-Original-

Metabolic and Inflammatory Changes with Orlistat and Sibutramine Treatment in Obese Malaysian Subjects

Belqes Abdullah Mohammad Al-Tahami¹, Ab Aziz Al-Safi Ismail², Zulkefli Sanip³, Zurkurnai Yusoff⁴, Tg. Muzaffar TM Shihabudin⁵, Taran Singh Pall Singh⁵ and Aida Hanum Ghulam Rasool¹

¹Pharmacology Vascular Laboratory, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
²Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
³Central Research Laboratory, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
⁴Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
⁵Department of Orthopaedic, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia

Introduction: Obesity is associated with numerous health problems, particularly metabolic and cardiovascular complications. This study aimed to assess the effects that, nine months of pharmacological intervention with orlistat or sibutramine, on obese Malaysians' body weight and compositions, metabolic profiles and inflammatory marker.
Methods: Seventy-six obese subjects were randomly placed into two groups. The first group received three daily 120 mg dosages of orlistat for nine months (n=39), and the second group received a once daily 10 or 15 mg dosage of sibutramine for nine months (n=37). Baseline measurements for weight, body mass index (BMI), waist circumference (WC), body fat percentage (BF), visceral fat (VF), adiponectin, fasting plasma glucose (FPG), fasting insulin, pancreatic B cell secretory capacity (HOMA%B), insulin sensitivity (HOMA%S), insulin resistance (HOMA-IR) and serum high sensitivity C-reactive protein (hs-CRP) were performed and repeated during the sixth and ninth months of treatment.
Results: Twenty-four subjects completed the trial in both groups. For both groups, weight, BMI, WC, BF, VF, HOMA-IR and hs-CRP were significantly lower at the end of the nine month intervention. However, there were no significant differences between the two groups for these parameters with nine months treatment. There was a significant decrease in FPG in orlistat group; while fasting insulin and HOMA%B reduced in sibutramine group. For both groups, there were also significant increases in adiponectin levels and HOMA%S at the end of the nine month intervention.
Conclusion: Nine months of treatment with orlistat and sibutramine not only reduced weight but also significantly improved BMI, WC, BF, VF, FPG, adiponectin, fasting insulin, HOMA%B, HOMA%S, HOMA-IR and hs-CRP. These improvements could prove useful in the reduction of metabolic and cardiovascular risks in obese subjects.

J Nippon Med Sch 2017; 84: 125-132

Keywords
high sensitivity-C-reactive protein, insulin sensitivity, obesity, orlistat, sibutramine

Correspondence to
Aida Hanum Ghulam Rasool, MD, Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Malaysia
aida.rasool@yahoo.com

Received, October 23, 2015
Accepted, February 14, 2017