title: Acute effect of weight loss on levels of total bilirubin in obese, cardiovascular high-risk patients: an analysis from the lead-in period of the Sibutramine Cardiovascular Outcome trial.
abstract: Low levels of bilirubin are associated with an increased risk of cardiovascular adverse events. Weight reduction is known to reduce several cardiovascular risk factors, but effects on bilirubin levels have not been reported. We studied the response of weight loss therapy with sibutramine and lifestyle change on levels of total bilirubin in an overweight or obese, cardiovascular high-risk population. Data from the first 4 weeks of the lead-in period of the Sibutramine Cardiovascular Outcome study were analyzed. A total of 10 198 patients provided body weight measurements before and after 4 weeks of sibutramine treatment (10 mg daily), of whom 1059 (10.4%) gained weight, 1467 (13.7%) lost greater than 0% to 1%, 2492 (23.2%) lost greater than 1% to 2%, 2280 (21.2%) lost greater than 2% to 3%, 1498 (13.9%) lost greater than 3% to 4%, and 1402 (13.1%) lost greater than 4% of their initial weight, respectively. At screening, bilirubin concentrations were similar between weight loss groups (around 11 micromol/L, P = .7) and increased linearly as a function of weight loss. The effect was significantly more pronounced in men compared with women (P for interaction = .003). Adjusted for multiple variables, each 1% increase in weight loss was associated with 0.21-micromol/L (+/- standard error 0.027) increase in men (P < .0001) and 0.11-micromol/L (+/-0.024) increase in women (P < .0001). Short-term weight loss during administration of sibutramine in combination with diet and exercise advice is effective in increasing bilirubin levels within the reference range, with bilirubin increasing as a linear function of weight change. The effect is greater in men than in women.
authors.affiliation: Department of Cardiology, Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark. ca@heart.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Andersson
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.forename: Emil Loldrup
authors.initials: EL
authors.lastname: Fosbøl
authors.forename: Bente
authors.initials: B
authors.lastname: Brendorp
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.forename: Walmir
authors.initials: W
authors.lastname: Coutinho
authors.forename: Arya M
authors.initials: AM
authors.lastname: Sharma
authors.forename: Luc
authors.initials: L
authors.lastname: Van Gaal
authors.forename: Nick
authors.initials: N
authors.lastname: Finer
authors.forename: W Philip T
authors.initials: WP
authors.lastname: James
authors.forename: Ian D
authors.initials: ID
authors.lastname: Caterson
authors.forename: Richard A
authors.initials: RA
authors.lastname: Rode
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
mesh_terms: D000368:Aged; D001067:Appetite Depressants / Q000627:therapeutic use*; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D015986:Confounding Factors, Epidemiologic; D003503:Cyclobutanes / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications; D050177:Overweight / Q000097:blood* / Q000150:complications*; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001067:Appetite Depressants; D015415:Biomarkers; D003503:Cyclobutanes; D001663:Bilirubin; C058254:sibutramine