作者：
【摘自】內(nèi)分泌雜志，2000年10月第13刊第2期。
【摘要】
奧利司他是一種新的非中樞神經(jīng)作用的減肥藥，可選擇性的抑制胃腸道脂肪酶的活性，可減少膳食中約1/3的脂肪吸收。在一系列1年和2年的肥胖患者的隨機對照試驗中，奧利司他結(jié)合輕度低熱量飲食減重效果比單純飲食控制更好。奧利司他治療1年和2年后，治療組患者獲得有臨床意義的體重減輕的數(shù)量高于安慰劑組。奧利司他可明顯降低長期減肥的反彈。此外，奧利司他治療可明顯改善幾個心血管風(fēng)險因子，包括血清總膽固醇和低密度脂蛋白膽固醇，血清胰島素水平，收縮壓和舒張壓以及腰圍。而且，與安慰劑組比較，肥胖伴2型糖尿病的患者服用奧利司他體重下降非常明顯，同時可明顯改善糖化血紅蛋白和空腹血糖水平。與安慰劑組比較，奧利司他可降低糖耐量異常患者發(fā)展成2型糖尿病的比例。奧利司他在胃腸道發(fā)揮作用，很少吸收入血。長期的臨床試驗發(fā)現(xiàn)，奧利司他在糖尿病和非糖尿病個體中都有很好的耐受性。
[關(guān)鍵詞] 奧利司他、減肥藥、限制脂肪的飲食、減重、冠狀動脈風(fēng)險
文獻(xiàn)原文：
Orlistat: selective inhibition of caloric absorption can affect long-term body weight
Author：Hauptman J.
Author information：Hoffmann-La Roche Inc., Nutley, NJ 07110-1199, USA.
Quote：Endocrine. 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.