The effects of orlistat and fenofibrate, alone or in combination, on high-density lipoprotein subfractions and pre-beta1-HDL levels in obese patients with metabolic syndrome.
OBJECTIVE
We assessed the effect of orlistat and fenofibrate, alone or in combination, on plasma high-density lipoprotein (HDL) subfractions and plasma pre-beta1-HDL levels in overweight and obese subjects with metabolic syndrome (MetS).


METHODS
Patients (n = 89) were prescribed a low-fat low-calorie diet and were randomly allocated to receive orlistat 120 mg three times daily (O group), micronized fenofibrate 200 mg/day (F group) or both (OF group) for 6 months. HDL subfractions were determined using a polyacrylamide gel tube electrophoresis method and pre-beta1-HDL levels using enzyme-linked immunoabsorbent assay.


RESULTS
We observed a significant change of high-density lipoprotein cholesterol (HDL-C) levels only in the F group (+3%, p < 0.05). Large HDL-C levels were significantly increased and small HDL-C levels were significantly reduced with O administration. In F group we observed a significant increase of small HDL-C levels. No significant change of large or small HDL-C levels was observed with combination treatment. We observed a significant increase of pre-beta1-HDL levels in all groups, which was significantly greater in OF group compared with O or F monotherapy.


CONCLUSIONS
OF combination increased the antiatherogenic pre-beta1-HDL levels in overweight and obese patients with MetS. Furthermore, OF combination counterbalanced the reduction of small HDL-C levels observed with orlistat monotherapy.
Filippatos
T D
TD
Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece.
Liberopoulos
E N
EN
Kostapanos
M
M
Gazi
I F
IF
Papavasiliou
E C
EC
Kiortsis
D N
DN
Tselepis
A D
AD
Elisaf
M S
MS
D019440:Anti-Obesity Agents / Q000008:administration & dosage* / Q000494:pharmacology; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage* / Q000494:pharmacology; D006115:Greece; D053442:High-Density Lipoproteins, Pre-beta / Q000097:blood / Q000187:drug effects; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage* / Q000494:pharmacology; D007783:Lactones / Q000008:administration & dosage* / Q000494:pharmacology; D008075:Lipoproteins, HDL / Q000097:blood* / Q000187:drug effects; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D000077403:Orlistat; D050177:Overweight / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy
D019440:Anti-Obesity Agents; D008076:Cholesterol, HDL; D053442:High-Density Lipoproteins, Pre-beta; D000960:Hypolipidemic Agents; D007783:Lactones; D008075:Lipoproteins, HDL; D000077403:Orlistat; D011345:Fenofibrate