Ben-Menachem Elinor, Axelsen Mette, Johanson Else Hellebö, Stagge Anna, Smith Ulf
Sahlgrenska Academy at Göteborg University, Göteborg, Sweden.
Obes Res. 2003 Apr;11(4):556-62. doi: 10.1038/oby.2003.78.
We examined predictors of weight loss with topiramate, an anticonvulsant associated with weight loss in adults.
In this uncontrolled, prospective clinical trial, topiramate was added to existing anticonvulsants in adults (40 to 110 kg) with partial-onset seizures. Primary measurements were change from baseline weight after 3 months and 1 year in patients completing 1 year of topiramate treatment (N = 38). Physiological and metabolic measures were analyzed for correlation with weight loss during topiramate treatment.
In patients who completed 1 year of topiramate treatment, baseline weight was reduced in 82% at 3 months and in 86% at 1 year. Mean body weight was reduced 3.0 kg (3.9% of baseline) at 3 months and 5.9 kg (7.3%) at 1 year. In obese patients [body mass index (BMI) >/= 30 kg/m(2)], mean weight loss was 4.2 kg (4.3%) at 3 months and 10.9 kg (11.0%) at 1 year. Weight loss was primarily caused by reduction in body fat mass. For all patients, weight loss at 3 months correlated most strongly with reduced caloric intake (p = 0.02). At 1 year, caloric intake had returned to baseline levels; weight loss correlated most strongly with higher baseline BMI (p = 0.0007).
Our results suggest that weight loss occurs in most adults treated with topiramate and is sustained for at least 1 year. Reduced caloric intake may account, in part, for weight loss during early treatment. The pattern of weight loss differs according to baseline BMI, with obese patients experiencing greater weight loss during continued therapy.
我们研究了托吡酯导致体重减轻的预测因素，托吡酯是一种与成人体重减轻相关的抗惊厥药物。
在这项非对照的前瞻性临床试验中，将托吡酯添加到患有部分性发作的成人（体重40至110千克）现有的抗惊厥药物中。主要测量指标是完成1年托吡酯治疗的患者（N = 38）在3个月和1年后相对于基线体重的变化。分析了生理和代谢指标与托吡酯治疗期间体重减轻的相关性。
在完成1年托吡酯治疗的患者中，3个月时82%的患者基线体重下降，1年时为86%。3个月时平均体重减轻3.0千克（占基线的3.9%），1年时减轻5.9千克（7.3%）。在肥胖患者[体重指数（BMI）≥30千克/米²]中，3个月时平均体重减轻4.2千克（4.3%），1年时减轻10.9千克（11.0%）。体重减轻主要是由于体脂肪量减少。对于所有患者，3个月时的体重减轻与热量摄入减少相关性最强（p = 0.02）。1年时，热量摄入已恢复到基线水平；体重减轻与较高的基线BMI相关性最强（p = 0.0007）。
我们的结果表明，大多数接受托吡酯治疗的成人会出现体重减轻，并且至少持续1年。热量摄入减少可能部分解释了早期治疗期间的体重减轻。体重减轻的模式因基线BMI而异，肥胖患者在持续治疗期间体重减轻更多。
