Predictors of weight loss in adults with topiramate-treated epilepsy
Predictors of weight loss in adults with topiramate-treated epilepsy
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DOI：
10.1038/oby.2003.78
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发表时间：
2003-04-01
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影响因子：
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通讯作者：
Smith, U
中科院分区：
文献类型：
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作者：
Ben-Menachem, E;Axelsen, M;Smith, U
目的：我们研究了与成人体重减轻相关的抗惊厥剂托吡酯对体重减轻的预测因素。研究方法和程序：在这项非对照的前瞻性临床试验中，托吡酯加入现有的抗惊厥剂中，用于成人部分发作(40-110公斤)。在完成托吡酯治疗1年的患者(N=38)中，主要测量指标在3个月和1年后与基线体重相比发生了变化。结果：托吡酯治疗1年后，基线体重在治疗3个月时下降82%，在1年时下降86%。平均体重在3个月时减少3.0公斤(基线的3.9%)，在1年时减少5.9公斤(7.3%)。在肥胖患者[体重指数(BMI)>30 kg/m(2)]中，3个月时体重平均减轻4.2公斤(4.3%)，1年时平均体重减轻10.9公斤(11.0%)。体重减轻的主要原因是体内脂肪质量的减少。对于所有患者，3个月后体重减轻与卡路里摄入量减少的相关性最强(p=0.02)。在1年时，卡路里摄入量已恢复到基线水平；体重减轻与较高的基线体重指数相关性最强(p=0.0007)。讨论：我们的结果表明，服用托吡酯的大多数成年人体重都有减轻，并持续至少1年。减少卡路里摄入量可能是早期治疗期间体重减轻的部分原因。体重减轻的模式根据基线BMI的不同而不同，肥胖患者在继续治疗期间体重下降幅度更大。
Objective: We examined predictors of weight loss with topiramate, an anticonvulsant associated with weight loss in adults.Research Methods and Procedures: In this uncontrolled, prospective clinical trial, topiramate was added to existing anticonvulsants in adults (40 to 110 kg) with partial-onset seizures. Primary measurements were change from baseline weight after 3 months and I year in patients completing 1 year of topiramate treatment (N = 38). Physiological and metabolic measures were analyzed for correlation with weight loss during topiramate treatment.Results: In patients who completed 1 year of topiramate treatment, baseline weight was reduced in 82% at 3 months and in 86% at 1 year. Mean body weight was reduced 3.0 kg (3.9% of baseline) at 3 months and 5.9 kg (7.3%) at I year. In obese patients [body mass index (BMI) greater than or equal to 30 kg/m(2)], mean weight loss was 4.2 kg (4.3%) at 3 months and 10.9 kg (11.0%) at 1 year. Weight loss was primarily caused by reduction in body fat mass. For all patients, weight loss at 3 months correlated most strongly with reduced caloric intake (p = 0.02). At 1 year, caloric intake had returned to baseline levels; weight loss correlated most strongly with higher baseline BMI (p = 0.0007).Discussion: Our results suggest that weight loss occurs in most adults treated with topiramate and is sustained for at least 1 year. Reduced caloric intake may account, in part, for weight loss during early treatment. The pattern of weight loss differs according to baseline BMI, with obese patients experiencing greater weight loss during continued therapy.