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Titolo:
Influence of orlistat on bone turnover and body composition
Autore:
Gotfredsen, A; Hendel, HW; Andersen, T;
Indirizzi:
Amager Inst, Dept Internal Med, DK-2300 Copenhagen S, Denmark Amager InstCopenhagen Denmark S rnal Med, DK-2300 Copenhagen S, Denmark Hvidovre Univ Hosp, Dept Endocrinol, DK-2650 Hvidovre, Denmark Hvidovre Univ Hosp Hvidovre Denmark DK-2650 l, DK-2650 Hvidovre, Denmark Hvidovre Univ Hosp, Dept Clin Physiol & Nucl Med, DK-2650 Hvidovre, Denmark Hvidovre Univ Hosp Hvidovre Denmark DK-2650 d, DK-2650 Hvidovre, Denmark Univ Copenhagen, Rigshosp, Dept Clin Physiol & Nucl Med, DK-2100 Copenhagen, Denmark Univ Copenhagen Copenhagen Denmark DK-2100 , DK-2100 Copenhagen, Denmark Roskilde Cty Psychiat Hosp Fjorden, Roskilde, Denmark Roskilde Cty Psychiat Hosp Fjorden Roskilde Denmark , Roskilde, Denmark
Titolo Testata:
INTERNATIONAL JOURNAL OF OBESITY
fascicolo: 8, volume: 25, anno: 2001,
pagine: 1154 - 1160
SICI:
0307-0565(200108)25:8<1154:IOOOBT>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
ENERGY X-RAY; SOFT-TISSUE MEASUREMENTS; INDUCED WEIGHT-LOSS; VITAMIN-D STATUS; POSTMENOPAUSAL WOMEN; MINERAL DENSITY; OBESE PATIENTS; MASS; ABSORPTIOMETRY; DIET;
Keywords:
obesity treatment; orlistat; body composition; bone turnover; bone mass; bone mineral content; bone mineral density;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
43
Recensione:
Indirizzi per estratti:
Indirizzo: Gotfredsen, A Amager Inst, Dept Internal Med, Italiensvej 1, DK-2300 Copenhagen S, Denmark Amager Inst Italiensvej 1 Copenhagen Denmark S n S, Denmark
Citazione:
A. Gotfredsen et al., "Influence of orlistat on bone turnover and body composition", INT J OBES, 25(8), 2001, pp. 1154-1160

Abstract

OBJECTIVE: To investigate the influence of the pancreas lipase inhibitor orlistat (OLS) on calcium metabolism, bone turnover, bone mass, bone densityand body composition when given for obesity as adjuvant to an energy- and fat-restricted diet. DESIGN: Randomized controlled double-blinded trial of treatment with OLS 120 mg three times daily or placebo for 1 y. SUBJECTS: Thirty obese subjects with a mean body mass index (BMI) of 36.9 /- 3.7 kg/m(2) and a mean age of 41 +/- 11 y. Sixteen patients were assigned to OLS and 14 to placebo. MEASUREMENTS: Dual energy X-ray absorptiometry (DXA) measurements of bone mineral and body composition included total bone mineral content (TBMC), total bone mineral density (TBMD), lumbar spine BMC and BMD, forearm BMC and BMD, fat mass (FM), fat free-mass (FFM), percentage fat mass (FM%) as well as a DXA estimate of the body weight. Body composition (FM, FFM and FM%) was estimated by total body potassium (TBK). Indices of calcium metabolism and bone turnover included serum values of ionized calcium (Ca++), iPTH (parathyroid hormone), alkaline phosphatase, 25(OH)-vitamin D, 1,25(OH)(2) vitamin D and osteocalcin as well as fasting urinary ratios of hydroxyproline/creatinine and Ca/creatinine (fU-OHpr/creat, FUCa/creat). RESULTS: There were no significant differences between OLS and placebo groups as to any of the body composition variables (FFM, FM, FM%) at baseline or after 1 y treatment. Weight loss was of 11.2 +/- 7.5 kg in the OLS groupand 8.1 +/- 7.5 kg in the placebo group (NS). The changes in FM and FM% were significant in both groups determined by DXA as well as by TBK but the group differences between these changes were not significant. The composition of the weight loss was approximately 80% fat in both groups. FFM only changed significantly by DXA in the OLS group (-1.3 kg), but the difference from the placebo group was not significant. Forearm BMD in both groups, forearm BMC in the OLS group and TBMD in the placebo group fell discretely but significantly, but there were no significant group differences between the OLS and the placebo-treated group. All biochemical variables except s-osteocalcin changed significantly after 1 y in the OLS group, disclosing a pattern of an incipient negative vitamin D balance, a secondary increase in PTH-secretion, and an increase in bone turnover with the emphasis on an increasein resorption parameters (fU-OHpr/creat, fUCa/creat). In the placebo group, only s-25(OH)vitamin D and fUOHpr/creat changed significantly, but the pattern was also that of a deteriorated vitamin D status and an increase in PTH levels and bone turnover. The only biochemical variable which was significantly different between OLS and placebo groups after one year was the fU-OHpr/creat ratio, which increased from 12.0 to 20.1 in the OLS group but only from 10.9 to 13.2 in the placebo group. CONCLUSION: One year's treatment with OLS induces a lipid malabsorption which enhances a dietary weight loss without any significant deleterious effects on body composition. OLS induces a relative increase in bone turnover in favour of resorption, possibly due to malabsorption of vitamin D and/or calcium. However, no changes in bone mass or density are seen after 1 y of OLS treatment apart from those explained by the weight loss itself. Thus 1 yof OLS treatment seems safe from a 'bone preserving' point of view. A vitamin D and calcium supplement should be taken during the treatment.

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Documento generato il 04/12/20 alle ore 13:23:03