title: Induction of artificial fat maldigestion by tetrahydrolipstatin assessed by the (13)C-hiolein breath test in healthy volunteers. A double-blind controlled pilot study.
abstract: BACKGROUND
  (13)C-hiolein is a purified algal triglyceride which is synthesized with 98% of all carbon atoms of the molecule uniformly (13)C-labeled. Orlistat is the new name for tetrahydrolipstatin (THL), which is a specific and potent inhibitor of gastrointestinal lipases which induces artificial fat malabsorption in humans. The aim of the present study was to use the (13)C-hiolein breath test (HBT) to assess THL-induced fat malabsorption in healthy volunteers.
  
  
  METHODS
  Eight healthy volunteers of normal body weight underwent 2 study periods of 4 days of diet with or without THL 120 mg t.i.d. On day 5, a HBT was performed. (13)CO(2) recovery in breath samples was measured over 24 h by isotope ratio mass spectrometry.
  
  
  RESULTS
  The peak (13)CO(2) excretion occurred only after 5 h in both treatment groups with little difference during the first 4 h between the groups. THL potently reduced fat digestion and absorption with the most pronounced effect observed after 8 h: 1.1+/-0.2 vs. 2.3+/-0.3% dose in control experiments (p<0.05). The 24-hour cumulative (13)CO(2) excretion was also significantly reduced by THL: 14.9+/-2.2 vs. 28.4+/-4.1% dose in control experiments (p<0.05). In 6 of the 8 subjects, the cumulative (13)CO(2) excretion was lower with THL 120 mg t.i.d. than with placebo.
  
  
  CONCLUSIONS
  The HBT well reflects THL-induced artificial fat maldigestion in healthy volunteers.
authors.affiliation: Outpatient Clinic and Division of Gastroenterology, University Hospital, Basel, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Ashraf
authors.forename: P
authors.initials: P
authors.lastname: Hildebrand
authors.forename: R
authors.initials: R
authors.lastname: Meier
authors.forename: C
authors.initials: C
authors.lastname: Beglinger
authors.forename: N
authors.initials: N
authors.lastname: Gyr
mesh_terms: D000328:Adult; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis; D002247:Carbon Isotopes; D018592:Cross-Over Studies; D004041:Dietary Fats / Q000378:metabolism*; D004063:Digestion / Q000502:physiology*; D004311:Double-Blind Method; D056890:Eukaryota / Q000737:chemistry; D005260:Female; D006801:Humans; D007783:Lactones / Q000494:pharmacology*; D008297:Male; D000077403:Orlistat; D010865:Pilot Projects; D014280:Triglycerides / Q000494:pharmacology*
chemical_list: D002247:Carbon Isotopes; D004041:Dietary Fats; D007783:Lactones; D014280:Triglycerides; C417773:hiolein; D002245:Carbon Dioxide; D000077403:Orlistat