Obesity, characterized by hyperleptinemia and hypoghrelinemia, has become a major health problem all over the world and is associated with an increased risk of complications including insulin resistance, hypertension, dyslipidemia, diabetes mellitus and atherosclerosis. The use of the pancreatic lipase inhibitor Orlistat can help seriously overweight people to achieve and maintain weight loss. The aim of our study was to compare the serum leptin and ghrelin levels in obese subjects who take orlistat with those receiving only dietary treatment. Twenty-one obese patients and 10 control subjects participated. The obese patients were divided into two groups; one group (n=11) took orlistat (120 mg, 3 times daily) and received dietary treatment and the other (n=10) only received the dietary treatment. The study lasted twelve weeks. The concentrations of serum ghrelin, leptin, insulin and C-peptide, and routine biochemical parameters, were measured in both groups. The serum ghrelin level was higher in control (183±62 fmol/ml) than obese (59±30 fmol/ml) subjects while the plasma leptin level was lower in control (8.7±12 μg/L) than obese (36.7±19 μg/L) subjects (all p<0.001). BMI and the total blood cholesterol, LDL and triglyceride levels fell significantly after both orlistat and dietary treatment in the obese subjects (all p<0.01), and the plasma ghrelin level rose (p<0.01). The leptin level demonstrated the opposite trend in both groups but only the patients taking orlistat showed a significant change (p<0.05).Taken together, these results show that orlistat has no effect on body weight in obese subjects additional to that conferred by a non-pharmacological life-style intervention. We therefore conclude that weight lost rather than type of treatment might be more valuable in obesity.

中文翻译：

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奥利司他对肥胖患者总生长素释放肽和瘦素水平的影响。

以高瘦素血症和低饥饿素血症为特征的肥胖症已成为全世界的主要健康问题，并与胰岛素抵抗、高血压、血脂异常、糖尿病和动脉粥样硬化等并发症的风险增加有关。使用胰脂肪酶抑制剂奥利司他可以帮助严重超重的人实现并保持体重减轻。我们研究的目的是比较服用奥利司他和仅接受饮食治疗的肥胖受试者的血清瘦素和生长素释放肽水平。21 名肥胖患者和 10 名对照受试者参与了研究。肥胖患者分为两组；一组 (n=11) 服用奥利司他 (120 毫克，每天 3 次) 并接受饮食治疗，另一组 (n=10) 仅接受饮食治疗。研究持续了十二周。在两组中测量血清生长素释放肽、瘦素、胰岛素和C肽的浓度以及常规生化参数。对照组的血清生长素释放肽水平 (183±62 fmol/ml) 高于肥胖 (59±30 fmol/ml) 受试者，而对照组的血浆瘦素水平 (8.7±12 μg/L) 低于肥胖 (36.7±19) μg/L) 受试者（所有 p<0.001）。在奥利司他和饮食治疗后，肥胖受试者的 BMI 和血液总胆固醇、低密度脂蛋白和甘油三酯水平显着下降（均 p<0.01），血浆生长素释放肽水平升高（p<0.01）。瘦素水平在两组中表现出相反的趋势，但只有服用奥利司他的患者表现出显着变化（p<0.05）。综合来看，这些结果表明，除了非药物生活方式干预所赋予的影响外，奥利司他对肥胖受试者的体重没有影响。因此，我们得出结论，体重减轻而不是治疗类型可能对肥胖症更有价值。