Effects of Orlistat on Fat-Soluble Vitamins in Obese Adolescents

Authors

  • Dr. Jennifer R. McDuffie Ph.D.,

    Corresponding author
    1. Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, Tufts University, Boston, Massachusetts.
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  • Dr. Karim A. Calis Pharm.D.,

    1. Pharmacy Department, Drug Information Service, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland, Tufts University, Boston, Massachusetts.
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  • Dr. Sarah L. Booth Ph.D.,

    1. Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
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  • Dr. Gabriel I. Uwaifo M.D.,

    1. Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, Tufts University, Boston, Massachusetts.
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  • Dr. Jack A. Yanovski M.D., Ph.D.

    1. Unit on Growth and Obesity, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, Tufts University, Boston, Massachusetts.
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Unit on Growth and Obesity, DEB, NICHD, NIH, 10 Center Drive, MSC 1862, Bethesda, MD 20892-1862; e-mail: Mcduffj@mail.nih.gov.

Abstract

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 μg.

Measurements and Main Results. During 3–6 months of orlistat treatment, acute absorption of retinol (vitamin A) was not significantly altered, but absorption of α-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.

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