title: Effect of Sibutramine on Plasma C-Reactive Protein, Leptin and Adipon ectin Concentrations: A Systematic Review and Meta-Analysis of Randomized Contr olled Trials.
abstract: Sibutramine is an anti-obesity medication whose effects on weight loss have been widely explored. Moreover, limited number of studies also evidenced its correlates on adipokines and proinflammatory markers; however, their results have not been conclusive. Hence, a systematic review and meta-analysis of available evidence was conducted in order to calculate the effect size of sibutramine therapy on C-reactive protein (CRP), leptin and adiponectin concentrations. Seven randomized clinical trials with a total of 601 subjects met the eligibility criteria. Random effect meta-analysis evidenced a significant decrease in plasma levels of CRP and leptin (weighted mean difference [WMD] -15.58%, 95% confidence interval [95%CI]: -28.84, -2.33, p=0.021 and WMD -9.25, 95%CI: -15.73, -2.78, p=0.005, respectively) and increase of adiponectin (WMD 9.86%, 95%CI: 1.76, 17.96, p=0.017) following sibutramine therapy. Subgroup analysis showed a greater CRP-lowering effect of sibutramine with doses <15 mg/day (WMD -17.26%, 95%CI: -31.02, -3.5, p=0.014) compared with doses .15 mg/day (WMD 6.01%, 95%CI: -43.38, 55.40, p=0.811). In meta-regression analysis, changes in CRP were found to be independent of baseline or percentage change in body mass index. These results suggest a significant improvement of plasma CRP, leptin and adiponectin levels following treatment with sibutramine. Possible impacts and relevance of these alterations on cardiovascular risk profile remain to be clarified, especially in post-hoc analyses of sibutramine outcome trials among people without pre-existing cardiovascular disease.
authors.affiliation: Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Vincentis
authors.affiliation: Unit of Geriatrics, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.affiliation: Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vespasiani-Gentilucci
authors.affiliation: Unit of Internal Medicine and Hepatology, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Picardi
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
authors.affiliation: PhD School in Experimental Medicine, University of Pavia, Pavia, Italy.
authors.forename: Pamela
authors.initials: P
authors.lastname: Maffioli
authors.affiliation: Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Amirhossein
authors.initials: A
authors.lastname: Sahebkar
mesh_terms: D052242:Adiponectin / Q000097:blood*; D019440:Anti-Obesity Agents / Q000737:chemistry / Q000494:pharmacology*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002097:C-Reactive Protein / Q000378:metabolism*; D003503:Cyclobutanes / Q000737:chemistry / Q000494:pharmacology*; D006801:Humans; D020738:Leptin / Q000097:blood*; D016032:Randomized Controlled Trials as Topic
chemical_list: D052242:Adiponectin; D019440:Anti-Obesity Agents; D003503:Cyclobutanes; D020738:Leptin; D002097:C-Reactive Protein; C058254:sibutramine
keywords: C-reactive protein; Sibutramine; adipokines; adiponectin; leptin