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Effects of orlistat on fat-soluble vitamins in obese adolescents
Jennifer R McDuffie1, Karim A Calis, Sarah L Booth
1Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland 20892-1862, USA. Mcduffj@mail.nih.gov
Study Objectives:
To determine whether orlistat causes fat-soluble vitamin deficiencies in African-American and Caucasian adolescents.
Design:
Prospective, open-label pilot study.
Setting:
Warren Grant Magnuson Clinical Center of the National Institutes of Health.
Patients:
Seventeen adolescents with body mass indexes above the 95th percentile for age, race, and gender who also had at least one obesity-related comorbid condition.
Intervention:
Subjects received orlistat 120 mg 3 times/day and a daily multivitamin supplement containing vitamin A 5000 IU, vitamin D 400 IU, vitamin E 300 IU, and vitamin K 25 microg.
Measurements And Main Results:
During 3-6 months of orlistat treatment, acute absorption of retinol (vitamin A) was not significantly altered, but absorption of alpha-tocopherol (vitamin E) was significantly reduced compared with baseline levels (p<0.001). Serum levels of vitamins A and E did not change significantly; however, there was a nonsignificant decrease in vitamin K. Mean vitamin D levels were significantly reduced compared with baseline (p<0.02) after 1 month of orlistat, despite multivitamin supplementation.
Conclusion:
It may be prudent to monitor vitamin D concentrations in adolescents who take orlistat, even when a multivitamin is prescribed.