Reduction of visceral adipose tissue and improvement of metabolic indices: effect of dexfenfluramine in NIDDM.
Increased visceral adipose tissue is thought to contribute to impaired glucose tolerance. We studied 10 men with non-insulin dependent diabetes (NIDDM) before and after a 12-week intervention study using dexfenfluramine. Subjects had a mean body mass index (BMI) of 26.4 +/- 1.7 kg/m2 and had an abdominal distribution of body fatness (waist-to hip ratio > 0.9). Anthropometric indices, biochemistry, macronutrient intake from 7-day food records as well as a euglycaemic glucose clamp and magnetic resonance imaging (MRI) were performed at week 0 and week 12. Abdominal adipose tissue area measured by MRI was reduced from 854 +/- 270 cm2 to 666 +/- 231 cm2 (p = 0.003) due mainly to a selective 32% reduction in visceral fat area from 484 +/- 230 cm2 to 333 +/- 72 cm2 (p = 0.002). Insulin sensitivity improved from 0.29 +/- 0.13 [min-1 (mU/L)] to 0.54 +/- 0.21 [min-1 (mU/L)] (p = 0.01) and C-peptide levels reduced from 0.77 +/- 0.24 mumol/L to 0.58 +/- 0.15 mumol/L (p = 0.002). The reductions in fasting glucose and glycated haemoglobin failed to achieve significance. Fasting total cholesterol and triglyceride levels significantly reduced (p = < 0.001 and p = 0.021 respectively). There was a reduction in total energy intake (p = 0.005) due to a significant reduction in calories obtained from fat (p < 0.001). Thus dexfenfluramine was shown to be a useful adjunct therapy for the reduction of visceral fat in abdominally-obese men with NIDDM with an associated improvement in insulin sensitivity.
Marks
S J
SJ
Sheikh Rashid Diabetes Unit, Radcliffe Infirmary Oxford, UK.
Moore
N R
NR
Clark
M L
ML
Strauss
B J
BJ
Hockaday
T D
TD
D000273:Adipose Tissue; D000328:Adult; D001067:Appetite Depressants / Q000494:pharmacology / Q000627:therapeutic use*; D001823:Body Composition / Q000187:drug effects*; D001824:Body Constitution; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000378:metabolism; D004032:Diet; D002149:Energy Intake; D005277:Fenfluramine / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000494:pharmacology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000188:drug therapy; D014280:Triglycerides / Q000097:blood
D001067:Appetite Depressants; D007328:Insulin; D014280:Triglycerides; D005277:Fenfluramine; D002784:Cholesterol