Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.
Metabolism. 2011 Mar;60(3):421-9. doi: 10.1016/j.metabol.2010.03.010. Epub 2010 Apr 27.
The aim of the study was to evaluate the effects of 12-month treatment with sibutramine plus L-carnitine compared with sibutramine alone on body weight, glycemic control, insulin resistance, and inflammatory state in type 2 diabetes mellitus patients. Two hundred fifty-four patients with uncontrolled type 2 diabetes mellitus (glycated hemoglobin [HbA(1c)] >8.0%) in therapy with different oral hypoglycemic agents or insulin were enrolled in this study and randomized to take sibutramine 10 mg plus L-carnitine 2 g or sibutramine 10 mg in monotherapy. We evaluated at baseline and after 3, 6, 9, and 12 months these parameters: body weight, body mass index, HbA(1c), fasting plasma glucose, postprandial plasma glucose, fasting plasma insulin, homeostasis model assessment of insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, tumor necrosis factor-α, adiponectin, vaspin, and high-sensitivity C-reactive protein. Sibutramine plus L-carnitine gave a faster improvement of fasting plasma glucose, postprandial plasma glucose, lipid profile, leptin, tumor necrosis factor-α, and high-sensitivity C-reactive protein compared with sibutramine alone. Furthermore, there was a better improvement of body weight, HbA(1c), fasting plasma insulin, homeostasis model assessment of insulin resistance index, vaspin, and adiponectin with sibutramine plus L-carnitine compared with sibutramine alone. Sibutramine plus L-carnitine gave a better and faster improvement of all the analyzed parameters compared with sibutramine alone without giving any severe adverse effect.
本研究旨在评估与单独使用西布曲明相比，西布曲明联合左旋肉碱治疗 12 个月对 2 型糖尿病患者体重、血糖控制、胰岛素抵抗和炎症状态的影响。本研究共纳入 254 例血糖控制不佳的 2 型糖尿病（糖化血红蛋白 [HbA1c]＞8.0%）患者，他们正在接受不同的口服降糖药或胰岛素治疗，将这些患者随机分为两组，分别服用西布曲明 10mg 加左旋肉碱 2g 或西布曲明 10mg 单药治疗。我们在基线和治疗 3、6、9 和 12 个月时评估了以下参数：体重、体重指数、HbA1c、空腹血糖、餐后血糖、空腹胰岛素、稳态模型评估的胰岛素抵抗指数、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯、瘦素、肿瘤坏死因子-α、脂联素、vaspin 和高敏 C 反应蛋白。与单独使用西布曲明相比，西布曲明联合左旋肉碱能更快地改善空腹血糖、餐后血糖、血脂谱、瘦素、肿瘤坏死因子-α和高敏 C 反应蛋白。此外，与单独使用西布曲明相比，西布曲明联合左旋肉碱能更好地改善体重、HbA1c、空腹胰岛素、稳态模型评估的胰岛素抵抗指数、vaspin 和脂联素。西布曲明联合左旋肉碱在不产生任何严重不良反应的情况下，比单独使用西布曲明能更快、更好地改善所有分析参数。
