目的:非酒精性脂肪性肝病(NAFLD)或代谢功能障碍相关的脂肪变性肝病(MASLD)是全球慢性肝病的重要贡献者。奥利司他阻断肠道脂肪吸收,导致肝脏脂肪含量降低。因此,这是NAFLD管理的可行选择。方法:我们使用随机对照试验(RCTs)进行系统评价和荟萃分析。我们使用均差(MD)来汇集连续结果,并给出相应的置信区间(CI)。结果:我们纳入了4个RCTs,共379例患者。奥利司他可有效降低肝脏脂肪含量(MD:-5.02,95%CI[-7.23,-2.82],P=0.00001),丙氨酸转移酶(MD:-10.03,95%CI[-17.80,-2.26],P=0.01),天冬氨酸转移酶(MD:-4.29,95%CI[-7.59,-0.99],P=0.01),腰围(MD:-3.18,95%CI[-4.25,-2.10],P=0.00001),体重指数(MD:-1.03,95%CI[-1.34,-0.73],P=0.00001),总胆固醇(MD:-3.75,95%CI[-4.02,-3.49],P=0.00001),和低密度脂蛋白(MD:-3.83,95%CI[-4.05,-3.61],P=0.00001)。然而,奥利司他与血清甘油三酯升高相关(MD:7.46,95%CI[6.48,8.44],P=0。00001)。结论:奥利司他是NAFLD管理的可行选择;然而,它增加了甘油三酯水平。需要更大的RCT。
Objective: Nonalcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant contributor to chronic liver disease worldwide. Orlistat blocks intestinal fat absorption, leading to decreased liver fat content. Therefore, it is a viable option for NAFLD management. Methods: We performed a systematic
review and metaanalysis using randomized controlled trials (RCTs). We used mean difference (MD) to pool continuous outcomes presented with the corresponding confidence interval (CI). Results: We included four RCTs with a total of 379 patients. Orlistat was effective in reducing liver fat content (MD: -5.02, 95% CI [-7.23, -2.82], P = 0.00001), alanine transferase (MD: -10.03, 95% CI [-17.80, -2.26], P = 0.01), aspartate transferase (MD: -4.29, 95% CI [-7.59, -0.99], P = 0.01), waist circumference (MD: -3.18, 95% CI [-4.25, -2.10], P = 0.00001), body mass index (MD: -1.03, 95% CI [-1.34, -0.73], P = 0.00001), total cholesterol (MD: -3.75, 95% CI [-4.02, -3.49], P = 0.00001), and low-density lipoprotein (MD: -3.83, 95% CI [-4.05, -3.61], P = 0.00001). However, orlistat was associated with increased serum triglycerides (MD: 7.46, 95% CI [6.48, 8.44], P = 0. 00001). Conclusion: Orlistat is a viable option for NAFLD management; however, it increases triglyceride levels. Larger RCTs are required.