Orlistat improves endothelial function in obese adolescents: a randomised trial.

AIM: To investigate the effect of orlistat on endothelial function in obese adolescents. METHODS: Single-blind 10-week controlled trial of 67 normolipidaemic obese adolescents randomised into three groups. Group 1 (diet alone), Group 2 (diet and orlistat), Group 3 (diet, orlistat and exercise). Endothelial function measured by flow-mediated dilatation (FMD) of the brachial artery, anthropometric parameters, blood pressure, fasting blood lipids, insulin and glucose levels were recorded at baseline and at 10 weeks. RESULTS: Sixty four subjects completed the study. Groups were comparable at baseline. FMD increased significantly with orlistat (Groups 2 and 3) but not in Group 1. Orlistat treatment resulted in significantly reduced bodyweight, body mass index (BMI), waist circumference, total and low-density lipoprotein (LDL) cholesterol levels. High-density lipoprotein cholesterol levels were unchanged. Triglyceride and insulin levels were significantly reduced in all three groups. The reduction in cholesterols did not correlate with reductions in weight and BMI. A slight reduction of body fat, both with and without orlistat treatment, correlated with reduction in BMI after adjustment for baseline values. Blood pressure was unaltered by orlistat. Calorie intake was reduced with orlistat, and the decrease noted in % fat and increase in % carbohydrate was significant only in those taking orlistat. The addition of exercise (Group 3 compared with Group 2) altered no parameter. CONCLUSIONS: Orlistat improves endothelial function and reduces bodyweight, BMI, fasting total and LDL-cholesterol in obese adolescents when combined with dietary control. Improvement in endothelial function if maintained could reflect long-term cardiovascular benefit.

Central adiposity and the propensity for rehearsal in children.

BACKGROUND: There is increasing evidence that continuous activation of the hypothalamic-pituitary adrenal axis and the central sympathetic nervous system contributes to the pathogenesis of central adiposity via increased psychological stress. The purpose of this study was to examine the link between central adiposity and the propensity for Chinese children to rehearse emotionally upsetting events, a dimension of psychological stress. Additionally, gender differences in this relationship were explored. METHODS: Waist circumference, which is a marker of central adiposity and associated risks of developing cardiovascular disease, was measured and the propensity for rehearsal was assessed twice over two consecutive years in Hong Kong Chinese children (n = 194, aged 7-9 years), using a psychometric tool. RESULTS: Children with waist circumference indicative of a risk of cardiovascular disease displayed higher rehearsal scores than children categorized as "not at risk", as did boys compared with girls. Our results suggest that central adiposity and the propensity for rehearsal of emotionally upsetting events may be linked in Chinese children. CONCLUSION: Future prospective studies examining the direction of causality between central adiposity and rehearsal can potentially have valuable clinical implications.