Sibutramine and L-Carnitine Compared to Sibutramine Alone on Insulin Resistance in Diabetic Patients
Sibutramine and L-Carnitine Compared to Sibutramine Alone on Insulin Resistance in Diabetic Patients
复制标题
DOI：
10.2169/internalmedicine.49.3401
复制
发表时间：
2010-01-01
影响因子：
1.2
通讯作者：
Cicero, Arrigo F. G.
中科院分区：
文献类型：
--
作者：
Derosa, Giuseppe;Maffioli, Pamela;Cicero, Arrigo F. G.
目的比较西布曲明联合左旋肉碱治疗1年与西布曲明治疗对2型糖尿病患者体重、血糖控制及胰岛素抵抗状态的影响。方法采用口服降糖药或胰岛素治疗的未控制的2型糖尿病（T2DM）[糖化血红蛋白(HbA(1c)) >8.0%]患者254例，随机分为西布曲明10 mg +左旋肉碱2 g或西布曲明10 mg单药治疗组。我们在基线、3个月、6个月、9个月和12个月后评估这些参数：体重、体重指数（BMI）、糖化血红蛋白（HbA(1c)）、空腹血糖（FPG）、餐后血糖（PPG）、空腹血浆胰岛素（FPI）、稳态模型评估胰岛素抵抗指数（HOMA-IR）、总胆固醇（TC）、低密度脂蛋白-胆固醇（LDL-C）、高密度脂蛋白-胆固醇（HDL-C）、甘油三酯（Tg）、视黄醇结合蛋白-4 （RBP-4）、抵抗素、visfatin、高敏c反应蛋白（HsCRP）。结果两组患者体重、BMI、HbA1c、FPI、HOMA-IR、RBP-4均有所下降，但西布曲明加左旋肉碱组低于西布曲明组。西布曲明加左旋肉碱组的FPG、PPG、TC、LDL-C、抵抗素和Hs-CRP的下降速度更快，即使两组之间没有差异。此外，只有西布曲明加左旋肉碱能改善Tg和visfatin。结论与西布曲明相比，西布曲明联合左旋肉碱能更快地改善血脂、胰岛素抵抗参数、血糖控制和体重。
Objective To evaluate the effects of one year of treatment with sibutramine plus L-carnitine compared to sibutramine on body weight, glycemic control, and insulin resistance state in type 2 diabetic patients.Methods Two hundred and fifty-four patients with uncontrolled type 2 diabetes mellitus (T2DM) [ glycated hemoglobin (HbA(1c)) >8.0%] in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomised to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy. We evaluated at baseline, and after 3, 6, 9, and 12 months these parameters: body weight, body mass index (BMI), glycated hemoglobin (HbA(1c)), fasting plasma glucose (FPG), post-prandial plasma glucose (PPG), fasting plasma insulin (FPI), homeostasis model assessment insulin resistance index (HOMA-IR), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (Tg), retinol binding protein-4 (RBP-4), resistin, visfatin, high sensitivity-C reactive protein (HsCRP).Results There was a decrease in body weight, BMI, HbA1c, FPI, HOMA-IR, and RBP-4 in both groups, even when the values obtained with sibutramine plus L-carnitine were lower than the values obtained in sibutramine group. There was a faster decrease of FPG, PPG, TC, LDL-C, resistin and Hs-CRP with sibutramine plus L-carnitine even when no differences between the two groups were obtained. Furthermore, only sibutramine plus L-carnitine improved Tg, and visfatin.Conclusion Sibutramine plus L-carnitine gave a faster improvement of lipid profile, insulin resistance parameters, glycemic control, and body weight compared to sibutramine.