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Sibutramine has been shown to result in a dose-dependent weight loss and to enhance the effects of a low-calorie diet for up to 2 years in obese adults, note Dr. Edgar G. A. H. Van Mil, of the VU University Medical Center, Amsterdam, and colleagues in the April issue of the Journal of Clinical Endocrinology and Metabolism.
They explain that sibutramine reduces energy intake by increasing satiety and by increasing energy expenditure by stimulating thermogenesis, but it is unclear whether the medication has the same effects on energy metabolism in obese adolescents.
The researchers examined the effect of sibutramine (10 mg daily) on body composition and energy expenditure in 24 obese adolescents, in a randomized, double-blind, placebo-controlled study.
The subjects were randomly assigned to sibutramine or placebo in combination with an energy-restricted diet and exercise plan for 12 weeks. This was followed by an identical treatment period (follow-up) without medication.
The primary measure of efficacy was the change in body mass index (BMI) SD score. It was comparable in both groups after the intervention, the researchers report. Further decreases in BMI were observed during follow-up in placebo patients. BMI stabilized in the sibutramine patients.
The team also measured body composition and total energy expenditure by stable isotopes and calculated according to a four-component model, using underwater weighing and dual x-ray absorptiometry. The changes in the percentage of fat mass were not different between the sibutramine and placebo groups, and there were no significant changes in total energy expenditure, the investigators found.
They measured basal metabolic rate (BMR) by ventilated hood adjusted for sex and body composition. The adjusted BMR decreased in the placebo group and remained constant in the sibutramine group. During follow-up, it decreased in the sibutramine group, and increased in the placebo group.
It's possible, the team says, that the potential effect of sibutramine may have been masked by the strict lifestyle management undertaken in the study.
J Clin Endocrinol Metab 2007;92:1409-1414.
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FACT:
Increasing Proportion of Cardiovascular Disease Due to Diabetes Over the Last 50 Years: A new study shows that as rates of diabetes have risen in the U.S., the proportion of cardiovascular disease (CVD) linked to diabetes has also increased. These findings emphasize the need for increased efforts to prevent diabetes and to aggressively treat and control CVD risk factors among those with diabetes, according to the results from the Framingham Heart Study. The researchers compared risk factors for cardiovascular disease and cardiovascular “events” such as heart attacks in Framingham study participants from two different time periods. The first group was examined between 1952 and 1974 and the more recent group was examined between 1975 and 1998. A total of 9,540 individuals age 45 to 64 were evaluated. The risk attributable to diabetes was 5.2 percent in the earlier time period, compared to 7.8 percent in the later period. Most of the increased risk was observed among men. The scientists also reported that the prevalence of diabetes among those with CVD almost doubled between the earlier and later time periods and there was also an increase in the prevalence of obesity. “Increasing Cardiovascular Burden Due to Diabetes: the Framingham Heart Study” is published in the March 27th issue of Circulation and is also currently available online (March 12 Rapid Access issue). |
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