Department of Health Statistics, Second Military Medical University, Shanghai, China.
PLoS One. 2012;7(6):e39062. doi: 10.1371/journal.pone.0039062. Epub 2012 Jun 20.
Anti-obesity drugs are widely used to prevent the complications of obesity, however, the effects of anti-obesity drugs on cardiovascular risk factors are unclear at the present time. We carried out a comprehensively systematic review and meta-analysis to assess the effects of anti-obesity drugs on cardiovascular risk factors.
We systematically searched Medline, EmBase, the Cochrane Central Register of Controlled Trials, reference lists of articles and proceedings of major meetings for relevant literatures. We included randomized placebo-controlled trials that reported the effects of anti-obesity drugs on cardiovascular risk factors compared to placebo. Overall, orlistat produced a reduction of 2.39 kg (95%CI-3.34 to -1.45) for weight, a reduction of 0.27 mmol/L (95%CI: -0.36 to -0.17) for total cholesterol, a reduction of 0.21 mmol/L (95%CI: -0.30 to -0.12) for LDL, a reduction of 0.12 mmol/L (95%CI: -0.20 to -0.04) for fasting glucose, 1.85 mmHg reduction (95%CI: -3.30 to -0.40) for SBP, and a reduction of 1.49 mmHg (95%CI: -2.39 to -0.58) for DBP. Sibutramine only showed effects on weight loss and triglycerides reduction with statistical significances. Rimonabant was associated with statistically significant effects on weight loss, SBP reduction and DBP reduction. No other significantly different effects were identified between anti-obesity therapy and placebo.
CONCLUSION/SIGNIFICANCE: We identified that anti-obesity therapy was associated with a decrease of weight regardless of the type of the drug. Orlistat and rimonabant could lead to an improvement on cardiovascular risk factors. However, Sibutramine may have a direct effect on cardiovascular risk factors.
抗肥胖药物被广泛用于预防肥胖并发症，但目前抗肥胖药物对心血管危险因素的影响尚不清楚。我们进行了全面的系统评价和荟萃分析，以评估抗肥胖药物对心血管危险因素的影响。
我们系统地检索了 Medline、Embase、Cochrane 对照试验中心注册库、文章参考文献和主要会议记录，以寻找相关文献。我们纳入了比较抗肥胖药物与安慰剂对心血管危险因素影响的随机安慰剂对照试验。总体而言，奥利司他可使体重降低 2.39 公斤（95%CI-3.34 至-1.45），总胆固醇降低 0.27mmol/L（95%CI：-0.36 至-0.17），LDL 降低 0.21mmol/L（95%CI：-0.30 至-0.12），空腹血糖降低 0.12mmol/L（95%CI：-0.20 至-0.04），SBP 降低 1.85mmHg（95%CI：-3.30 至-0.40），DBP 降低 1.49mmHg（95%CI：-2.39 至-0.58）。西布曲明仅显示对体重减轻和甘油三酯降低有统计学意义的影响。利莫那班与体重减轻、SBP 降低和 DBP 降低有统计学意义的关联。在抗肥胖治疗与安慰剂之间没有发现其他具有显著差异的效果。
结论/意义：我们发现，无论药物类型如何，抗肥胖治疗都与体重减轻有关。奥利司他和利莫那班可能改善心血管危险因素。然而，西布曲明可能对心血管危险因素有直接影响。
