减肥药奥利司他和西布曲明对心血管疾病危险因素及游离睾酮水平的影响

The effects of Xenical and Sibutramine on the risk factors of cardiovascular disease and free testosterone level

目的 观察肥胖患者使用奥利司他及西布曲明的临床疗效 ,并测定其血脂及性激素变化。方法年龄 1 8～ 65岁非孕或已避孕妇女 60例 ,随机分成 3组 ,其中奥利司他组 2 0例 ,西布曲明组 2 0例 ,安慰剂组 2 0例。治疗并随访 2 4周。结果 试验组体重、体重指数、胆固醇在服药后显著下降 ,而对照组无显著差异 ;三酰甘油在 3组中均无改变 ;奥利司他组游离睾酮显著下降伴随性激素结合球蛋白明显上升 ; 3组瘦素前后无变化。结论 奥利司他和西布曲明不仅显著减轻肥胖者体重 ,同时降低胆固醇 ,而且奥利司他能纠正肥胖妇女高雄激素现象。

Objective To evaluate the effectiveness of Orlistat and Sibutramine on hormonal changes of obese patients. Methods Sixty women aged 18～65 years non pregnant or receiving contraceptives were enrolled into randomized study, of these, twenty in each group took Orlistat, Sibutramine or placebo. All patients were followed up for 24 weeks. Results The body weight of Orlistat and Sibutramine groups decreased significantly, except the placebo group. The serum cholesterol of the tested groups lowered significantly, but with no change in placebo group . There were no change in serum triglyceride of the two tested groups as well as the placebo group. The serum free testosterone also decreased in the tested groups while the sex hormone binding globulin increased. There was no change in leptin in all groups. Conclusion Weight loss in obesity may lower the risk of cardiovascular diseases and type 2 diabetes mellitus, it can improve the clinical manifestation due to abnormal secretion of testosterone. Orlistat and sibutramine not only reduce the body weight of obese women, they also decrease blood cholesterol, moreover Orlistat can correct the high testosterone level in the obese women.