concentrations in both diabetic and non-diabetic obese patients.