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Pharmacotherapy of Obesity and Metabolic Syndrome

Metabolic Syndrome

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Abstract

The management of metabolic syndrome requires a healthy low-calorie diet, increased physical activity, and other behaviors that promote the maintenance of weight loss. Medications for obesity, diabetes, hypertension, and dyslipidemia may be necessary for the treatment of components of metabolic syndrome and to reduce the risk of cardiovascular disease. This chapter describes current medications available for treatment of obesity and metabolic syndrome.

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References

  • Adams TD, Stroup AM, Gress RE, et al. Cancer incidence and mortality after gastric bypass surgery. Obesity. 2009;17(4):796–802. doi:10.1038/oby.2008.610.

    Article  PubMed Central  PubMed  Google Scholar 

  • Addy C, Rosko JP, Li S, et al. Pharmacokinetics, safety, and tolerability of phentermine in healthy participants receiving taranabant, a novel cannabinoid-1 receptor (CB1R) inverse agonist. J Clin Pharmacol. 2009;49:1228–1238.

    Article  CAS  PubMed  Google Scholar 

  • Aguilar-Salinas CA, Fanghanel-Salmon G, Meza E, et al. Ciprofibrate versus gemfibrozil in the treatment of mixed hyperlipidemias: an open-label, multicenter study. Metab Clin Exp. 2001;50(6):729–733.

    Article  CAS  PubMed  Google Scholar 

  • ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981–2997. Erratum in: JAMA. 2004; 291(18):2196. JAMA 2003 Jan 8;289(2):178.

    Google Scholar 

  • Allison DB, Downey M, Atkinson RL, et al. Obesity as a disease: a white paper on evidence and arguments commissioned by the Council of the Obesity Society. Obesity. 2008;16(6):1161–1177. doi:10.1038/oby.2008.231.

    Article  PubMed  Google Scholar 

  • Allison DB, Gadde KM, Garvey WT, et al. Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP). Obesity. 2012;20(2):330–342. doi:10.1038/oby.2011.330.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Amery A, Berthaux P, Bulpitt C, et al. Glucose intolerance during diuretic therapy: results of trial by the European working party on hypertension in the elderly. Lancet. 1978;1(8066):681–683.

    Article  CAS  PubMed  Google Scholar 

  • Andersen T, Gluud C, Franzmann MB, Christoffersen P. Hepatic effects of dietary weight loss in morbidly obese subjects. J Hepatol. 1991;12(2):224–229.

    Article  CAS  PubMed  Google Scholar 

  • Aronne LJ, Halseth AE, Burns CM, Miller S, Shen LZ. Enhanced weight loss following coadministration of pramlintide with sibutramine or phentermine in a multicenter trial. Obesity. 2010;18(9):1739–1746. doi:10.1038/oby.2009.478.

    Article  CAS  PubMed  Google Scholar 

  • Astrup A, Rössner S, Van Gaal L, et al. Effects of liraglutide in the treatment of obesity: a randomised, double- blind, placebo-controlled study. Lancet. 2009;374(9701):1606–1616.

    Article  CAS  PubMed  Google Scholar 

  • Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366(9493):1267–1278. doi:10.1016/S0140-6736(05)67394-1.

    Article  CAS  PubMed  Google Scholar 

  • Bailey CJ, Gross JL, Pieters A, Bastien A, List JF. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with metformin: a randomised, double-blind, placebo-controlled trial. Lancet. 2010;375(9733):2223–2233. doi:10.1016/S0140-6736(10)60407-2.

    Article  CAS  PubMed  Google Scholar 

  • Bakris GL, Sarafidis PA, Weir MR, et al. Renal outcomes with different fixed-dose combination therapies in patients with hypertension at high risk for cardiovascular events (ACCOMPLISH): a prespecified secondary analysis of a randomised controlled trial. Lancet. 2010;375(9721):1173–1181. doi:10.1016/S0140-6736(09)62100-0.

    Article  CAS  PubMed  Google Scholar 

  • Bakris G, Briasoulis A, Dahlof B, et al. Comparison of benazepril plus amlodipine or hydrochlorothiazide in high-risk patients with hypertension and coronary artery disease. Am J Cardiol. 2013;112(2):255–259. doi:10.1016/j.amjcard.2013.03.026.

    Article  CAS  PubMed  Google Scholar 

  • Bray GA, Greenway FL. Pharmacological treatment of the overweight patient. Pharmacol Rev. 2007;59(2):151–184. doi:10.1124/pr.59.2.2.

