EFECTOS DE LA ADMINISTRACION DE LEPTINA EN DIFERENTES DOSIS PARA LA REGULACION DEL PESO CORPORAL EN HOMBRES OBESOS

(especial para SIIC © Derechos reservados)
El tratamiento con 20 mg de leptina/semana modificó el apetito pero no la pérdida de masa corporal, mientras que ésta pudo lograrse con la dosis de 80 mg/semana, en comparación con el placebo. Por otra parte, los pacientes que recibieron placebo mostraron mayor cumplimiento en la restricción alimentaria.
westerterp.jpg Autor:
Margriet s. Westerterp plantenga
Columnista Experto de SIIC
Artículos publicados por Margriet s. Westerterp plantenga
Recepción del artículo
15 de Mayo, 2003
Aprobación
19 de Junio, 2003
Primera edición
7 de Noviembre, 2003
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El aumento terapéutico de las concentraciones de leptina circulante en seres humanos obesos puede provocar la pérdida del peso corporal. Se determinaron los efectos de 20 mg y de 80 mg de leptina (pegilación de la proteína OB) subcutánea administrada en forma semanal, combinada con restricción en el ingreso de energía de 2.1 MJ/d, sobre la regulación del peso corporal en 30 y 24 hombres obesos, respectivamente (índice de masa corporal, 32 ± 3 kg/m2; edad, 40 ± 5 años).En comparación con el grupo placebo, el hambre antes del desayuno disminuyó en el grupo de leptina (p < 0.0001) y sólo con las dosis más altas se observaron pérdidas adicionales en el peso corporal (p < 0.03), pero las reducciones en la ingesta de energía en las 24 horas, el gasto energético, la tasa metabólica durante el sueño, el cociente respiratorio (CR), el peso corporal, la masa grasa y la libre de grasa (p < 0.01) no fueron significativamente diferentes. La recuperación en el peso corporal fue más rápida en el grupo de leptina comparado con el placebo (p < 0.05) y se correlacionó inversamente con el incremento en la concientización de la restricción alimentaria (p < 0.02).De este modo, el tratamiento con 20 mg de leptina/semana modificó el apetito pero no la pérdida de masa corporal, mientras que ésta pudo lograrse con dosis de 80 mg/semana, en comparación con placebo. El metabolismo energético no difirió significativamente entre los grupos. El mantenimiento del peso se apoyó en la restricción alimentaria, la cual fue más efectiva en los tratados con placebo.

Palabras clave
Obesidad, leptina, saciedad, restricción dietética


Artículo completo

(castellano)
Extensión:  +/-8.46 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes

Abstract
Therapeutic augmentation of circulating leptin concentrations in obese humans, may result in body mass loss. We assessed the effects of 20 mg and of 80 mg weekly subcutaneous (SC) leptin (pegylated-OB protein) administration, combined with a 2.1 MJ/d energy intake restriction, on body weight regulation in 30 respectively 24 obese men (BMI: 32±3 kg.m-2; age: 40±5 yrs). In comparison to placebo, hunger before breakfast was reduced in the leptin-group (p<.0001), and only with the higher dosage additional body-mass loss (p<0.03) was observed, but reductions of 24h energy intake, energy expenditure, sleeping metabolic rate, respiratory quotient, body mass, fat mass, and fat free mass (p<.01) was not significantly different. Body weight regain was faster in the leptin group compared to placebo (p<0.05), and was inversely correlated with the increase in cognitive dietary restraint (p<0.02). Thus, 20 mg/week leptin treatment modified appetite but not body mass loss, whereas treatment with 80 mg leptin/week led to a greater body mass loss relative to placebo. Energy metabolism did not differ significantly between groups. Weight maintenance was supported by dietary restraint, which was more effective in the placebo treated group than in the leptin treated group.

