Document Detail


Orlistat reverse fatty infiltration and improves hepatic fibrosis in obese patients with nonalcoholic steatohepatitis (NASH).
MedLine Citation:
PMID:  17404856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nonalcoholic steatohepatitis (NASH) may cause progressive hepatic fibrosis, cirrhosis, and hepatocellular carcinoma. Treatment, thus far, has been restricted to diet and weight loss, but without compelling results. In this study we aimed to evaluate the efficacy of orlistat therapy in obese patients with NASH. Fourteen obese patients with NASH underwent liver biopsy prior to and subsequent to 6 months treatment with orlistat (120 mg tid). Hepatic fat extension was graded as normal, mild, moderate, or severe. Hepatic fibrosis was scored on a scale from 0 to 4, with 0 denoting no fibrosis and 4, cirrhosis. Portal inflammation was scored as 0-3, with 0 = normal, 1 = mild, 2 = moderate, and 3 = severe inflammation. Fourteen patients had NASH associated with diabetes, hyperlipidemia, or obesity. Orlistat reduced fatty infiltration in 10 patients (70%; P<0.01), 3 of whom had normal liver fat content after treatment. Orlistat improved inflammatory activity by 2 grades in 28% and by 1 grade in 50% of patients and effected no change in 22% of patients. Five patients (35%) returned to normal inflammatory activity. Orlistat improved hepatic fibrosis by 2 grades in three patients (21%) and by 1 grade in seven patients (50%). There was no change in four patients (28%). Orlistat lowered aminotransferases levels, total cholesterol, triglycerides and low-density lipoprotein, respectively. Insulin resistance index and malonyl dialdehyde levels improved significantly after orlistat therapy, whereas HbAic remained unchanged. In conclusion, in obese patients with NASH, liver fibrosis and inflammation improved after therapy with orlistat.
Authors:
Osamah Hussein; Masha Grosovski; Sorina Schlesinger; Sergio Szvalb; Nimer Assy
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Publication Detail:
Type:  Journal Article     Date:  2007-04-03
Journal Detail:
Title:  Digestive diseases and sciences     Volume:  52     ISSN:  0163-2116     ISO Abbreviation:  Dig. Dis. Sci.     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-06     Completed Date:  2007-10-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902782     Medline TA:  Dig Dis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2512-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine A, Sieff Government Hospital, Safed, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Biopsy
Body Mass Index
Enzyme Inhibitors / therapeutic use*
Fatty Liver / complications,  drug therapy*,  pathology
Female
Follow-Up Studies
Humans
Lactones / therapeutic use*
Lipase / antagonists & inhibitors
Liver Cirrhosis / complications,  drug therapy*,  pathology
Male
Middle Aged
Obesity / blood,  complications*
Recovery of Function / drug effects*
Severity of Illness Index
Transaminases / blood
Treatment Outcome
Chemical
Reg. No./Substance:
0/Enzyme Inhibitors; 0/Lactones; 96829-58-2/orlistat; EC 2.6.1.-/Transaminases; EC 3.1.1.3/Lipase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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