西布曲明治疗6个月可降低肥胖患者血清游离脂肪酸水平  

Level of Free Fat Acid Could be Decreased in Obese Subjects after 6 Months' Treatment with Sibutramine

作　　者：高鑫[1] 孙璇[1] 赵耐青[2] 潘柏申[1] 江孙芳[1] 余丹菁[1] 陆志强[1] 

机构地区：[1]复旦大学附属中山医院内分泌科,上海200032 [2]复旦大学公共卫生学院统计学教研室,上海200032

出　　处：《复旦学报（医学版）》2002年第4期239-243,共5页Fudan University Journal of Medical Sciences

摘　　要：目的　观察用西布曲明治疗肥胖病 6个月对肥胖患者血清游离脂肪酸 (FFA)水平的影响 ,并探讨FFA水平的改变与血糖脂代谢、胰岛素抵抗和胰岛 β细胞功能的关系。 方法　对 42例肥胖患者分别服用西布曲明和安慰剂进行随机、双盲、平行对照研究 ,同时结合低热卡饮食治疗 ,治疗 6个月后 ,观察体重和血清FFA水平的变化、体脂参数 (体重指数和腰臀比 )、血糖、血脂水平和胰岛素分泌代谢的相关指标的变化。结果　治疗后 ,西布曲明组体重下降幅度 7.80 (4 .80～ 10 .10 )kg ,明显大于安慰剂组 2 .90 (1.2 0～ 3.40 )kg(P =0 .0 0 0 6 )。西布曲明组空腹FFA水平下降幅度 0 .2 5 (0 .12～ 0 .35 )mmol/L ,(P =0 .0 0 2 5 ) ,大于安慰剂组 0 .18(0 .0 1～ 0 .44 )mmol/L ,(P =0 .0 171) ,(P =0 .76 41)。西布曲明组FFAarea减少了 0 .32 (0 .16～ 0 .5 0 )mmol/ (L·h) ,(P =0 .0 0 0 3) ,安慰剂组比治疗前减少了 0 .2 2 (0 .0 3～ 0 .5 8)mmol/ (L·h) ,(P =0 .0 0 45 ) ,但两组间FFA水平下降程度相似 (P =0 .90 71)。两组患者的空腹血糖、血脂、胰岛素水平、HOMA IR和胰岛素原 /胰岛素比值 (P/I比值 )较治疗前有不同程度的改善。结论　减重治疗后 。Purpose. To evaluate the effect of lose weight treated by sibutramine on free fatty add(FFA) levels, and accordingly the relationship between changes of FFA and those of serum glucose level and lipid profiles, insulin sensitivity and β cell function. Methods. Forty-two obese patients(BMI≥24 kg/m 2, with or without impairment of glucose metabolism) were randomized in this double-blind, placebo-controlled study. Each patient received sibutramine or placebo for 6 months. All the participants were instructed to consume a low-calorie diet. The primary outcome measures were changes in weight and serum FFA levels. Secondary outcome measures were changes in anthropometrical parameters (BMI and WHR), serum glucose, lipid levels and the HOMA-IR. Results. After 6 months of treatment, weight loss of sibutramine-treated objects was greater than that of placebo- treated objects(P = 0. 000 6). The declination of fasting serum FFA levels(P = 0.002 5) in sibutramine group was also greater than that in placebo group(P = 0. 017 1), but there was no difference between two groups(P = 0. 764 1). The declination of FFA area in sibutramine group was greater than that in placebo group was(P = 0.004 5), and there was still no difference between the subjects receiving sibutramine or placebo(P = 0. 907 1). Compared to the baseline, fasting glucose, lipid profile, insulin, HOMA-IR and proinsulin/insulin ratio between two groups declined to different extent. Conclusions. After the antiobesity therapy, fasting FFA levels and FFA area were decreased depending on the extent of weight loss in both sibutramine group and placebo group. As weight loss and reduction of FFA, insulin sensitivity(the reduction of HOMA-IR) and β cell function (the reduction of proinsulin/insulin ratio) were improved in both groups.

关 键 词：西布曲明 治疗 肥胖 血清 游离脂肪酸 

分 类 号：R589.2[医药卫生—内分泌]