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SIBUTRAMINA NO TRATAMENTO DE PACIENTES DE ALTO RISCO CARDIOVASCULAR: EFEITOS SOBRE A PRESSAO ARTERIAL , SENSIBILIDADE A INSULINA E DISTRIBUIÇO DE GORDURA

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SIBUTRAMINA NO TRATAMENTO DE PACIENTES DE ALTO RISCO CARDIOVASCULAR: EFEITOS SOBRE A PRESSAO ARTERIAL , SENSIBILIDADE A INSULINA E DISTRIBUIÇO DE GORDURA

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Sibutramina induziu maior perda de peso, reduções na RCQ e VF e decréscimo na resistência periférica a insulina sem interferir no controle da PA em pacientes hipertensos.
nunes9.jpg Autor:
Alessandra Nunes Faria
Columnista Experto de SIIC
Artículos publicados por Alessandra Nunes Faria
Coautores
Maria Teresa Zanella (MD, PhD)*  Sandra Roberta Gouvea Ferreira (MD, PhD)*  Fernando Flexa Ribeiro Filho (MD, PhD)* 
Universidade Federal de São Paulo*
Recepción del artículo
6 de Octubre, 2003 		Primera edición
18 de Marzo, 2004 		Segunda edición, ampliada y corregida
7 de Junio, 2021

SIBUTRAMINA NO TRATAMENTO DE PACIENTES DE ALTO RISCO CARDIOVASCULAR: EFEITOS SOBRE A PRESSAO ARTERIAL , SENSIBILIDADE A INSULINA E DISTRIBUIÇO DE GORDURA

Resumen
Os efeitos da sibutramina sobre o peso corporal, distribuição de gordura, resistência à insulina e perfil da pressão arterial nas 24 horas foram avaliados em 86 pacientes obesos hipertensos (IMC, 39 ± 5 kg/m2, 84% mulheres, 48 ± 8.5 anos), randomizados para receber sibutramina 10 mg ou placebo por 24 semanas. Realizados antes e após o estudo: exame físico, monitorização ambulatorial da pressão arterial e ultrassonografia abdominal (estimativa da gordura visceral; GV). A resistência à Insulina foi estudada através do HOMA-r e do índice de resistência à insulina após sobrecarga de glicose (IRIp). Leptina plasmática e lipídios séricos foram determinados em jejum. Resultados: Sibutramina induziu maior perda de peso que placebo (6,7% vs. 2,5%; p<0,001). Reduções na razão cintura quadril (RCQ, 0.97 ± 0.08 vs. 0.94 ± 0.07; p<0,01), IRIp (0.11 ± 0.07 vs 0.09 ± 0.06 mmol.mu/l2) e GV (6.4 ± 2.4 vs 6.0 ± 2.4 cm; p<0,01) foram observadas apenas com sibutramina. Leptina plasmática decaiu no grupo placebo (24 ± 15 vs 18 ± 10 UI/l; p<0,01) mas não com sibutramina (18.8 ± 8.4 vs 18.2 ± 13.2 UI/l). O perfil lipídico e o perfil da pressão arterial (PA) não se alterou em nenhum dos grupos. Conclusão: Sibutramina induziu maior perda de peso, reduções na RCQ e VF e decréscimo na resistência periférica a insulina sem interferir no controle da PA em pacientes hipertensos.

Palabras clave
Sibutramina, gordura visceral, resistencia a insulina, hipertensao arterial.


Artículo completo
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SIBUTRAMINE IN THE TREATMENT OF CARDIOVASCULAR HIGH RISK PATIENTS: EFFECTS OVER ARTERIAL BLOOD PRESSURE, INSULIN RESISTANCE AND BODY FAT DISTRIBUTION

Abstract
To study the effects of sibutramine on body weight, body fat distribution, insulin resistance, and blood pressure profiles in hypertensive obese patients, eighty-six central obese hypertensive patients, (BMI=395kg/m2, 84% female, 488.5 years old), were randomized to receive sibutramine 10 mg or placebo for 24 weeks. Before and after the study was performed: complete physical examination, 24-hour ambulatory blood pressure and abdominal ultrasonography ( to estimate the amount visceral fat; VF). Insulin resistance was studied through HOMA-r and an Insulin Resistance Index after oral glucose load (IRIp). Fasting plasma leptin and lipid levels were also determined. Results: Sibutramine induced greater weight loss than placebo (6,7% vs. 2,5%; p<0,001). Reductions in waist-hip-ratio (WHR= 0.970.08 vs 0.940.07; p<0,01), IRIp (0.11 0.07 VS 0.090.06 mmol.mu/l2 and VF (from 6.42.4 to 6.02.4 cm; p<0,01) were observed only with sibutramine. Plasma leptin decreased with placebo (2415 vs 1810 UI/l; p<0,01) but not with sibutramine (18.88.4 vs 18.213.2 UI/l). There were no changes in lipid profile or in the 24 hour blood pressure values during placebo or sibutramine therapy. Conclusion: sibutramine induced greater weight loss, WHR reduction, decreases in VF and in the peripheral insulin resistance without interfering in blood pressure control in hypertensive patients.

Key words
Sibutramine, visceral fat, insulin resistance, hypertension.

Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
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Especialidades
Principal: Nutrición
Relacionadas: Cardiología, Endocrinología y Metabolismo, Epidemiología, Farmacología, Medicina Interna



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Bibliografía del artículo
  1. Lurbe E, Alvarez V, Liao Y, Tacons J, Cooper R, Cremades B et al. The impact of obesity and body fat distribution on ambulatory blood pressure in children and adolescents. Am J Hypertens 1998; 11(4 Pt 1):418-424.
  2. Hall JE, Brands MW, Zappe DH, Alonso GM. Insulin resistance, hyperinsulinemia, and hypertension: causes, consequences, or merely correlations Proc Soc Exp Biol Med 1995; 208(4):317-329.
  3. Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potter JD et al. Body fat distribution and 5-year risk of death in older women. JAMA 1993; 269(4):483-487.
  4. Banerji MA, Faridi N, Atluri R, Chaiken RL, Lebovitz HE. Body composition, visceral fat, leptin, and insulin resistance in Asian Indian men. J Clin Endocrinol Metab 1999; 84(1):137-144.
  5. Finer N, Bloom SR, Frost GS, Banks LM, Griffiths J. Sibutramine is effective for weight loss and diabetic control in obesity with type 2 diabetes: a randomised, double-blind, placebo-controlled study. Diabetes Obes Metab 2000; 2(2):105-112.
  6. Sjostrom CD, Lissner L, Wedel H, Sjostrom L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS Intervention Study. Obes Res 1999; 7(5):477-484.
  7. Benotti PN, Bistrain B, Benotti JR, Blackburn G, Forse RA. Heart disease and hypertension in severe obesity: the benefits of weight reduction. Am J Clin Nutr 1992; 55(2 Suppl):586S-590S.
  8. Foley EF, Benotti PN, Borlase BC, Hollingshead J, Blackburn GL. Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 1992; 163(3):294-297.
  9. Finer N. Prevention and management of obesity: pharmacology. Proc Nutr Soc 2000; 59(3):413.
  10. Moan A, Nordby G, Rostrup M, Eide I, Kjeldsen SE. Insulin sensitivity, sympathetic activity, and cardiovascular reactivity in young men. Am J Hypertens 1995; 8(3):268-275.
  11. Castro CM, Halkes CJ, Erkelens DW. Obesity and free fatty acids: double trouble. Nutr Metab Cardiovasc Dis 2001; 11(2):134-142.
  12. Faria AN, Ribeiro Filho FF, Lerario DD, Kohlmann N, Ferreira SR, Zanella MT. Effects of sibutramine on the treatment of obesity in patients with arterial hypertension. Arq Bras Cardiol 2002; 78(2):172-180.
  13. Coutinho W. Obesity prevention in Brazil. West Indian Med J 2002; 51 Suppl 1:36-37.
  14. Despres JP, Lemieux I, Prud'homme D. Treatment of obesity: need to focus on high risk abdominally obese patients. BMJ 2001; 322(7288):716-720.
  15. Despres JP. Health consequences of visceral obesity. Ann Med 2001; 33(8):534-541.
  16. Sniderman AD, Dagenais GR, Cantin B, Despres JP, Lamarche B. High apolipoprotein B with low high-density lipoprotein cholesterol and normal plasma triglycerides and cholesterol. Am J Cardiol 2001; 87(6):792-3, A8.
  17. Scarsella C, Almeras N, Mauriege P, Blanchet C, Sauve L, Dewailly E et al. Prevalence of metabolic alterations predictive of cardiovascular disease risk in the Quebec population. Can J Cardiol 2003; 19(1):51-57.
  18. Ribeiro-Filho FF, Faria AN, Kohlmann O, Jr., Ajzen S, Ribeiro AB, Zanella MT et al. Ultrasonography for the evaluation of visceral fat and cardiovascular risk. Hypertension 2001; 38(3 Pt 2):713-717.
  19. Ribeiro-Filho FF, Faria AN, Kohlmann NE, Zanella MT, Ferreira SR. Two-hour insulin determination improves the ability of abdominal fat measurement to identify risk for the metabolic syndrome. Diabetes Care 2003; 26(6):1725-1730.
  20. Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care 1998; 21(12):2191-2192.
  21. Grandi AM, Gaudio G, Fachinetti A, Piantanida E, Zanzi P, Ceriani L et al. Insulin sensitivity in obese normotensive adults: influence of family history of hypertension. Int J Obes Relat Metab Disord 1998; 22(9):910-914.
  22. Freitas JB, Tavares A, Kohlmann O, Jr., Zanella MT, Ribeiro AB. Cross-sectional study on blood pressure control in the department of nephrology of the Escola Paulista de Medicina - UNIFESP. Arq Bras Cardiol 2002; 79(2):123-128.
  23. Levin BE, Dunn-Meynell AA. Sibutramine alters the central mechanisms regulating the defended body weight in diet-induced obese rats. Am J Physiol Regul Integr Comp Physiol 2000; 279(6):R2222-R2228.
  24. Hansen DL, Toubro S, Stock MJ, Macdonald IA, Astrup A. The effect of sibutramine on energy expenditure and appetite during chronic treatment without dietary restriction. Int J Obes Relat Metab Disord 1999; 23(10):1016-1024.
  25. James WP, Astrup A, Finer N, Hilsted J, Kopelman P, Rossner S et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet 2000; 356(9248):2119-2125.
  26. Smith IG, Goulder MA. Randomized placebo-controlled trial of long-term treatment with sibutramine in mild to moderate obesity. J Fam Pract 2001; 50(6):505-512.
  27. Toubro S, Hansen DL, Hilsted JC, Porsborg PA, Astrup AV. [The effect of sibutramine for the maintenance of weight loss. A randomized controlled clinical trial]. Ugeskr Laeger 2001; 163(21):2935-2940.
  28. Nisoli E, Carruba MO. An assessment of the safety and efficacy of sibutramine, an anti-obesity drug with a novel mechanism of action. Obes Rev 2000; 1(2):127-139.
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