Comparison of the effects of sibutramine versus sibutramine plus metformin in obese women

Abstract

Sibutramine and metformin are drugs commonly used to obtain weight loss. We aimed to compare the effects of sibutramine alone with that of sibutramine plus metformin combination on weight loss, insulin sensitivity, leptin and C reactive protein in obese women. Seventy obese women were included. After a diet period of month (baseline), each individual was randomly assigned to receive 15 mg sibutramine (sibutramine group; n = 36) or 15 mg sibutramine plus 1,700 mg metformin per day (sibutramine plus metformin group; n = 34) during the next 12 months. Body weight, insulin resistance by the homeostasis model assessment model (HOMA-IR), leptin and C reactive protein were measured at baseline, after 3 months and after 12 months. Mean weight losses in sibutramine and sibutramine plus metformin groups were 5.3 +/- 4.0% (P < 0.001) and 6.8 +/- 3.9% (P < 0.001) after 3 months, and 10.5 +/- 4.4% (P < 0.001) and 15.7 +/- 4.6% (P = 0.007) after 12 months, respectively. HOMA-IR value also decreased in both sibutramine (P = 0.045 and P = 0.002) and sibutramine plus metformin groups (P = 0.04 and P = 0.015) after 3 and 12 months, respectively. Similarly, serum leptin levels decreased in both sibutramine (P = 0.04, P = 0.01) and sibutramine plus metformin groups (P = 0.023, P = 0.025) after 3 and 12 months, respectively. There was also significant reductions in serum C reactive protein levels in both sibutramine (P = 0.045, P = 0.02) and sibutramine plus metformin groups (P = 0.007, P = 0.001) after 3 and 12 months, respectively. These decrements of body weight, HOMA-IR, serum leptin and C reactive protein levels were not statistical significance between these two groups both after 3 and 12 months (P > 0.05). Combination of sibutramine with metformin did not result in any further effects on weight loss, insulin resistance, leptin and C reactive protein levels when compared to sibutramine alone.

Metformin use in children with obesity and normal glucose tolerance – effects on cardiovascular markers and intrahepatic fat

“…Love-Osborne et al (10) compared weight changes in obese multiethnic adolescents and observed no group differences between metformin and placebo in weight loss measures, whereas other investigators showed a modest decrease in weight and BMI in obese adolescents with normal glucose tolerance treated with metformin vs. placebo (9, 12, 14, 40). However, several recent studies in women with obesity, T2D, and polycystic ovary syndrome, and first-degree relatives of patients with T2D, for example (41–48), have also shown a relative lack of efficacy of metformin in normalizing measures of inflammation (hsCRP) or thrombosis (fibrinogen) similar to our findings here. Even in the diet/exercise group, the changes were modest and the intervention improved, but did not normalize the values as compared to normal children.…”

Effects of Lifestyle Measures, Antiobesity Agents, and Bariatric Surgery on Serological Markers of Inflammation in Obese Patients

“…In addition to the unclear effects of metformin on inflammatory markers, it should be emphasized that metformin is not currently recommended for the management of obesity. Moreover, a recent study in nondiabetic obese women showed that sibutramine monotherapy reduced hsCRP levels and that adding metformin to sibutramine did not result in any additional decrease in hsCRP levels [ 147 ].…”

Effect of Short Term Sibutramine Supplementation on Appetite Suppression and Related Metabolic Responses

“…However, they did not find any significant changes in these peptides when administered for 6 months to obese women.While a few studies reported a reduction in leptin levels dependent on weight loss, no significant change was observed even with a decrease in body fat [33]. Studies have also shown that changes in serum leptin levels were not statistically significant even after 3, 9 and 12 months of sibutramine administration [34,35]. Bush et al [36] have shown no effect of chronic sibutramine treatment on ghrelin levels in obese mice.…”