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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.

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Especialidades
Principal: Nutrición
Relacionadas: Cardiología, Endocrinología y Metabolismo, Epidemiología, Farmacología, Medicina Interna



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Bibliografía del artículo
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