Cardiac valve evaluation and adipokine levels in obese women treated with sibutramine.
OBJECTIVE
The aims of present study were 1) to evaluate cardiac valve characteristics, 2) to determine the plasma concentrations of fibrinogen, high sensitivity C-reactive protein (hsCRP), adiponectin, and tumor necrosis factor-alpha (TNF-alpha) in the obese women before and after 19 months sibutramine treatment in the obese women.


METHODS
Sixty obese women were enrolled in this prospective, randomized study. Thirty women received 10 mg once daily dose of sibutramine for 19 months. The rest of the obese women received 15 mg once daily dose of sibutramine for 19 months. All patients were evaluated with echocardiography. Plasma levels of adiponectin and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA) and hsCRP by immunoturbimetric assay. Student paired and unpaired t tests were used to compare the 10 mg or 15 mg dose sibutramine effects either in groups or between the groups.


RESULTS
There were no signs of significant regurgitation or thickening of the mitral and aortic valves on echocardiographic evaluation performed after 19 months of treatment. Parameters of systolic function after 10 or 15 mg treatment were not different from pretreatment characteristics. Minimal tricuspid regurgitation was found in one (1/27) patient treated with 10 mg sibutramine after 19 months. Among obese patients treated with 15 mg sibutramine one patient (1/28) had minimal mitral valve regurgitation and 2 patients (2/28) had minimal aortic insufficiency. Stage II diastolic dysfunction in the 15 obese treated with 15 mg regressed to stage I diastolic dysfunction (50%). Stage II diastolic dysfunction in the 10 obese treated with 10 mg regressed to stage I diastolic dysfunction (33.3%). Mean levels of TNF-alpha(p=0.04), fibrinogen (p=0.03) and hsCRP (p=0.04)i decreased and adiponectin (p=0.03) levels increased in the obese treated with 10 mg sibutramine. Likewise, in the patients treated with 15 mg sibutramine, mean levels of TNF- alpha(p=0.01), fibrinogen (p= 0.02), and hsCRP (p= 0.04) decreased and adiponectin (p= 0.02) levels increased.


CONCLUSIONS
Nineteen months of sibutramine treatment does not affect heart valve and systolic functions, however, diastolic dysfunction severity reduced with sibutramine treatment. Also In addition, mean levels of adiponectin, TNF- alpha, fibrinogen and hs- CRP change with 19 months sibutramine treatment.
Department of Cardiology, Sada Hospital, Izmir, Turkey.
Sefa
S
Saraç
Fulden
F
Saraç
D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D001067:Appetite Depressants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D003503:Cyclobutanes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D048909:Diabetes Complications / Q000097:blood / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006349:Heart Valve Diseases / Q000453:epidemiology; D006351:Heart Valves / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D018579:Patient Selection; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D054392:Adipokines; D052242:Adiponectin; D001067:Appetite Depressants; D003503:Cyclobutanes; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; C058254:sibutramine