Effect of metformin and sibutramine on insulin sensitivity and adiposity in obese patients
E. Martínez-Abundis1,2, I.G. Valera-González1, E. Hernández-Salazar1, and M. González-Ortiz1,2
1Medical Research Unit in Clinical Epidemiology, Specialties Hospital, Medical Unit of High Specialty, West National Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco, 2Cardiovascular Research Unit, Physiology Department, Health Sciences University Center, University of Guadalajara, Guadalajara, Jalisco, Mexico

Abstract

Aims: To compare the effect of metformin and sibutramine as monotherapy or as combined therapy on insulin sensitivity and adiposity in obese patients. Methods: A randomized, double-blind, placebo-controlled clinical trial was performed in 27 patients aged between 18 and 40 years and with a body mass index (BMI) between 30 and 40 kg/m². Subjects were allocated to receive one of the following interventions: a) placebo and metformin, b) sibutramine and placebo or c) sibutramine and metformin. The intervention was maintained for 90 days and consisted of 15 mg of sibutramine during the morning, 500 mg of metformin during the evening and placebo homologated in accordance with the hour of administration of each group. Estimation of insulin sensitivity by insulin tolerance test and evaluation of fat mass by electrical bioimpedance were performed at the beginning of the study and at 90 days of the study. Results: BMI was reduced in all groups at different magnitudes. Insulin sensitivity was increased in metformin group (3.6±0.9 vs 4.5±1.1%/min; p=0.050). Adiposity decreased significantly in sibutramine group (39.9±7.0 vs 33.0±9.1%; p≤0.01). Metformin as monotherapy or combined with sibutramine demonstrated a beneficial effect on lipid profile. Conclusion: The three pharmacological interventions reduced BMI at different magnitudes. Metformin improved insulin sensitivity. Sibutramine decreased adiposity. Metformin as monotherapy or combined with sibutramine had a beneficial effect on lipid profile. Obesity and Metabolism 2010; 6: 100-104.

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