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Non-alcoholic steatohepatitis (NASH) may cause progressive hepatic fibrosis and cirrhosis.1,2 To date, treatment has been restricted to diet and weight loss, but without compelling results. Orlistat (Xenical) is a natural lipase inhibitor, which reduces the absorption of dietary fat by 30%3 and improves insulin resistance and lipid profile.4,5 Whether or not orlistat reverses hepatic fibrosis and inflammation in obese patients with NASH has not been assessed.
A total of 14 obese patients with NASH underwent liver biopsy before and after 6 months treatment with orlistat (120 mg thrice daily). Patients were also provided a moderate calorie-restricted diet with a median daily intake of 25 kcal/kg body weight/day. Parameters of oxidative stress, insulin resistance, lipids and liver histology were measured. All patients signed informed consent. Of 22 recruited patients, 14 (10 women and 4 men, mean (SD) age of 42 (3) years, …