Endocrine Abstracts

Objective: Assess the effectiveness of complex treatment of obesity with the use of orlistat (intestinal lipase inhibitor) on the knee OA (KOA) and the dynamics of cytokines (CRP, IL-6, TNF-α) depending on the degree of weight loss.

Methods: 50 female patients (45–65 y.o.) with Kellgren-Lawrence stage II-III KOA and obesity (BMI > 30 kg/m²). Patients in Group 1 (n = 25) took 120 mg of orlistat 3 times a day in combination with a low-calorie diet and exercise for 6 months. Patients in Group 2 (n = 25) were recommended non-drug therapy for obesity for 6 months. At baseline and after 6 months, the clinical parameters of the KOA (WOMAC) were evaluated, the quality of life was assessed (EQ-5D). A laboratory study of peripheral blood was conducted at baseline and after 6 months: CRP, IL-6, TNF-α.

Results: After 6 months of complex treatment of obesity with the use of orlistat, patients in Group 1 achieved a significant weight loss of 10.07% (P < 0.05). Depending on the degree of weight loss in Group 1, 15 patients lost > 10% and 10 patients lost 5–9.9% of the initial body weight. In the 2nd group, an insignificant weight loss of 0.84% (P > 0.05) was achieved, all patients in Group 2 lost less than 5%. Depending on the degree of weight loss, it is noted that in patients with weight loss more than 5% better than WOMAC (pain, stiffness, functional state) (P < 0.05), EQ-5D (P < 0.05) compared with less weight loss. In patients with weight loss > 10%, a significant decrease in CRP level was observed (P = 0.03) compared with baseline and patients with a 5–9.9% weight loss (P = 0.03) and < 5% (P = 0.02). Data for statistically significant changes from TNF-α and IL-6, depending on the degree of weight loss was not detected.

Conclusion: The results of the study demonstrated a significant effectiveness of the complex treatment of obesity in patients with KOA. A decrease in body mass of more than 5% helps to improve the clinical manifestations of KOA. A decrease in body weight of more than 10% demonstrates a decrease in the level of CRP, which suggests an effect on meta-inflammation in OA.