Orlistat Modulates Caspase-4, Interleukin-15, and Pancreatic Lipase Activity in Obese Females: A Cohort Study.

Abstract

Caspase-4 is a pro-inflammatory mediator involved in activation of non-canonical inflammasomes and has been strongly associated with obesity-related inflammation and metabolic dysfunction. Interleukin-15 (IL-15) plays an important role in body weight regulation and reduction of adipose tissue mass, while pancreatic lipase is a key enzyme responsible for lipid digestion and absorption, making it essential for lipid metabolism and energy balance. This study aimed to evaluate the effect of orlistat treatment on serum levels of IL-15, Caspase-4, and lipase activity in obese women and to compare the therapeutic outcomes between single-dose and double-dose orlistat regimens. This case–control study was conducted on women attending the Nutrition Clinic at Marjan Teaching Hospital, Babylon, Iraq. A total of 300 women aged between 21 and 42 years were enrolled, including 60 obese women, 90 obese women treated with one dose of orlistat for two weeks, 90 obese women treated with two doses of orlistat for two weeks, and 60 non-obese healthy controls classified according to body mass index (BMI). Women with endocrine, autoimmune, renal, or cardiovascular diseases were excluded. Serum IL-15 and Caspase-4 levels were measured using enzyme-linked immunosorbent assay (ELISA) kits supplied by BT Lab, China, while serum lipase activity was estimated spectrophotometrically using the kinetic method (Biolabo, France). Obese women receiving two doses of orlistat showed significantly better improvement in inflammatory and metabolic biomarkers than those receiving a single dose. The two-dose regimen produced the most favorable therapeutic outcomes, while untreated obese women exhibited the poorest metabolic status.