Objective To study the influence of hyperlipemia on rats with acute pancreatits during pregnancy and its mechanism. Methods Seventy two pregnant Sprague-Dawley rats were randomly divided into the test group and the control group， and then they were fed with high fat diet and balanced diet for 16 days separately. Pregnant rats were given intraperitoneal injection with L-arginine for 2 times (one time is 250 mg/100 g, the other is 200 mg/100 g) at an interval of 1 h. The serum triglyceride (TG), serum amylase (AMS), and lipase (LPS) from blood samples were tested just after injection, and 12 h， 18 h， 24 h， 30 h and 48 h after injection respectively, and wet/dry ratio of pancreas were measured. The histopathological score of pancreatic tissue was evaluated based on microscopic changes, and the expression of TNF-α protein was determined by SP immunohistochemical technique. Results After the last injection, the level of TG in the test group was obviously higher than that in the control group in each time (P＜0.05). The peak values of AMS and LPS in the test group appeared at 24， 18 h respectively, while the peaks appeared at 30， 24 h in the control group, respectively, which were significantly lower than those in the test group (P＜0.05). Compared with the control group, the wet/dry ratio of pancreas in the test group increased at 12, 18 and 24 h after injection (P＜0.05); The pathological changes of pancreas in test group was more serious with higher histopathological score at 0, 12, 18 and 24 h (P＜0.05), and expression of the TNF-α protein was higher at 12, 18 and 24 h (P＜0.05), too. Conclusion Hyperlipemia can make L-arginine-induced-acute-pancreatitis during pregnancy earlier occur and lead to more serious injury in pancreas. This study demonstrates that hyperlipemia may be a high risk factor for acute pancreatitis during pregnancy, making a great amount of free fatty acid released from TG and up-regulated the expression of TNF-α.
ObjectivesTo systematically review the efficacy and safety of Orlistat for obese patients with cardiovascular risk including hyperlipidemia, hypertension, diabetes and prediabetes.MethodsSinomed, CNKI, WanFang Data, PubMed, EMbase, The Cochrane Library and ClinicalTrails.gov databases were electronically searched to collect randomized controlled trials (RCTs) of Orlistat for obese patients with cardiovascular risk such as hyperlipemia, diabetes, prediabetes and hypertension from inception to Jan 7th, 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed using Stata 14.0 software.ResultsA total of 28 RCTs were included. The results of meta-analysis showed that, compared with placebo, Orlistat could significantly reduce the weight (MD=–2.85, 95%CI –3.47 to –2.24, P=0.000), waist (MD=–2.45, 95%CI –3.07 to –1.83, P=0.000) and BMI (MD=–1.29, 95%CI –2.08 to –0.49, P=0.002) of patients. Orlistat could also control the blood pressure, blood glucose and other cardiovascular risk factors well. Compared with the blank control, Orlistat could improve the waist and parts of cardiovascular risk factors (P<0.05). The incidence of adverse events of Orlistat was slightly higher than that of placebo, but most could be self-healing.ConclusionsCurrent evidence shows that compared with placebo and blank control, Orlistat is effective for improving both weight loss and some cardiovascular risk factors. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.