    Article  CAS  PubMed  Google Scholar 

  • Bray GA, Ryan DH. Medical therapy for the patient with obesity. Circulation. 2012;125(13):1695–1703. doi:10.1161/CIRCULATIONAHA.111.026567.

    Article  PubMed  Google Scholar 

  • Buchwald H, Avidor Y, Braunwald E, Jensen MD, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–1737. doi:10.1001/jama.292.14.1724.

    Article  CAS  PubMed  Google Scholar 

  • Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–256. doi:10.1016/j.amjmed.2008.09.041. e245.

    Article  PubMed  Google Scholar 

  • Bushe CJ, Bradley AJ, Doshi S, Karagianis J. Changes in weight and metabolic parameters during treatment with antipsychotics and metformin: do the data inform as to potential guideline development? A systematic review of clinical studies. Int J Clin Pract. 2009;63(12):1743–1761. doi:10.1111/j.1742-1241.2009.02224.x.

    Article  CAS  PubMed  Google Scholar 

  • Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–1638. doi:10.1056/NEJMoa021423.

    Article  PubMed  Google Scholar 

  • Chanoine JP, Hampl S, Jensen C, Boldrin M, Hauptman J. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873–2883. doi:10.1001/jama.293.23.2873.

    Article  CAS  PubMed  Google Scholar 

  • Charlton-Menys V, Durrington PN. Human cholesterol metabolism and therapeutic molecules. Exp Physiol. 2008;93(1):27–42. doi:10.1113/expphysiol.2007.035147.

    Article  CAS  PubMed  Google Scholar 

  • Chin BS, Langford NJ, Nuttall SL, Gibbs CR, Blann AD, Lip GY. Anti-oxidative properties of beta-blockers and angiotensin-converting enzyme inhibitors in congestive heart failure. Eur J Heart Fail. 2003;5(2):171–174.

    Article  CAS  PubMed  Google Scholar 

  • Chobanian AV, Bakris GL, Black HR, et al. National heart, lung, and blood institute joint national committee on prevention, detection, evaluation, and treatment of high blood pressure; national high blood pressure education program coordinating committee. The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–2572.

    Article  CAS  PubMed  Google Scholar 

  • Cholesterol Treatment Trialists C, Mihaylova B, Emberson J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581–590. doi:10.1016/S0140-6736(12)60367-5.

    Article  CAS  Google Scholar 

  • Christensen R, Bartels EM, Astrup A, Bliddal H. Effect of weight reduction in obese patients diagnosed with knee osteoarthritis: a systematic review and meta-analysis. Ann Rheum Dis. 2007;66(4):433–439. doi:10.1136/ard.2006.065904.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen RV, Pinheiro JC, Schiavon CA, Salles JE, Wajchenberg BL, Cummings DE. Effects of gastric bypass surgery in patients with type 2 diabetes and only mild obesity. Diabetes Care. 2012;35(7):1420–1428. doi:10.2337/dc11-2289.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002;359(9311):995–1003. doi:10.1016/S0140-6736(02)08089-3.

    Article  CAS  PubMed  Google Scholar 

  • Deedwania P. Hypertension, dyslipidemia, and insulin resistance in patients with diabetes mellitus or the cardiometabolic syndrome: benefits of vasodilating beta-blockers. J Clin Hypertens. 2011;13(1):52–59. doi:10.1111/j.1751-7176.2010.00386.x.

    Article  CAS  Google Scholar 

  • Deedwania PC, Hunninghake DB, Bays HE, et al. Effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin on atherogenic dyslipidemia in patients with characteristics of the metabolic syndrome. Am J Cardiol. 2005;95(3):360–366. doi:10.1016/j.amjcard.2004.09.034.

    Article  CAS  PubMed  Google Scholar 

  • DeFronzo RA, Davidson JA, Del Prato S. The role of the kidneys in glucose homeostasis: a new path towards normalizing glycaemia. Diabetes Obes Metab. 2012;14(1):5–14. doi:10.1111/j.1463-1326.2011.01511.x.

    Article  CAS  PubMed  Google Scholar 

  • Diabetes Prevention Program Research Group. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care. 2012;35(4):731–737. doi:10.2337/dc11-1299.

    Article  CAS  Google Scholar 

  • Diabetes Prevention Program Research Group, Knowler WC, Fowler SE, et al. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374(9702):1677–1686. doi:10.1016/S0140-6736(09)61457-4.

    Article  PubMed Central  Google Scholar 

  • Edwards CM, Stanley SA, Davis R, et al. Exendin-4 reduces fasting and postprandial glucose and decreases energy intake in healthy volunteers. Am J Physiol Endocrinol Metab. 2001;281(1):E155–E161.

    CAS  PubMed  Google Scholar 

  • Edwards KM, Ziegler MG, Mills PJ. The potential anti-inflammatory benefits of improving physical fitness in hypertension. J Hypertens. 2007;25(8):1533–1542. doi:10.1097/HJH.0b013e328165ca67.

    Article  CAS  PubMed  Google Scholar 

  • Ferrannini E, Solini A. SGLT2 inhibition in diabetes mellitus: rationale and clinical prospects. Nat Rev Endocrinol. 2012;8(8):495–502. doi:10.1038/nrendo.2011.243.

    Article  CAS  PubMed  Google Scholar 

  • Ferrannini E, Ramos SJ, Salsali A, Tang W, List JF. Dapagliflozin monotherapy in type 2 diabetic patients with inadequate glycemic control by diet and exercise: a randomized, double-blind, placebo-controlled, phase 3 trial. Diabetes Care. 2010;33(10):2217–2224. doi:10.2337/dc10-0612.

    Article  PubMed Central  PubMed  Google Scholar 

  • Fidler MC, Sanchez M, Raether B, et al. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab. 2011;96(10):3067–3077. doi:10.1210/jc.2011-1256.

    Article  CAS  PubMed  Google Scholar 

  • Flegal KM, Carroll MD, Ogden CL, Curtin LR. Prevalence and trends in obesity among US adults, 1999–2008. JAMA. 2010;303(3):235–241. doi:10.1001/jama.2009.2014.

    Article  CAS  PubMed  Google Scholar 

  • Fransen M. Dietary weight loss and exercise for obese adults with knee osteoarthritis: modest weight loss targets, mild exercise, modest effects. Arthritis Rheum. 2004;50(5):1366–1369. doi:10.1002/art.20257.

    Article  PubMed  Google Scholar 

  • Gadde KM, Allison DB, Ryan DH, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377(9774):1341–1352. doi:10.1016/S0140-6736(11)60205-5.

    Article  CAS  PubMed  Google Scholar 

  • Garvey WT, Ryan DH, Look M, et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012;95(2):297–308. doi:10.3945/ajcn.111.024927.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Gerich JE. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabet Med. 2010;27(2):136–142. doi:10.1111/j.1464-5491.2009.02894.x.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;129(25 Suppl 2):S49-S73. doi:10.1161/01.cir.0000437741.48606.98.

    Article  PubMed  Google Scholar 

  • Greenway FL, Whitehouse MJ, Guttadauria M, et al. Rational design of a combination medication for the treatment of obesity. Obesity. 2009;17(1):30–39. doi:10.1038/oby.2008.461.

    Article  CAS  PubMed  Google Scholar 

  • Greenway FL, Fujioka K, Plodkowski RA, for the COR-I Study Group, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicenter, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2010;376:595–605.

    Google Scholar 

  • Gress TW, Nieto FJ, Shahar E, Wofford MR, Brancati FL. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med. 2000;342(13):905-912. doi:10.1056/NEJM200003303421301.

    Article  CAS  PubMed  Google Scholar 

  • Gutzwiller JP, Drewe J, Goke B, et al. Glucagon-like peptide-1 promotes satiety and reduces food intake in patients with diabetes mellitus type 2. Am J Physiol. 1999;276(5 Pt 2):R1541-R1544.

    CAS  PubMed  Google Scholar 

  • Halford JC, Harrold JA, Boyland EJ, Lawton CL, Blundell JE. Serotonergic drugs: effects on appetite expression and use for the treatment of obesity. Drugs. 2007;67(1):27–55.

    Article  CAS  PubMed  Google Scholar 

  • Harper R, Ennis CN, Heaney AP, et al. A comparison of the effects of low and conventional dose thiazide diuretic on insulin action in hypertensive patients with NIDDM. Diabetologia. 1995;38(7):853–859.

    Article  CAS  PubMed  Google Scholar 

  • Henriksen EJ, Prasannarong M. The role of the renin-angiotensin system in the development of insulin resistance in skeletal muscle. Mol Cell Endocrinol. 2013;378(1–2):15-22. doi:10.1016/j.mce.2012.04.011.

    Article  CAS  PubMed  Google Scholar 

  • Henry RR, Murray AV, Marmolejo MH, Hennicken D, Ptaszynska A, List JF. Dapagliflozin, metformin XR, or both: initial pharmacotherapy for type 2 diabetes, a randomised controlled trial. Int J Clin Pract. 2012;66(5):446–456. doi:10.1111/j.1742-1241.2012.02911.x.

    Article  CAS  PubMed  Google Scholar 

  • Holst JJ. Incretin hormones and the satiation signal. Int J Obes (Lond). 2013;37(9):1161–1168. doi:10.1038/ijo.2012.208.

    Article  CAS  Google Scholar 

  • Hoskins B, Jackson CM 3rd. The mechanism of chlorothiazide-induced carbohydrate intolerance. J Pharmacol Exp Ther. 1978;206(2):423–430.

    CAS  PubMed  Google Scholar 

  • Huang MH, Chen CH, Chen TW, Weng MC, Wang WT, Wang YL. The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity. Arthritis Care Res. 2000;13(6):398–405.

    Article  CAS  PubMed  Google Scholar 

  • Huang MA, Greenson JK, Chao C, et al. One-year intense nutritional counseling results in histological improvement in patients with non-alcoholic steatohepatitis: a pilot study. Am J Gastroenterol. 2005;100(5):1072–1081. doi:10.1111/j.1572-0241.2005.41334.x.

    Article  PubMed  Google Scholar 

  • Iepsen EW, Torekov SS, Holst JJ. Therapies for inter-relating diabetes and obesity – GLP-1 and obesity. Expert Opin Pharmacother. 2014;15(17):2487–2500. doi:10.1517/14656566.2014.965678.

    Article  CAS  PubMed  Google Scholar 

  • Ilanne-Parikka P, Eriksson JG, Lindstrom J, et al. Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study. Diabetes Care. 2008;31(4):805–807. doi:10.2337/dc07-1117.

    Article  PubMed  Google Scholar 

  • Jamerson K, Weber MA, Bakris GL, et al. Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med. 2008;359(23):2417–2428. doi:10.1056/NEJMoa0806182.

    Article  CAS  PubMed  Google Scholar 

  • Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-S138. doi:10.1161/01.cir.0000437739.71477.ee.

    Article  PubMed  Google Scholar 

  • Jung CH, Jang JE, Park JY. A Novel Therapeutic Agent for Type 2 Diabetes Mellitus: SGLT2 Inhibitor. Diab Metab J. 2014;38(4):261–273. doi:10.4093/dmj.2014.38.4.261.

    Article  Google Scholar 

  • Kanda M, Satoh K, Ichihara K. Effects of atorvastatin and pravastatin on glucose tolerance in diabetic rats mildly induced by streptozotocin. Biol Pharm Bull. 2003;26(12):1681–1684.

    Article  CAS  PubMed  Google Scholar 

  • Keech A, Simes RJ, Barter P, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366(9500):1849–1861. doi:10.1016/S0140-6736(05)67667-2.

    Article  CAS  PubMed  Google Scholar 

  • Kelly EM, Tungol AA, Wesolowicz LA. Formulary management of 2 new agents: lorcaserin and phentermine/topiramate for weight loss. J Manage Care Pharm. 2013;19(8):642–654.

    Google Scholar 

  • Kilicarslan A, Yavuz B, Guven GS, et al. Fenofibrate improves endothelial function and decreases thrombin-activatable fibrinolysis inhibitor concentration in metabolic syndrome. Blood Coagul Fibrinolysis. 2008;19(4):310–314. doi:10.1097/MBC.0b013e3283009c69.

    Article  CAS  PubMed  Google Scholar 

  • Kim KK, Cho H-J, Kang J-C, et al. Effects on weight reduction and safety of short-term phentermine administration in Korean obese people. Yonsei Med J. 2006;47:614–625.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kintscher U, Bramlage P, Paar WD, Thoenes M, Unger T. Irbesartan for the treatment of hypertension in patients with the metabolic syndrome: a sub analysis of the Treat to Target post authorization survey. Prospective observational, two armed study in 14,200 patients. Cardiovasc Diabetol. 2007;6:12. doi:10.1186/1475-2840-6-12.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  • Klosiewicz-Latoszek L, Szostak WB. Comparative studies on the influence of different fibrates on serum lipoproteins in endogenous hyperlipoproteinaemia. Eur J Clin Pharmacol. 1991;40(1):33–41.

    Article  CAS  PubMed  Google Scholar 

  • Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. doi:10.1056/NEJMoa012512.

    Article  CAS  PubMed  Google Scholar 

  • Kuna ST, Reboussin DM, Borradaile KE, et al. Long-term effect of weight loss on obstructive sleep apnea severity in obese patients with type 2 diabetes. Sleep. 2013;36(5):641–649A. doi:10.5665/sleep.2618.

    PubMed Central  PubMed  Google Scholar 

  • LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005;352(14):1425–1435. doi:10.1056/NEJMoa050461.

    Article  CAS  PubMed  Google Scholar 

  • Lean ME, Carraro R, Finer N, et al. Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults. Int J Obes (Lond). 2014;38(5):689–697.

    Article  CAS  Google Scholar 

  • Leslie WS, Hankey CR, Lean ME. Weight gain as an adverse effect of some commonly prescribed drugs: a systematic review. QJM. 2007;100(7):395–404. doi:10.1093/qjmed/hcm044.

    Article  CAS  PubMed  Google Scholar 

  • Liao JK. Beyond lipid lowering: the role of statins in vascular protection. Int J Cardiol. 2002;86(1):5–18.

    Article  PubMed  Google Scholar 

  • Lim S, Park YM, Sakuma I, Koh KK. How to control residual cardiovascular risk despite statin treatment: focusing on HDL-cholesterol. Int J Cardiol. 2013a;166(1):8–14. doi:10.1016/j.ijcard.2012.03.127.

    Article  PubMed  Google Scholar 

  • Lim S, Sakuma I, Quon MJ, Koh KK. Potentially important considerations in choosing specific statin treatments to reduce overall morbidity and mortality. Int J Cardiol. 2013b;167(5):1696–1702. doi:10.1016/j.ijcard.2012.10.037.

    Article  PubMed  Google Scholar 

  • List JF, Woo V, Morales E, Tang W, Fiedorek FT. Sodium-glucose cotransport inhibition with dapagliflozin in type 2 diabetes. Diabetes Care. 2009;32(4):650–657. doi:10.2337/dc08-1863.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Madsbad S. The role of glucagon-like peptide-1 impairment in obesity and potential therapeutic implications. Diabetes Obes Metab. 2014;16(1):9–21. doi:10.1111/dom.12119.

    Article  CAS  PubMed  Google Scholar 

  • Manabe S, Okura T, Watanabe S, Fukuoka T, Higaki J. Effects of angiotensin II receptor blockade with valsartan on pro-inflammatory cytokines in patients with essential hypertension. J Cardiovasc Pharmacol. 2005;46(6):735–739.

    Article  CAS  PubMed  Google Scholar 

  • Martin CK, Redman LM, Zhang J, et al. Lorcaserin, a 5-HT(2C) receptor agonist, reduces body weight by decreasing energy intake without influencing energy expenditure. J Clin Endocrinol Metab. 2011;96(3):837–845. doi:10.1210/jc.2010-1848.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Meier JJ. GLP-1 receptor agonists for individualized treatment of type 2 diabetes mellitus. Nat Rev Endocrinol. 2012;8(12):728–742. doi:10.1038/nrendo.2012.140.

    Article  CAS  PubMed  Google Scholar 

  • Messerli FH, Grossman E. beta-Blockers in hypertension: is carvedilol different? Am J Cardiol. 2004;93(9A):7B–12B. doi:10.1016/j.amjcard.2004.01.020.

    Article  CAS  PubMed  Google Scholar 

  • Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50(5):1501–1510. doi:10.1002/art.20256.

    Article  PubMed  Google Scholar 

  • Meyer-Sabellek W, Brasch H. Atherosclerosis, inflammation, leukocyte function and the effect of statins. J Hypertens. 2006;24(12):2349–2351. doi:10.1097/HJH.0b013e3280113648.

    Article  CAS  PubMed  Google Scholar 

  • Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–1585. doi:10.1056/NEJMoa1200111.

    Article  CAS  PubMed  Google Scholar 

  • Muscogiuri G, Cignarelli A, Giorgino F, et al. GLP-1: benefits beyond pancreas. J Endocrinol Invest. 2014. doi:10.1007/s40618-014-0137-y.

    PubMed  Google Scholar 

  • Nauck MA, Del Prato S, Meier JJ, et al. Dapagliflozin versus glipizide as add-on therapy in patients with type 2 diabetes who have inadequate glycemic control with metformin: a randomized, 52-week, double-blind, active-controlled noninferiority trial. Diabetes Care. 2011;34(9):2015–2022. doi:10.2337/dc11-0606.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Niskanen L, Hedner T, Hansson L, Lanke J, Niklason A, Group CS. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic/beta-blocker-based treatment regimen: a subanalysis of the Captopril Prevention Project. Diabetes Care. 2001;24(12):2091–2096.

    Article  CAS  PubMed  Google Scholar 

  • O’Neil PM, Smith SR, Weissman NJ, et al. Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study. Obesity. 2012;20(7):1426–1436. doi:10.1038/oby.2012.66.

    Article  PubMed  CAS  Google Scholar 

  • Packard KA, Backes JM, Lenz TL, Wurdeman RL, Destache C, Hilleman DE. Comparison of gemfibrozil and fenofibrate in patients with dyslipidemic coronary heart disease. Pharmacotherapy. 2002;22(12):1527–1532.

    Article  PubMed  Google Scholar 

  • Palmer M, Schaffner F. Effect of weight reduction on hepatic abnormalities in overweight patients. Gastroenterology. 1990;99(5):1408–1413.

    CAS  PubMed  Google Scholar 

  • Pepine CJ, Handberg EM, Cooper-DeHoff RM, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003;290(21):2805–2816. doi:10.1001/jama.290.21.2805.

    Article  CAS  PubMed  Google Scholar 

  • Phelan S, Wadden TA, Berkowitz RI, et al. Impact of weight loss on the metabolic syndrome. Int J Obes (Lond). 2007;31(9):1442–1448. doi:10.1038/sj.ijo.0803606.

    Article  CAS  Google Scholar 

  • Plavinik FL, Rodrigues C, Zanella MT, Ribeiro AB. Hypokalemia, glucose intolerance, and hyperinsulinemia during diuretic therapy. Hypertension. 1992;19(2 suppl):26–29.

    Google Scholar 

  • Preiss D, Seshasai SR, Welsh P, et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011;305(24):2556–2564. doi:10.1001/jama.2011.860.

    Article  CAS  PubMed  Google Scholar 

  • Pyorala K, Ballantyne CM, Gumbiner B, et al. Reduction of cardiovascular events by simvastatin in nondiabetic coronary heart disease patients with and without the metabolic syndrome: subgroup analyses of the Scandinavian Simvastatin Survival Study (4S). Diabetes Care. 2004;27(7):1735–1740.

    Article  CAS  PubMed  Google Scholar 

  • Rapoport MI, Hurd HF. Thiazide-induced glucose intolerance treated with potassium. Arch Intern Med. 1964;113:405-408.

    Article  CAS  PubMed  Google Scholar 

  • Reisin E, Jack AV. Obesity and hypertension: mechanisms, cardio-renal consequences, and therapeutic approaches. Med Clin North Am. 2009;93(3):733–751. doi:10.1016/j.mcna.2009.02.010.

    Article  CAS  PubMed  Google Scholar 

  • Reisin E, Owen J. Treatment: special conditions. Metabolic syndrome: obesity and the hypertension connection. J Am Soc Hypertens. 2015;9(2):156–159. doi:10.1016/j.jash.2014.12.015. quiz 160.

    Article  PubMed  Google Scholar 

  • Reisin E, Weir MR, Falkner B, Hutchinson HG, Anzalone DA, Tuck ML. Lisinopril versus hydrochlorothiazide in obese hypertensive patients: a multicenter placebo-controlled trial. Treatment in Obese Patients With Hypertension (TROPHY) Study Group. Hypertension. 1997;30(1 Pt 1):140–145.

    Article  CAS  PubMed  Google Scholar 

  • Ripley TL, Saseen JJ. beta-blockers: a review of their pharmacological and physiological diversity in hypertension. Ann Pharmacother. 2014;48(6):723–733. doi:10.1177/1060028013519591.