Key words
Obesidad, leptina, saciedad, restricción dietética


Full text
(english)
para suscriptores/ assinantes

Clasificación en siicsalud
Artículos originales > Expertos del Mundo >
página   www.siicsalud.com/des/expertocompleto.php/

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



Comprar este artículo
Extensión: 8.46 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Bibliografía del artículo
    1.
  1. National Institutes of Health Consensus Developments Panel on the Health Implications of Obesity. Health Implications of obesity. Ann Intern Med. 1985; 103:1073-1077.2.
  2. Lew E. Mortality and weight: Insured lives and the American Cancer Society. Ann intern Med. 1985; 103:1024-1029.3.
  3. Hubert H, Feinleid M, McNamara P, et al. Obesity as an independent risk factor for cardiovascular disease: A 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67:986-977.4.
  4. Donahue R, Bloom E, Abbot R. et al. Central obesity and coronary heart disease in men. Lancet. 1987;1(8537):821-824.5.
  5. Pasman WJ, Rössner S, Westerterp-Plantenga MS, Saris WHM. Body weight changes after treatment of obesity or pregnancy. Chapter 13 in: Regulation of food intake Westerterp-Plantenga MS, Steffens A, Tremblay A (eds) EDRA, Milan, 1999.6.
  6. Hanotin C, Thomas F, Jones SP, Leutenegger E, Drouin P. A comparison of sibutramine and dexfenfluramine in the treatment of obesity. Obes Res. 1998; 6:285-291. 7.
  7. Sjostrom L, Rissanen A, Andersen T, et al., Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. The Lancet 1998;352:167-172. 8.
  8. Kuczmarski RJ, Flegal RM, Campbell SM, et al. Increased prevalence of overweight among US adults. The National Health and Nutrition examination surveys, 1960-1991. JAMA 1994;272:205-211.9.
  9. Seidell JC. The impact of obesity on health status: some implication for health care costs. Int J Obes 1997:suppl 6;S13-16. 10.
  10. Sjöstrom L, Narbo K, Sjöstrom D. Costs and benefits when treating obesity. Int J Obes. 1997:suppl 6:S9-15.11.
  11. Zhang Y, R Proenca, M Maffei, M.Barone, L.Leopold, J.M. Friedman. Positional cloning of the mouse obese gene and its human homologue. Nature 1994; 372: 425-432. 12.
  12. Campfield LA, Smith FJ, Guisez Y, Devos R, Burn P. The OB protein (leptin) pathway-a link betwen adipose tisse mass and central neural networks. Horm. Metab. Res. 1996; 28:619-632. 13.
  13. Campfield LA, Smith FJ, Burn P. OB protein: A hormonal controller of central neural network mediating behavioral, metabolic and neuro endocrine responses. Endocrinology and Metabolism 1997: 4; 81-102.14.
  14. Montague CT, Farrogi IS, Whitehead J, et al. Congenital deficiency is associated with severe early-onset obesity in humans. Nature, 1997; 387: 903-908.15.
  15. Considine RV, Sinha MK, Heiman ML, et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. New England journal of Medicine. 1996; 334:292-295.16.
  16. Pasman WJ, Westerterp-Plantenga MS, Saris WHM. The effect of exercise training on leptin levels in obese males. Am J. Physiol. 1998; 274: E280-E286. 17.
  17. Kahler A, Geary N, Eckel LA, Campfield LA, Smith FJ, Langhans W. Chronic administration of OB protein decreases food intake by selectively reducing meal size in male rats. Am J Physiol 1998; 275: R180-R185. 18.
  18. Eckel LA, Langhans W, Kahler A, Campfield LA, Smith FJ, Geary N. Chronic administration of ob protein decreases food intake by selectively reducing meal size in female rats. Am J Physiol 1998; 275: R186-R193. 19.
  19. Pelleymounter MA, Cullen MJ, Baker MB, Hecht R, Winters D, Boone T, Collins F. Effects of the obese gene product on body weight regulation in ob/ob mice. Science 1995; 269:540-543.20.
  20. Doring H, Schwarzer K, Nuesslein-Hildesheim B, Schmidt I. Leptin selectively increases energy expenditure of food-restricted lean mice. Int J Obes 1998, 22: 83-88.21.
  21. Fujioka K, Patane J, Lubina J, Lau D. CSF Leptin levels after exogenous administration of recombinant methionyl human leptin. JAMA 1999; 282: 1517-1518.22.
