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重组甲硫氨酰人瘦素三种治疗方案对肥胖成年人体重的影响:一项随机、安慰剂对照试验

Effect of three treatment schedules of recombinant methionyl human leptin on body weight in obese adults: a randomized, placebo-controlled trial.

作者信息

Zelissen P M J, Stenlof K, Lean M E J, Fogteloo J, Keulen E T P, Wilding J, Finer N, Rössner S, Lawrence E, Fletcher C, McCamish M

机构信息

University Medical Center Utrecht, Utrecht, The Netherlands.

出版信息

Diabetes Obes Metab. 2005 Nov;7(6):755-61. doi: 10.1111/j.1463-1326.2005.00468.x.

Abstract

AIM

The aim of this study was to evaluate the effect on body weight and safety of subcutaneously administered recombinant leptin in obese adults and to evaluate whether the timing of recombinant leptin administration influences efficacy.

METHODS

A randomized, double-blind, placebo-controlled, multicentre study was designed, comprising of a 3-week dietary lead-in followed by a 12-week leptin or placebo treatment period. A total of 284 overweight and obese (body mass index 27-37.0 kg/m(2)) predominantly white (98%) women (66%) and men (34%) with a mean (+/-s.d.) 46.8+/-10.4 years of age were randomized into three treatment groups with three matching placebo groups. Recombinant leptin was administered by subcutaneous injection [10 mg/morning, 10 mg/evening or 20 mg/day (10 mg twice daily)]. Patients were counselled at baseline to reduce dietary intake by 2,100 kJ/day (500 kcal/day), and dietary advice was reinforced every 2-4 weeks.

RESULTS

No statistically significant change in body weight occurred with recombinant leptin treatment compared with placebo treatment in any treatment group. No clinically significant adverse effects were observed with the exception of an increase in injection-site reactions in patients treated with recombinant leptin (83%) vs. placebo (36%).

CONCLUSIONS

Administration of recombinant leptin to an overweight and obese population, in addition to a mildly energy-restricted diet, was not efficacious in terms of weight loss at the doses and schedules studied. The hypothesis that nocturnal administration of recombinant leptin might have a specific effect on weight loss was not supported.

摘要

目的

本研究旨在评估皮下注射重组瘦素对肥胖成年人体重及安全性的影响,并评估重组瘦素给药时间是否会影响疗效。

方法

设计了一项随机、双盲、安慰剂对照、多中心研究,包括为期3周的饮食导入期,随后是为期12周的瘦素或安慰剂治疗期。共有284名超重和肥胖(体重指数27 - 37.0 kg/m²)的人群(主要为白人,占98%),其中女性占66%,男性占34%,平均年龄(±标准差)为46.8 ± 10.4岁,被随机分为三个治疗组和三个匹配的安慰剂组。重组瘦素通过皮下注射给药[10 mg/早晨,10 mg/晚上或20 mg/天(10 mg,每日两次)]。在基线时建议患者将饮食摄入量减少2100 kJ/天(500 kcal/天),并每2 - 4周强化一次饮食建议。

结果

与安慰剂治疗相比,任何治疗组接受重组瘦素治疗后体重均未发生具有统计学意义的变化。除了接受重组瘦素治疗的患者(83%)注射部位反应增加,而接受安慰剂治疗的患者为36%外,未观察到具有临床意义的不良反应。

结论

在研究的剂量和给药方案下,对超重和肥胖人群除给予轻度能量限制饮食外,注射重组瘦素在减肥方面无效。夜间注射重组瘦素可能对减肥有特定作用这一假设未得到支持。

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