Orlistat improves postprandial triglyceride metabolism in obese patients with type 2 diabetes

SUMMARYORLISTAT IMPROVES POSTPRANDIAL TRIGLYCERIDE METABOLISM INOBESE PATIENTS WITH TYPE 2 DIABETESIntroduction and Objective: Accumulating data suggests that post-prandialhypertriglyceridemia is important in the pathogenesis and progression of atherosclerosis, andthus cardiovascular diseases. We aimed to assess the acute effect of the orlistat vs. placebo onpost-prandial triglyceride (TG) level in diabetic and non-diabetic obese patients.Research Design and Methods: The acute effect of orlistat on postprandial TG, glucose andinsulin levels was evaluated in a randomized and placebo-controlled study. Study included 24patients with type 2 and obesity. Before the standard test meal that contains 50 gr fat, it wasgiven one dose orlistat to 14 patients and plasebo to 10 patients. Plasma TG, glucose andinsulin levels were measured at fasting 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 incrementalarea under the curves (d AUC) for TG was also calculated.Results: There were no statistically significant difference between the orlistat and placebogroups with regard to age, sex, BMI, HbA1C, basal triglyceride and basal total cholesterol.Post-prandial glucose and insulin responses to test meal were not significant between theorlistat and the placebo groups. Significant post-prandial TG reduction in TG 4-h (p=0.005)and in TG 6-h (p=0.002) were achieved with orlistat, which resulted in a significant lower TGAUC (p= 0.042) and TG dAUC (p<0.001) compared to the placebo group.Conclusion: Orlistat improves postprandial TG concentrations in type 2 diabetic obesepatients.Keywords: Obesity, orlistat, post-prandial lipemia, triglyceride, diabetes