  22. Heymsfield SB, Greenberg AS, Fujioka K, Russell MD, Kushner R, Hunt T, Lubina J, Patane J, Self B, Hunt P, McCamish M. Recombinant leptin for weight loss in obese and lean adults. A randomized, controlled dose-escalation trial. JAMA 1999; 282:1568-1575.23.
  23. Farooqi LS, Jebb S, Langmack G, Lawrence E, Cheetham CH, Prentice A, Hughes LA, McCamish M, O\'Rahilly S. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. The New Eng. J. Med. 1999; 341: 879-884.24.
  24. Nucci ML, Shor R, Abuchoweski A. The therapeutic value of poly(ethylene glycol)-modified proteins. Adv Drug Delivery Rev. 1991; 6:133-151. 25.
  25. Fuertges F, Abuchowski A. The clinical efficacy of poly(ethylene glycol)-modified proteins. J Controlled Rel. 1990; 11:139-148.26.
  26. Campfield LA, Devos R, Guisez Y. Pegylated obese (OB) protein compositions. US Patent Number 6,025,324, 2/15/2000. 27.
  27. Bailon P, Campfield LA, Devos R. Pegylated obese (OB) protein compositions. US Patent Number 6,025,325, 2/15/2000.28.
  28. Pasman WJ, Saris WHM, Westerterp-Plantenga MS. Predictors of weight maintenance. Obes Res 1999; 7: 43-50.29.
  29. Westerterp-Plantenga MS, Kempen KP, Saris WHM. Determinants of weight maintenance in women after diet-induced weight reduction. Int J Obes Relat Metab Disord 1998; 22: 1-6.30.
  30. Pekkarinen T, Takala I, Mustajoki P. Two year maintenance of weight loss after a VLCD and behavioral therapy for obesity: correlation to the scores of questionnaires measuring eating behavior. Int J Obes Relat Metab Disord 1996; 20: 332-337.31.
  31. Clark MM, Marcus BH, Pera V, Niaura RS. Changes in eating inventory scores following obesity treatment. Int J Eat Disord 1994; 15:401-405.32.
  32. Lejeune MPGM, Van Aggel DCP, Van Baak MA, Westerterp-Plantenga MS. Dietary restraint during weight maintenance with or without exercise training, in men. Int J Obes Relat Metab Disord 2001; 25 suppl 2: S51.33.
  33. Hukshorn CJ, Saris WHM, Westerterp-Plantenga MS, Farid AR, Smith FJ, Campfield LA. Weekly Subcutaneous Pegylated Recombinant Native Human Leptin (PEG-OB) Administration in Obese Men. JCEM, 2000; 85:4003-4009.34.
  34. Westerterp-Plantenga MS, Saris WHM, Hukshorn CJ, Campfield LA. Effects of weekly administration of pegylated recombinant human OB-protein on appetite profile and energy metabolism in obese men. Am J Clin Nutr 2001; 74: 426-434.35.
  35. Hukshorn CJ, Westerterp-Plantenga MS, Saris WHM. Pegylated human recombinant leptin (PEG-OB) causes additional weight loss in severly energy-restricted, overweight men. Am J Clin Nutr 2003; 77: 771-776.36.
  36. Lejeune MPGM, Hukshorn CJ, Saris WHM, Westerterp-Plantenga MS. Effect of dietary restraint during and following pegylated recombinant leptin (PEG-OB) treatment of overweight men. In press, 2003.37.
  37. Westerterp-Plantenga MS, Westerterp KR, Nicolson NA, Mordant A, Schoffelen PFM, ten Hoor F. The shape of the cumulative food intake curve in humans, during basic and manipulated meals. Physiol Behav 1990; 47, 3: 569-576.38.
  38. Westerterp-Plantenga MS, Rolland V, Wilson SAJ, Westerterp KR. Satiety related to 24h diet-induced thermogenesis during high protein /carbohydrate versus high fat diets, measured in a respiration chamber . EJCN, 1999; 53:495-502.39.
  39. Stunkard AJ, Messick S. The Three Factor Eating Questionnaire to measure dietary restraint, disinhibition and hunger. Psych Res 1985;29:71-83. 40.
  40. Westerterp KR, Wouters L, van Marken Lichtenbelt WD. The Maastricht protocol for the measurement of body composition and energy expenditure with labeled water. Obes. Res. 1995; 3 suppl 1:49-57.41.
  41. Schoffelen PFM, Westerterp KR, Saris WHM, ten Hoor F. A dual respiration chamber with automated calibration. J. Appl. Physiol. 1997; 83, 2064-2072.42.
  42. Siri WE. Body composition from fluid spaces and density: analysis of methods. In: Techniques for measuring body composition. Brozek J, Henschel A (eds) National Academy of Science, Washington DC1961; 223-244.

Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

 English title
 Abstract
 Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia

Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008