title: Decreasing levels of tumour necrosis factor alpha and interleukin 6 during lowering of body mass index with orlistat or placebo in obese subjects with cardiovascular risk factors.
abstract: OBJECTIVE
  Obesity is associated with increased levels of inflammatory mediators. The objective of this study was to evaluate changes in the leucocyte derived inflammatory mediators tumour necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6) and the isoprostane 8-epi-prostaglandin (PG) F2alpha during BMI lowering with orlistat (Xenical(R), Roche) or placebo.
  
  
  METHODS
  TNF-alpha, IL-6, and 8-epi PGF2alpha evaluated in 376 subjects aged 18-75 years with BMI 28-38 kg/m2 before and after 1 year of double-blind, randomized treatment with orlistat 120 mg or placebo three times daily.
  
  
  RESULTS
  Weight reduction was associated with decreasing (p < 0.001) levels of TNF-alpha and IL-6 in both orlistat and placebo groups. After 12 months, TNF-alpha was lower (p < 0.05) in the orlistat compared with the placebo group. In the orlistat group, the change in TNF-alpha correlated with change in s-glucose (r = 0.22; p = 0.01), and the change in 8-epi-PGF2alpha correlated with changes in s-cholesterol (r = 0.27; p < 0.001) and s-LDL-cholesterol (r = 0.28; p < 0.001).
  
  
  CONCLUSIONS
  Weight reduction was associated with decreasing levels of both TNF-alpha and IL-6. After 12 months of treatment, TNF-alpha levels were lower in orlistat than in placebo-treated subjects. Whether these results translate into reduced incidence of cardiovascular disease remains to be elucidated.
authors.affiliation: Department of Vascular Diseases, University Hospital, S-205 02 Malmö, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Samuelsson
authors.forename: A
authors.initials: A
authors.lastname: Gottsäter
authors.forename: F
authors.initials: F
authors.lastname: Lindgärde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology* / Q000517:prevention & control; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007783:Lactones / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000077403:Orlistat; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D015431:Weight Loss
chemical_list: D019440:Anti-Obesity Agents; D015850:Interleukin-6; D007783:Lactones; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; C075750:8-epi-prostaglandin F2alpha; D000077403:Orlistat; D015237:Dinoprost