Antonio De Vincentis, Claudio Pedone, Umberto Vespasiani-Gentilucci, Antonio Picardi, Giuseppe Derosa, Pamela Maffioli and Amirhossein Sahebkar Pages 870 - 878 ( 9 )
Sibutramine is an anti-obesity medication whose effects on weight loss have been widely explored. Moreover, limited number of studies also evidenced its correlates on adipokines and proinflammatory markers; however, their results have not been conclusive. Hence, a systematic review and meta-analysis of available evidence was conducted in order to calculate the effect size of sibutramine therapy on C-reactive protein (CRP), leptin and adiponectin concentrations. Seven randomized clinical trials with a total of 601 subjects met the eligibility criteria. Random effect meta-analysis evidenced a significant decrease in plasma levels of CRP and leptin (weighted mean difference [WMD] -15.58%, 95% confidence interval [95%CI]: -28.84, -2.33, p=0.021 and WMD -9.25, 95%CI: -15.73, -2.78, p=0.005, respectively) and increase of adiponectin (WMD 9.86%, 95%CI: 1.76, 17.96, p=0.017) following sibutramine therapy. Subgroup analysis showed a greater CRP-lowering effect of sibutramine with doses <15 mg/day (WMD -17.26%, 95%CI: -31.02, -3.5, p=0.014) compared with doses 15 mg/day (WMD 6.01%, 95%CI: -43.38, 55.40, p=0.811). In meta-regression analysis, changes in CRP were found to be independent of baseline or percentage change in body mass index. These results suggest a significant improvement of plasma CRP, leptin and adiponectin levels following treatment with sibutramine. Possible impacts and relevance of these alterations on cardiovascular risk profile remain to be clarified, especially in post-hoc analyses of sibutramine outcome trials among people without pre-existing cardiovascular disease.
Sibutramine, C-reactive protein, leptin, adiponectin, adipokines.
Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, ROME, Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, ROME, Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, ROME, Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, ROME, Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, PAVIA, PhD School in Experimental Medicine, University of Pavia, PAVIA, Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad