奥利司他对单纯性肥胖患者胰岛素抵抗的影响

Effects of Orlistat on Insulin-resistance in Simple Obese Patients

目的观察奥利司他对单纯性肥胖患者胰岛素抵抗的影响。方法 90例患者分成 2组,治疗组 (60例 )给予奥利司他 360mg/d,共 24周;对照组(30例)给予安慰剂 21金维他片;并与同期 30例健康体检者比较。观察各组的体质量指数 (BMI)、腰臀比 (WHR)、空腹血糖 (FPG)、空腹血浆胰岛素 (FPI)、胰岛素敏感性指数(ISI)、血清胆固醇(TC)、甘油三酯(TG)及血压(BP)。结果治疗前单纯性肥胖患者存在高胰岛素血症,与健康组比较ISI显著下降 (P<0. 01),治疗后BMI、WHR、FPI及舒张压明显下降 (P<0. 05 )。ISI明显上升 (P<0.05),且优于对照组治疗后(P<0. 05)。ISI的提高与BMI、WHR的下降呈显著负相关(P<0. 05)。结论奥利司他不仅能改善单纯性肥胖患者的体脂参数,同时也能降低胰岛素抵抗,防止高血压病和糖尿病等相关疾病。

Objective To study the effects of the orlistat on insulin-resistance in simple obese patients.Methods Ninety obese patients were randomly divided into two groups.The patients in treatment group(60 cases) were treated with the orlistat while in control group(30 cases) with Vitamine 21 genus.Both groups were contrasted with 30 healthy subjects.The changes of the body mass index(BMI),waist hip ratio(WHR),fasting plasma glucose(FPG),fasting plasma insulin(FPI),insulin sensitivity index(ISI),total cholesterol(TC),triglyceride(TG) as well as blood pressure were observed before and after treatment.Results Before treatment,the ISI of simple obese patients with hyperinsulinemia was lower than that in healthy subjects(P<0.01).After treatment,BMI,WHR,FPI and diastolic blood pressure in the treatment group remarkably declined(P<0.05) while ISI rosed(P<0.05),and excessed that in control group(P<0.05).The increase of ISI was negatively correlated to the decrease of BMI and WHR(P<0.05).Conclusion The orlistat can effectively decrease BMI and WHR of simple obese patients,improve their insulin-resistance and guard them against concerned diseases such as hypertension,diabetes and so on.