Long-term effects of lipase inhibition by orlistat on gastric emptying and orocecal transit time of a solid meal.
BACKGROUND
We assessed the impact of a prolonged lipase inhibition upon gastric emptying (GE) and orocecal transit time (OCTT) of a 355-kcal low-fat solid meal.


METHODS
In double-blind manner, 40 obese women BMI > 30 kg/m2, randomly allocated into two equal groups, took orally t.i.d. 120 mg orlistat or placebo during 8 weeks of a weight-reducing management. At randomization and after 2 months, GE was measured simultaneously with OCTT by means of a 13C-octanoic acid and a hydrogen breath test, respectively. Lipolytic activity was evaluated with a 13C-mixed triglyceride breath test (13C-MTGBT).


RESULTS
A profound lipase inhibition by orlistat was confirmed by a 79.5% +/- 16.9% reduction of the cumulative 6-h 13C recovery with 13CMTGBT. GE remained unchanged either in the orlistat (T1/2, 188 +/- 35 min start versus 198 +/- 36 min end) or the placebo (T1/2, 191 +/- 35 min start versus 180 +/- 39 min end) group. OCTT increased from 208 +/- 54 min to 271 +/- 64 min (P < 0.01) after orlistat treatment and did not change significantly (216 +/- 76 vs. 234 +/- 72 min) in the placebo group.


CONCLUSIONS
No adverse effect on the GE and a moderate prolongation of the OCTT of a low-fat solid meal is to be expected under a prolonged treatment with orlistat at a typical dosage regimen.
Kocełak
Piotr
P
Department of Pathophysiology, Medical University of Silesia, 18 Medyków Street, Katowice, 40-752, Poland.
Zahorska-Markiewicz
Barbara
B
Jonderko
Krzysztof
K
Olszanecka-Glinianowicz
Magdalena
M
Zak-Gołab
Agnieszka
A
Holecki
Michał
M
Kamińska
Magdalena
M
Szymszal
Małgorzata
M
D000284:Administration, Oral; D000328:Adult; D019440:Anti-Obesity Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005502:Food; D005746:Gastric Emptying / Q000187:drug effects*; D005772:Gastrointestinal Transit / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007583:Jejunum / Q000201:enzymology; D007783:Lactones / Q000008:administration & dosage / Q000627:therapeutic use*; D008049:Lipase / Q000037:antagonists & inhibitors*; D009765:Obesity / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D000077403:Orlistat; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat; D008049:Lipase