Orlistat Abolishes Postprandial Lipid Peaking

Postprandial hyperlipemia is associated with the development of cardiovascu-lar disease. Orlistat is a pancreatic li-pase inhibitor that reduces fat absorp-tion from the diet by inhibition of hy- drolysis of triglycerides. Since the effect of orlis-tat on postprandial lipemia has not been fully elucidated, we studied the effect of orlistat on postprandial lipemia after a 50% oral fat chal-lenge test (OFCT). Materials and Methods: Twenty-seven healthy volunteers, aged 18-45 years old, with normal body mass index (BMI) and normal fasting lipid levels, were studied. The control group (n=15) was given the 50% OFCT while the study/orlistat group (n=12), was given 120 mg orlistat followed by intake of the 50% OFCT. Total cholesterol (TC), triglycerides (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) were determined at baseline and serially over a 6-hour period. Re- sults: In the control group, TC, TG and HDL peaked in the 4th hour. This lipid peaking was not observed in the orlistat group. Percentage change between baseline to the 4th hour values in the control vs. the study group were, respec-tively, as follows: TC = 65.80% vs. -1.60%; TG = 262.64% vs. 24.74%; and HDL = 205.26% vs. - 1.43%. The mean postprandial levels for TC, TG and LDL were well within the normal fasting cut-offs of 6.20 mmol/L, 2.26 mmol/L, and 4.14 mmol/L respectively throughout the entire 6-hour study period. Conclusion: Orlistat ab- olished the peaking of TC, TG, and HDL after a 50% OFCT. Nonetheless, lipid values were main-tained within normal fasting levels in the orlistat group.