Effects of orlistat on fat-soluble vitamins in obese adolescents.
OBJECTIVE
To determine whether orlistat causes fat-soluble vitamin deficiencies in African-American and Caucasian adolescents.


METHODS
Prospective, open-label pilot study.


METHODS
Warren Grant Magnuson Clinical Center of the National Institutes of Health.


METHODS
Seventeen adolescents with body mass indexes above the 95th percentile for age, race, and gender who also had at least one obesity-related comorbid condition.


METHODS
Subjects received orlistat 120 mg 3 times/day and a daily multivitamin supplement containing vitamin A 5000 IU, vitamin D 400 IU, vitamin E 300 IU, and vitamin K 25 microg.


RESULTS
During 3-6 months of orlistat treatment, acute absorption of retinol (vitamin A) was not significantly altered, but absorption of alpha-tocopherol (vitamin E) was significantly reduced compared with baseline levels (p<0.001). Serum levels of vitamins A and E did not change significantly; however, there was a nonsignificant decrease in vitamin K. Mean vitamin D levels were significantly reduced compared with baseline (p<0.02) after 1 month of orlistat, despite multivitamin supplementation.


CONCLUSIONS
It may be prudent to monitor vitamin D concentrations in adolescents who take orlistat, even when a multivitamin is prescribed.
Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland 20892-1862, USA. Mcduffj@mail.nih.gov
Jennifer R
JR
McDuffie
Karim A
KA
Calis
Sarah L
SL
Booth
Gabriel I
GI
Uwaifo
Jack A
JA
Yanovski
D000293:Adolescent; D000704:Analysis of Variance; D001361:Avitaminosis / Q000097:blood* / Q000139:chemically induced; D002648:Child; D005260:Female; D006801:Humans; D007783:Lactones / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009765:Obesity / Q000097:blood* / Q000188:drug therapy*; D000077403:Orlistat; D010865:Pilot Projects; D011446:Prospective Studies; D014801:Vitamin A / Q000097:blood; D014807:Vitamin D / Q000097:blood; D014810:Vitamin E / Q000097:blood
D007783:Lactones; D014801:Vitamin A; D014807:Vitamin D; D014810:Vitamin E; D000077403:Orlistat