Nishikawa T, Iizuka T, Omura M, Kuramoto N, Miki T, Ito H, Chiba S
Department of Medicine, Yokohama Rosai Hospital, Kanagawa, Japan.
Endocr J. 1996 Dec;43(6):671-7. doi: 10.1507/endocrj.43.671.
The present investigations were performed in order to clarify the effects of mazindol on body weight and insulin sensitivity in patients with morbid obesity who had already been treated with a very-low-calorie diet containing 480 kcal food (VLCD) with various amino acids. We attempted to study whether a further decrease in body weight would be achieved by the administration of mazindol, because it is difficult to obtain sufficient and continuous reduction of body weight after VLCD therapy. Thirteen female severely obese subjects were 51.0 +/- 13.9 years old (25-73 years old), with a mean height of 154.7 +/- 5.6 cm (146.0-160.5 cm), mean weight of 84.5 +/- 9.4 kg (69-98 kg) and a mean body mass index (BMI) of 35.3 +/- 3.6 kg/m2 (29.2-41.0 kg/m2). Their mean body weight decreased to 76.7 +/- 2.2 kg (net decrease: 6.3 +/- 0.9 kg) after VLCD therapy for 2-4 weeks. Then they were treated by the administration of mazindol with diet restriction (1000-1200 kal/day). Mazindol administration resulted in a further weight reduction of 2.9 +/- 0.5 kg after 4 weeks, 4.9 +/- 0.5 kg after 8 weeks and 6.9 +/- 0.9 kg after 12 weeks. Their blood pressure was not changed after mazindol treatment. The responses of blood glucose and insulin levels in a 75 g oral glucose tolerance test (OGTT) were not significantly different before and after mazindol administration. The blood glucose area calculated from the data obtained during OGTT for 120 min did not significantly differ before and after mazindol administration, while the insulin area significantly decreased after mazindol treatment (from 98.0 +/- 12.1 before administration to 70.1 +/- 7.8). The mean M value reflecting insulin sensitivity in the whole body determined by euglycemic glucose clamping was increased significantly after mazindol treatment (from 4.92 +/- 0.30 mg/kg/min to 6.36 +/- 0.43 mg/kg/min). The results demonstrated that mazindol administration with diet restriction further reduced body weight in the morbidly obese subjects after treatment with VLCD, with an increase in the M value and a decrease in insulin release. The results suggest that mazindol is useful for reducing body weight as well as improving insulin sensitivity.
进行本研究是为了阐明马吲哚对病态肥胖患者体重及胰岛素敏感性的影响，这些患者已接受含480千卡食物（极低热量饮食，VLCD）及多种氨基酸的治疗。我们试图研究给予马吲哚是否能进一步减轻体重，因为极低热量饮食疗法后难以实现足够且持续的体重减轻。13名重度肥胖女性受试者年龄为51.0±13.9岁（25 - 73岁），平均身高154.7±5.6厘米（146.0 - 160.5厘米），平均体重84.5±9.4千克（69 - 98千克），平均体重指数（BMI）为35.3±3.6千克/平方米（29.2 - 41.0千克/平方米）。经过2 - 4周的极低热量饮食疗法后，她们的平均体重降至76.7±2.2千克（净减少：6.3±0.9千克）。然后对她们进行马吲哚治疗并限制饮食（1000 - 1200千卡/天）。服用马吲哚4周后体重进一步减轻2.9±0.5千克，8周后减轻4.9±0.5千克，12周后减轻6.9±0.9千克。马吲哚治疗后她们的血压未改变。在75克口服葡萄糖耐量试验（OGTT）中，服用马吲哚前后血糖和胰岛素水平的反应无显著差异。根据OGTT 120分钟期间获得的数据计算的血糖曲线下面积在服用马吲哚前后无显著差异，而胰岛素曲线下面积在马吲哚治疗后显著降低（从服用前的98.0±12.1降至70.1±7.8）。通过正常血糖钳夹法测定的反映全身胰岛素敏感性的平均M值在马吲哚治疗后显著升高（从4.92±0.30毫克/千克/分钟升至6.36±0.43毫克/千克/分钟）。结果表明，在极低热量饮食疗法治疗后的病态肥胖受试者中，服用马吲哚并限制饮食可进一步减轻体重，同时M值升高，胰岛素释放减少。结果提示，马吲哚有助于减轻体重并改善胰岛素敏感性。
