Scheen A J
Service de Diabétologie, Nutrition et Maladies métaboliques et de Médecine interne générale, Département de Médecine, CHU Sart Tilman, Université de Liège.
Rev Med Liege. 2002 Sep;57(9):617-21.
The results of the XENDOS study were presented by Professor Lars Sjöström (Gothenburg, Sweden), on August 26, 2002, at the 9th International Congress on Obesity in Sao Paulo, Brazil. XENDOS (XENical in the prevention of Diabetes in Obese Subjects) is a multicentre, randomised, double-blind, placebo-controlled, parallel-group prospective study performed in Sweden over a period of 4 years. The aim of XENDOS was to investigate the use of a weight loss agent (orlistat, Xenical) compared with lifestyle changes for the prevention of type 2 diabetes in obese patients (body mass index > or = 30 kg/m2). Weight loss was greater in the orlistat group (-6.9 kg; n = 1.640) than in the placebo group (-4.1 kg; n = 1.637; p < 0.001). Such a difference in weight reduction was sufficient to significantly reduce the cumulative incidence of type 2 diabetes (6.2% versus 9.0%; p = 0.0032; relative risk reduction of 37.3%). The difference was especially remarkable in obese patients with impaired glucose tolerance (21% of the cohort), with a reduction of conversion to diabetes from 28.8% in the placebo group to 18.8% in the orlistat group (p < 0.005) and a number needed to treat to avoid one event of 11 only. Significant and sustained reductions in cardiovascular risk factors such as arterial blood pressure and lipid levels were also observed in the orlistat group as compared to the placebo group. XENDOS is the first study demonstrating that an antiobesity agent, like orlistat, is able to reduce the progression to diabetes in obese subjects as compared with lifestyle changes alone.
2002年8月26日，来自瑞典哥德堡的拉尔斯·斯约斯特姆教授在巴西圣保罗举行的第9届国际肥胖大会上公布了XENDOS研究的结果。XENDOS（赛尼可预防肥胖患者糖尿病）是一项在瑞典进行的为期4年的多中心、随机、双盲、安慰剂对照、平行组前瞻性研究。XENDOS的目的是研究一种减肥药物（奥利司他，赛尼可）与生活方式改变相比，在预防肥胖患者（体重指数≥30kg/m²）2型糖尿病方面的效果。奥利司他组的体重减轻幅度（-6.9kg；n=1640）大于安慰剂组（-4.1kg；n=1637；p<0.001）。这种体重减轻差异足以显著降低2型糖尿病的累积发病率（6.2%对9.0%；p=0.0032；相对风险降低37.3%）。在糖耐量受损的肥胖患者（占队列的21%）中，这种差异尤为显著，糖尿病转化率从安慰剂组的28.8%降至奥利司他组的18.8%（p<0.005），预防一例糖尿病事件所需治疗人数仅为11人。与安慰剂组相比，奥利司他组还观察到动脉血压和血脂水平等心血管危险因素显著且持续降低。XENDOS是第一项表明像奥利司他这样的抗肥胖药物与单纯生活方式改变相比，能够降低肥胖患者糖尿病进展的研究。
