Weight loss in obese men by caloric restriction and high-dose diazoxide-mediated insulin suppression
| Autor: | A.A. van Sorge, Sandra Loves, G.A.J van Boekel, J. Ruinemans-Koerts, T. Rijnders, H.D. de Boer |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Diet Reducing Endocrinology Diabetes and Metabolism medicine.medical_treatment Blood lipids Pilot Projects Insulin Antagonists Endocrinology Weight loss Internal medicine Weight Loss Internal Medicine medicine Humans Insulin Obesity Life Style Caloric Restriction Dose-Response Relationship Drug Adiponectin business.industry Diazoxide Middle Aged medicine.disease Renal disorders [UMCN 5.4] Treatment Outcome Blood pressure Body Composition Lean body mass medicine.symptom business Body mass index Hyperinsulinism |
| Zdroj: | Diabetes, Obesity & Metabolism, 10, 1195-203 Diabetes, Obesity & Metabolism, 10, 12, pp. 1195-203 |
| ISSN: | 1462-8902 |
| Popis: | Item does not contain fulltext OBJECTIVE: To examine the concept whether high-dose diazoxide (DZX)-mediated insulin suppression, in combination with moderate caloric restriction and increased physical activity, can establish a weight loss of at least 15% in obese hyperinsulinaemic men. DESIGN: Open, uncontrolled, 6-month pilot study. Energy intake was reduced by 30%, and walking for at least 30 min a day was strongly recommended. DZX treatment was started at 50 mg t.i.d. and increased by 50 mg per dose every 4 weeks to a maximum of 300 mg t.i.d., unless hyperglycaemia or other side-effects occurred. SUBJECTS AND METHODS: Eighteen obese hyperinsulinaemic men with a body mass index of 30-35 kg/m(2). Measurements included body weight, body composition, blood pressure, glycaemic control, insulin response, adiponectin and serum lipids. RESULTS: Body weight decreased by 9.4 kg (95% CI: 5.6-13.2 kg, p < 0.001), waist circumference reduced by 9.2 cm (95% CI: 5.3-12.9 cm, p < 0.001) and total body fat mass decreased by 23.3% (95% CI: 13.7-32.9%, p < 0.001), without a concomitant change in soft tissue lean body mass or bone mass. Fat loss was inversely related to fasting insulin levels achieved at 6 months (r = -0.76, p < 0.002). Diastolic blood pressure decreased by 10.9 mmHg (95% CI: 6.5-15.4 mmHg, p < 0.002). Fasting and postmeal peak insulin levels were reduced by about 65% (p < 0.001) and decreased to the normal range for non-obese men. Fasting and postmeal peak glucose levels increased by 0.8 +/- 0.3 mmol/l (p = 0.01) and 1.4 +/- 0.7 mmol/l (p = 0.06) respectively. Haemoglobin A1c rose by 0.5% to 5.9 +/- 0.2%. CONCLUSION: High-dose DZX-mediated insulin suppression, in combination with moderate caloric restriction and lifestyle advice, is associated with a clinically relevant degree of weight reduction. A more extensive exploration is warranted to optimize this mode of treatment and to further clarify its risks and benefits. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text