Effect of orlistat-assisted weight loss in decreasing coronary heart disease risk in patients with syndrome X

Am J Cardiol. 2001 Apr 1;87(7):827-31. doi: 10.1016/s0002-9149(00)01521-6.


This study describes the changes in risk factors for coronary heart disease in obese persons with syndrome X after orlistat-assisted weight loss. Data were available for 1,700 patients who completed 52 weeks of weight loss; 128 were defined as having syndrome X by being in the quintile with the highest plasma triglyceride levels (>2.2 mM/L) and the lowest high-density lipoprotein cholesterol (HDL, <1.0 mM/L) concentrations. Initial characteristics of those with syndrome X were similar to the 119 subjects (non-syndrome X) in the lowest quintile of plasma triglyceride (<0.975 mM/L) and highest quintile of HDL cholesterol (>1.5 mM/L). Subjects were placed on a calorie-restricted diet, and randomized to receive orlistat or placebo. Initial values were higher in those with syndrome X for diastolic blood pressure (p = 0.03), plasma insulin (p = 0.0001), triglyceride (p = 0.0001) concentrations, and ratio of low-density lipoprotein cholesterol to HDL cholesterol (p = 0.0001), and were lower for HDL cholesterol (p = 0.001) concentrations. Weight loss was greater in both groups of orlistat-treated patients (p = 0.026); in those with syndrome X, it was associated with a significant reduction in plasma insulin (p = 0.019) and triglyceride (p = 0.0001) concentrations, an increase in HDL cholesterol concentration, and a decrease in low-density lipoprotein/HDL cholesterol ratio (p = 0.0001). There were no significant changes in plasma insulin, triglycerides, or HDL cholesterol concentration in the non-syndrome X group. In conclusion, weight loss attenuates coronary heart disease risk factors in obese persons with syndrome X, and the risk factor reduction is enhanced with administration of orlistat.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Anti-Obesity Agents / therapeutic use*
  • Cholesterol, HDL / blood
  • Diet, Reducing*
  • Double-Blind Method
  • Female
  • Humans
  • Insulin / blood
  • Lactones / therapeutic use*
  • Lipase / antagonists & inhibitors*
  • Male
  • Microvascular Angina / complications
  • Microvascular Angina / prevention & control*
  • Middle Aged
  • Obesity / complications
  • Obesity / prevention & control*
  • Orlistat
  • Risk Factors
  • Treatment Outcome
  • Triglycerides / blood
  • Weight Loss


  • Anti-Obesity Agents
  • Cholesterol, HDL
  • Insulin
  • Lactones
  • Triglycerides
  • Orlistat
  • Lipase