Long-term effect of dexfenfluramine on amino acid profiles and food selection in obese patients during weight loss.
In depressive disorders an association between basal pre-treatment plasma ratios of tryptophan (Trp) and tyrosine (Tyr) to other large neutral amino acids (LNAA) and the clinical efficacy of serotonergic acting drugs have been established. In order to clarify whether a similar relation exists in obesity and to elucidate the long-term effect of dexfenfluramine (dF) on plasma amino acid profiles and macronutrient selection, we examined 29 obese patients participating in a 12 months double-blind weight loss trial with either dexfenfluramine (dF) (30 mg/day) or placebo (PL) in conjunction with 4.2-5.0 MJ/d diet. Maximum weight loss was obtained after 6 months (dF 12.8 +/- 5.4 kg; PL 13.8 +/- 9.2 kg, x +/- s.d., ns). Plasma Trp/LNAA and Tyr/LNAA were found to be lower than in normal weight controls and were further reduced during treatment (p < 0.05), but without differences between dF and PL groups. Macronutrient selection was not affected by the dF treatment. In the placebo group weight loss was associated with a high pre-treatment energy intake and a high carbohydrate-protein ratio (p < 0.05). A decrease in dietary fat and increase in protein intake (%) and age was found to explain 82% of the variation in weight loss (p < 0.0005), whereas no correlation could be shown in the dF group. Pre-treatment plasma Trp/LNAA or Tyr/LNAA and weight loss were not correlated. In conclusion, neither food selection nor basal plasma amino acid profiles were predictors of weight loss during long-term treatment with dF as an adjuvant to energy restriction, and they were not affected by the drug treatment.
Breum
L
L
Department of Internal Medicine and Endocrinology, Hvidovre Hospital, University of Copenhagen, Denmark.
Møller
S E
SE
Andersen
T
T
Astrup
A
A
D000328:Adult; D000596:Amino Acids / Q000097:blood*; D001067:Appetite Depressants / Q000494:pharmacology* / Q000627:therapeutic use; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D005277:Fenfluramine / Q000494:pharmacology* / Q000627:therapeutic use; D005518:Food Preferences; D006801:Humans; D008297:Male; D009765:Obesity / Q000188:drug therapy*; D014364:Tryptophan / Q000097:blood; D014443:Tyrosine / Q000097:blood; D015431:Weight Loss
D000596:Amino Acids; D001067:Appetite Depressants; D004041:Dietary Fats; D004044:Dietary Proteins; D005277:Fenfluramine; D014443:Tyrosine; D014364:Tryptophan