#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Obesity treatment in metabolic syndrome patients


Authors: Š. Svačina
Authors‘ workplace: III. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Štěpán Svačina, DrSc., MBA
Published in: Vnitř Lék 2009; 55(7-8): 622-625
Category: 134th Internal Medicine Day - 23rd Vanysek's Day Brno 2009 - Vanysek's Lecture

Overview

Fat accumulation is an important pathogenetic factor in metabolic syndrome. Weight reduction, at the same time, has a positive effect on metabolic syndrome components. Lifestyle changes are important in the treatment of obesity although they are usually unlikely to provide permanent effect. At present, bariatric surgery and pharmacotherapy represent easily accessible and effective treatment options. In addition, bariatric surgery often results in full remission of type 2 diabetes. Unlike older anti-obesity agents, currently available anti-obesitics sibutramine and orlistat might be taken long-term for years, allowing avoidance of the typical weight increase following treatment completion phenomenon. Furthermore, both agents provide broad therapeutic effect as they affect all components of metabolic syndrome. The weigh of obese patients with impaired glucose tolerance and increased fasting glycaemia might be reduced with metformin. A range of other substances is in development, of which incretin analogues, expected to be used in obese non-diabetic patients, appear the most promising. Bariatric surgery decreases significantly mortality of obese patients with metabolic syndrome. It is likely that mortality reduction following the use of anti-obesity agents will soon be proven as well.

Key words:
obesity – sibutramine – orlistat – SGLT2 inhibitors – incretin mimetics – metabolic surgery – bariatric surgery


Sources

1. Svačinová H. Role pohybové léčby a tělesné zdatnosti v prevenci a léčbě metabolického syndromu. Vnitř Lék 2005; 51: 87–92.

2. Svačinová H. Pohybová léčba u pacientů s metabolickým syndromem. Vnitř Lék 2007; 53: 540–544.

3. Stránská Z, Matoulek M, Fábin P et al. Pravidelná fyzická aktivita zlepšuje lipidový profil u obézních. Vnitř Lék 2007; 53: 404–407.

4. Fried M, Svačina Š, Owen K. Bariatrická chirurgie a diabetes. Trendy v diabetologii 10. Praha: Galén 2005.

5. Tice JA, Karliner L, Walsh J et al. Gastric banding or bypass? A systematic review comparing the two most popular bariatric procedures. Am J Med 2008; 121: 885–893.

6. Frachetti KJ, Goldfine AB. Bariatric surgery for diabetes management. Curr Opin Endocrinol Diabetes Obes 2009; 16: 119–124.

7. Svačina Š. Prevence diabetu a jeho komplikací. Praha: Triton 2008.

8. Rubino F, Forgione A. Gastrointestibal surgery to treat type 2 diabetes. In: Parini U, Nebilo PE (eds). Bariatric surgery. Italy: Mosumeci Editore, Quart 2007.

9. Aguirre V, Stylopoulos N, Grinbaum R et al. An endoluminal sleeve induces substantial weight loss and normalizes glucose homeostasis in rats with diet‑induced obesity. Obesity (Silver Spring) 2008; 16: 2585–2592.

10. Tarnoff M, Shikora S, Lembo A. Acute technical feasibility of an endoscopic duodenal-jejunal bypass sleeve in a porcine model: a potentially novel treatment for obesity and type 2 diabetes. Surg Endosc 2008; 22: 772–776.

11. Anderson JW. Orlistat for the management of overweight individuals and obesity: a review of potential for the 60-mg, over-the-counter dosage. Expert Opin Pharmacother 2007; 8: 1733–1742.

12. Šmahelová A. Výsledky multicentrického sledování léčby sibutraminem u obézních diabetiků v České republice. Vnitř Lék 2005; 51: 676–680.

13. Arterburn D, Crane PK, Veenstra DL. The efficacy and safety of sibutramine for weight loss. A systematic review. Ann Intern Med 2004; 164: 994–1003.

14. Svacina S, Owen K, Hendl J et al. Comparison of lipid lowering effect of sibutramine in patients treated or not treated with statins – 3 month follow‑up. Prague Med Rep 2007; 108: 333–338.

15. Wadden TA, Berkowitz RI, Womble LG et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N Engl J Med 2005; 353: 2111–2120.

16. James WP, Astrup A, Finer N et al. Effect of sibutramine on weight maintenance after weight loss: a randomised trial. STORM Study Group. Sibutramine Trial of Obesity Reduction and Maintenance. Lancet 2000; 356: 2119–2125.

17. Svačina Š a kol. Metabolický syndrom. Praha: Triton 2006.

18. Kvasnička T. Endokanabinoidy – nová volba v léčbě metabolického syndromu a zástavě kouření. Čas Lék Čes 2005; 144: 81–84.

19. Svačina Š. Metabolické účinky psychoafarmak. Praha: Triton 2004.

20. Rotella CM, Monami M, Mannucci E. Metformin beyond diabetes: new life for an old drug. Curr Diabetes Rev 2006; 2: 307–315.

21. Svačina Š. Novinky ve farmakoterapii obesity. Farmakoterapie 2007; 4: 314–317.

22. Svačina Š, Doležal T. Exenatid. Farmakoterapie 2008; 3: 291–295.

23. Svačina Š. Antidiabetika a krevní tlak. In: Widimský J (ed). Arteriální hypertenze. Současné trendy. Praha: Triton 2009.

24. Bhushan R, Elkind-Hirsch KE, Bhushan M et al. Exenatide use in the management of metabolic syndrome: a retrospective database study. Endocr Pract 2008; 14: 993–999.

25. Svačina Š. Potenciální nová antidiabetika v příštím desetiletí. Vnitř Lék 2009; 55: 429–433.

26. Jee SH, Sull JW, Park J et al. Body‑mass index and mortality in Korean men and women. N Engl J Med 2006; 355: 779–787.

27. Adams KF, Schatzkin A, Harris TB et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med 2006; 355: 763–778.

28. Maggioni A et al. Safety profile of sibutramine during a six week treatment period in high risk patients – an analysis of SCOUT Study. Int J Obes 2007; 31 (Suppl 1):S167.

Labels
Diabetology Endocrinology Internal medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#