Effects of orlistat, simvastatin, and orlistat plus simvastatin in obese patients with hypercholesterolemia: A randomized, open-label trial

被引:17
作者
Derosa, G [1 ]
Mugellini, A [1 ]
Ciccarelli, L [1 ]
Rinaldi, A [1 ]
Fogari, R [1 ]
机构
[1] Univ Pavia, IRCCS, Policlin San Matteo, Dept Internal Med & Therapeut, I-27100 Pavia, Italy
来源
CURRENT THERAPEUTIC RESEARCH-CLINICAL AND EXPERIMENTAL | 2002年 / 63卷 / 09期
关键词
obese; hypercholesterolemia; blood pressure; diet; orlistat; simvastatin;
D O I
10.1016/S0011-393X(02)80066-2
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Background: Many obese patients have comorbidities that worsen their prognoses, particularly if hypercholesterolemia is present. In these patients, dietary restrictions are not sufficient to reduce hypercholesterolemia and lose body weight. Objective: This 1-year, single-center, randomized, open-label study assessed the effects of diet and exercise plus treatment with orlistat, simvastatin, and orlistat + simvastatin on lipid profile, body composition, and blood pressure in obese patients with hypercholesterolemia. Methods: Obese, normotensive patients with hypercholesterolemia aged >45 years were eligible. Patients were prescribed a restricted-calorie diet and were randomized to receive orlistat 120 mg TID (group O), simvastatin 20 mg/d (group S), or orlistat 120 mg TID plus simvastatin 20 mg/d (group OS) for 1 year. Serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels; body mass index (BMI); waist-circumference reduction (WCR); body weight loss (BWL); and diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured at baseline and after 6 months and 1 year of treatment. Results: We enrolled 87 patients (45 women, 42 men; mean age, 55 years). Four patients dropped out due to nontransient adverse events. After 1 year of treatment, significant improvements were found in all measured parameters in all treatment groups versus baseline values, except for HDL-C in group O. Significant. between-group differences at 1 year included the following: TC, LDL-C, and TG levels and BMI, WCR, and BWL were significantly decreased in group OS versus groups O and S; DBP was significantly decreased in group OS versus group O; SBP and DBP were significantly decreased in group OS versus group S. HDL-C was significantly increased in group OS but not in groups O and S. Five patients in group O and 1 patient in group OS experienced transient gastrointestinal adverse events. Conclusions: In this study population, all 3 treatments produced significant improvements in most measured parameters from baseline. The combination treatment showed significantly greater reductions in serum TC and LDL-C levels, BMI, WCR, and BWL than with either orlistat or simvastatin alone. Small but significant differences in blood pressure were found with combination treatment.
引用
收藏
页码:621 / 633
页数:13
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