Phelan S, Wadden T A, Berkowitz R I, Sarwer D B, Womble L G, Cato R K, Rothman R
Brown Medical School/The Miriam Hospital, Providence, RI, USA.
Int J Obes (Lond). 2007 Sep;31(9):1442-8. doi: 10.1038/sj.ijo.0803606. Epub 2007 Mar 13.
To evaluate the effects of weight loss on the risk of having metabolic syndrome after 1 year of treatment with lifestyle modification alone, pharmacotherapy alone (sibutramine) or the combination of the two.
Randomized, controlled, 1-year clinical trial.
One hundred and eighty women and 44 men, 18-65 years of age, with a body mass index of 30-45 kg/m(2), free of uncontrolled hypertension or type 1 or 2 diabetes.
Fifteen milligrams of sibutramine per day alone, lifestyle modification counseling alone, sibutramine plus lifestyle modification counseling or sibutramine plus brief lifestyle modification counseling.
The metabolic syndrome, as defined by the Adult Treatment Panel III.
Before treatment, 34.8% of the participants had the metabolic syndrome. Metabolic syndrome was more prevalent in Caucasians than African Americans (42.5 vs 20.3%; P<0.03), in males than females (65.1 vs 34.9%; P<0.002) and in older (>44 years) than younger (</=44 years) participants (47.5 vs 20.8%; P<0.0001). After 1 year of treatment, a moderate decrease in weight (8.0+/-8.7 kg) resulted in significant reductions in the prevalence of metabolic syndrome from 34.8 to 27.2% of all participants (P<0.02). Logistic regression analyses indicated that for each 1 kg of weight lost, the odds of metabolic syndrome were reduced by 8% (CI=0.89-0.97; P<0.003). Lifestyle modification either alone (P<0.04), or in combination with sibutramine (P<0.05), significantly reduced the prevalence of metabolic syndrome compared with sibutramine alone. The group effect was removed after controlling for weight loss.
The metabolic syndrome was prevalent in over one-third of obese individuals who sought weight loss treatment, and the prevalence differed by age, sex and ethnicity. Moderate weight loss markedly reduced the odds of metabolic syndrome in this sample.
评估单纯生活方式改变、单纯药物治疗（西布曲明）或两者联合治疗1年后体重减轻对代谢综合征风险的影响。
随机对照1年临床试验。
180名女性和44名男性，年龄18 - 65岁，体重指数为30 - 45kg/m²，无未控制的高血压或1型或2型糖尿病。
每日单独服用15毫克西布曲明、单独进行生活方式改变咨询、西布曲明加生活方式改变咨询或西布曲明加简短生活方式改变咨询。
采用成人治疗小组第三次报告所定义的代谢综合征。
治疗前，34.8%的参与者患有代谢综合征。代谢综合征在白人中比非裔美国人更常见（42.5%对20.3%；P<0.03），男性比女性更常见（65.1%对34.9%；P<0.002），年龄较大（>44岁）的参与者比年龄较小（≤44岁）的参与者更常见（47.5%对20.8%；P<0.0001）。治疗1年后，体重适度下降（8.0±8.7千克）使代谢综合征的患病率从所有参与者的34.8%显著降至27.2%（P<0.02）。逻辑回归分析表明，每减轻1千克体重，代谢综合征的几率降低8%（CI = 0.89 - 0.97；P<0.003）。与单独使用西布曲明相比，单独进行生活方式改变（P<0.04）或与西布曲明联合使用（P<0.05）均显著降低了代谢综合征的患病率。在控制体重减轻因素后消除了组间效应。
在寻求减肥治疗的肥胖个体中，超过三分之一的人患有代谢综合征，且患病率因年龄、性别和种族而异。在本样本中，适度体重减轻显著降低了代谢综合征的几率。
