Orlistat increases serum paraoxonase activity in obese patients

Background and aim: Previous studies have demonstrated that oxidative stress is increased in obese patients. The high-density lipoprotein (HDL) associated human paraoxonase 1 (PON1) can inhibit tow-density lipoprotein oxidation and has an antiatherogenic effect. Our objective was to assess the effects of orlistat therapy combined with diet on body mass index (BMI), waist circumference, lipid parameters, blood pressure, serum glucose level. and POW activity. Methods and results: A longitudinal, multicenter, randomized study with and without orlistat treatment was performed. One hundred thirty nine otherwise healthy, obese subjects were divided in to two groups: 78 persons received orlistat (120 mg three times a day) combined with diet while 61 persons were kept on diet only. Anthropornetricat parameters, serum lipid levels and POW activity were measured at baseline and after 6 months of treatment. BMI and waist circumference were reduced more pronouncedty in the orlistat group than in the control group. Patients receiving orlistat also had significantly greater improvements in fasting blood glucose levels and blood pressure. The ortistat-treated group showed a greater reduction in total cholesterol and triglyceride levels. In addition, the serum PON1 activity in these patients was significantly increased compared to the diet-only group. Conclusions: The 6-month treatment with orlistat had a beneficial effect on the Lipid profile and improved the antioxidant status by increasing serum PON1 activity. However, because of the Limited therapeutic effectiveness, obese patients with hyperchotesterolemia should receive additional lipid towering medications. (c) 2006 Elsevier B.V. All rights reserved.