The effects of orlistat and fenofibrate, alone or in combination, on high-density lipoprotein subfractions and pre-beta1-HDL levels in obese patients with metabolic syndrome.

Description

In this randomized clinical trial performed in obese patients with the metabolic syndrome, Filippatos et al. tested the effect of fenofibrate and orlistat on HDL physicochemical properties. A total of 89 patients were prescribed a low-fat low-calorie diet and were randomized to receive orlistat (O group) 120 mg three times daily, fenofibrate (F group) 200 mg/day, or both (OF group). As expected, orlistat had a greater effect on body weight and on the homeostasis model assessment of insulin resistance, whereas fenofibrate had a more pronounced effect on triglyceride levels. Most of the anthropometric and biochemical characteristics were improved in the OF group. As for HDL characteristics, fenofibrate had a greater impact on HDL cholesterol and apolipoprotein AI levels. In the F group, the concentration of small HDL particles was also increased, whereas the concentration of large HDL only increased in the O group. The plasma levels of pre-β1-HDL increased by 17, 50, and 65%, respectively, in groups O, F, and OF. Overall, although the drug combination had no real effects on HDL physicochemical properties, it had beneficial effects on several coronary heart disease risk factors.