Effect of orlistat-assisted weight rose in decreasing coronary heart disease risk in patients with syndrome X

This study describes the changes in risk factors for coronary heart disease in obese persons with syndrome X after orlistat-assisted weight loss. Data were available for 1,700 patients who completed 52 weeks of weight loss; 1 28 were defined as having syndrome X by being in the quintile with the high est plasma triglyceride levels (>2.2 mM/L) and the lowest high-density lipo protein cholesterol (HDL, <1.0 mM/L) concentrations. Initial characteristic s of those with syndrome X were similar to the 119 subjects (non-syndrome X ) in the lowest quintile of plasma triglyceride (<0.975 mM/L) and highest q uintile of HDL cholesterol (>1.5 mM/L). Subjects were placed on a calorie-r estricted diet, and randomized to receive orlistat or placebo. Initial valu es were higher in those with syndrome X for diastolic blood pressure (p = 0 .03), plasma insulin (p = 0.0001), triglyceride (p = 0.0001) concentrations , and ratio of low-density lipoprotein cholesterol to HDL cholesterol (p = 0.0001), and were lower for HDL cholesterol (p = 0.001) concentrations. Wei ght loss was greater in both groups of orlistat-treated patients (p = 0.026 ); in those with syndrome X, it was associated with a significant reduction in plasma insulin (p = 0.019) and triglyceride (p = 0.0001) concentrations , an increase in HDL cholesterol concentration, and a decrease in low-densi ty lipoprotein/HDL cholesterol ratio (p = 0.0001), There were no significan t changes in plasma insulin, triglycerides, or HDL cholesterol concentratio n in the non-syndrome X group. In conclusion, weight loss attenuates corona ry heart disease risk factors in obese persons with syndrome X, and the ris k factor reduction is enhanced with administration of orlistat. (C) 2001 by Excerpta Medico, Inc.