The effect of orlistat and sibutramine treatment on serum adiponectin and ghrelin level

2-ABSTRACTThe effect of orlistat and sibutramine treatment on serum adiponectin andghrelin levelObesity is an inevitable consequence of chronic positive energy balance. Theregulation of energy balance are mediated by a complex network of signalsoriginating from a number of tissues. Obesity is associated with an increasedincidence of diabetes, hypertension, dyslipidaemia and coronary artery disease.Current management strategies of obesity include lifestyle interventions andpharmacotherapy. Sibutramine and orlistat are drugs with established efficacy inweight reduction and maintenance of weight loss. Adiponectin, an adipose tissue-specific plasma protein, is associated with insulin resistance and was recentlyrevealed to have anti-inflammatory effects. It may provide a biological link betweenobesity and obesity-related disorders. Ghrelin has been recognized as an importantregulator of growth hormone secretion and energy homeostasis. Ghrelin stimulatesfood intake and stimulates metabolic changes leading to an increas in body weightand body fat mass. In the prsent study, we aimed to examine that the effect of orlistatand sibutramine treatment on serum adiponectin and ghrelin levels in obese subjects.Forty-eight eligible obese subjects were randomly divided three groups. Onegroup was recommended lifestyle change and diet (n=16). Other two groups weretreated with sibutramine 15 mg/day (n=16) and orlistat 120 mg 3X1(n=16) for weightloss. The study lasted 6 months. Before and after the study, blood samples werecollected from the participants and blood pressure and anthropometric measurementswere performed.By the end of six months in the group of lifestyle change and diet, statisticallysignificant changes from baseline were observed for weight (% 5), BMI, waist andhip circumference, fasting plasma glucose (PG), 2-h PG, T-CHOL, LDL-C, CRP andadiponectin (p<0.05) without a significant alteration of ghrelin. In obese subjects thathad the sibutramine treatment with a loss of weight about % 10 the changes in BMI,waist and hip circumference, fasting PG, 2-h PG, insulin, C-peptide, HOMA-IR, T-CHOL, LDL-C, TG, CRP and microalbuminuria and the increas level of adiponectinand ghrelin was a significant increas according to the statistics (p<0.05). In the groupthat had orlistat teatment for weight loss with a weight loss about % 8 statisticallysignificant improves was observed in BMI, waist and hip circumference, systolicblood pressure, fasting PG and 2-h PG, insulin, C-peptide, HOMA-IR, LDL-C, CRP,adiponectin and ghrelin (p<0.05).In obesity while the weight loss with lifestyle change and diet increasedadiponectin level in a good way, weight loss with medical treatment (with orlistat andsibutramin) increased both adiponectin level and ghrelin level.Key words: Obesity, Sibutramine, Orlistat, Adiponectin, Ghrelin