Orlistat and L-carnitine Compared to Orlistat Alone on Insulin Resistance in Obese Diabetic Patients

Endocr J. 2010;57(9):777-86. doi: 10.1507/endocrj.k10e-049. Epub 2010 Jul 30.

Abstract

Our study wants to evaluate the effects of one year treatment with orlistat plus L-carnitine compared to orlistat alone on body weight, glycemic and lipid control, and insulin resistance state in type 2 diabetic patients. Two hundred and fifty-eight patients with uncontrolled type 2 diabetes mellitus (T2DM) [glycated hemoglobin (HbA(1c)) > 8.0%] in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomised to take orlistat 120 mg three times a day plus L-carnitine 2 g one time a day or orlistat 120 mg three times a day. We evaluated at baseline, and after 3, 6, 9, and 12 months these parameters: body weight, body mass index (BMI), HbA(1c), fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (Tg), retinol binding protein-4 (RBP-4), resistin, visfatin, high sensitivity-C reactive protein (Hs-CRP). We observed a faster, and better decrease of body weight, HbA(1c), FPG, PPG, LDL-C, HOMA-IR with orlistat plus L-carnitine compared to orlistat. A faster improvement of TC, Tg, FPI, resistin, RBP-4, visfatin, and Hs-CRP was reached with orlistat plus L-carnitine compared to orlistat. We can safely conclude that the association of orlistat plus L-carnitine was better than orlistat in improving body weight, glycemic and lipid profile, insulin resistance, and inflammatory parameters and no significant adverse events were recorded.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Obesity Agents / administration & dosage*
  • Body Weight / drug effects
  • Carnitine / administration & dosage*
  • Carnitine / adverse effects
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / metabolism
  • Drug Synergism
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage*
  • Inflammation / prevention & control
  • Insulin Resistance*
  • Lactones / administration & dosage*
  • Lactones / adverse effects
  • Male
  • Middle Aged
  • Obesity / metabolism
  • Orlistat

Substances

  • Anti-Obesity Agents
  • Hypoglycemic Agents
  • Lactones
  • Orlistat
  • Carnitine