    Article  CAS  PubMed  Google Scholar 

  • Rosenstock J, Aggarwal N, Polidori D, et al. Dose-ranging effects of canagliflozin, a sodium-glucose cotransporter 2 inhibitor, as add-on to metformin in subjects with type 2 diabetes. Diabetes Care. 2012;35(6):1232–1238. doi:10.2337/dc11-1926.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Rucker D, Padwal R, Li SK, Curioni C, Lau DC. Long term pharmacotherapy for obesity and overweight: updated meta-analysis. BMJ. 2007;335(7631):1194–1199. doi:10.1136/bmj.39385.413113.25.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Ryan D, Peterson C, Troupin B, et al. Weight loss at 6 months with VI-0521 (PHEN/TPM combination) treatment. Obes Facts. 2010;3:139-146.

    Article  Google Scholar 

  • Sattar N, Preiss D, Murray HM, et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials. Lancet. 2010;375(9716):735–742. doi:10.1016/S0140-6736(09)61965-6.

    Article  CAS  PubMed  Google Scholar 

  • Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–1576. doi:10.1056/NEJMoa1200225.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Schmidt M, Johannesdottir SA, Lemeshow S, et al. Obesity in young men, and individual and combined risks of type 2 diabetes, cardiovascular morbidity and death before 55 years of age: a Danish 33-year follow-up study. BMJ Open. 2013;3(4). doi:10.1136/bmjopen-2013-002698

    Google Scholar 

  • Scott LJ. Liraglutide: a review of its use in adult patients with type 2 diabetes mellitus. Drugs. 2014;74(18):2161–2174. doi:10.1007/s40265-014-0321-6.

    Article  CAS  PubMed  Google Scholar 

  • Shatanawi A, Romero MJ, Iddings JA, et al. Angiotensin II-induced vascular endothelial dysfunction through RhoA/Rho kinase/p38 mitogen-activated protein kinase/arginase pathway. Am J Physiol Cell Physiol. 2011;300(5):C1181–C1192. doi:10.1152/ajpcell.00328.2010.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Sjostrom L, Gummesson A, Sjostrom CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10(7):653–662. doi:10.1016/S1470-2045(09)70159-7.

    Article  PubMed  Google Scholar 

  • Smith SR, Weissman NJ, Anderson CM, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363(3):245–256. doi:10.1056/NEJMoa0909809.

    Article  CAS  PubMed  Google Scholar 

  • Stalenhoef AF, Ballantyne CM, Sarti C, et al. A comparative study with rosuvastatin in subjects with metabolic syndrome: results of the COMETS study. Eur Heart J. 2005;26(24):2664–2672. doi:10.1093/eurheartj/ehi482.

    Article  PubMed  Google Scholar 

  • Stender S, Schuster H, Barter P, Watkins C, Kallend D, Group MIS. Comparison of rosuvastatin with atorvastatin, simvastatin and pravastatin in achieving cholesterol goals and improving plasma lipids in hypercholesterolaemic patients with or without the metabolic syndrome in the MERCURY I trial. Diabetes Obes Metab. 2005;7(4):430–438. doi:10.1111/j.1463-1326.2004.00450.x.

    Article  CAS  PubMed  Google Scholar 

  • Strojek K, Yoon KH, Hruba V, Elze M, Langkilde AM, Parikh S. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with glimepiride: a randomized, 24-week, double-blind, placebo-controlled trial. Diabetes Obes Metab. 2011;13(10):928–938. doi:10.1111/j.1463-1326.2011.01434.x.

    Article  CAS  PubMed  Google Scholar 

  • Torgerson JS, Hauptman J, Boldrin MN, Sjostrom L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155–161.

    Article  CAS  PubMed  Google Scholar 

  • Tuomilehto J, Lindstrom J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–1350. doi:10.1056/NEJM200105033441801.

    Article  CAS  PubMed  Google Scholar 

  • Turton MD, O’Shea D, Gunn I, et al. A role for glucagon-like peptide-1 in the central regulation of feeding. Nature. 1996;379(6560):69–72. doi:10.1038/379069a0.

    Article  CAS  PubMed  Google Scholar 

  • Ueno T, Sugawara H, Sujaku K, et al. Therapeutic effects of restricted diet and exercise in obese patients with fatty liver. J Hepatol. 1997;27(1):103–107.

    Article  CAS  PubMed  Google Scholar 

  • van Gool CH, Penninx BW, Kempen GI, et al. Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. Arthritis Rheum. 2005;53(1):24–32. doi:10.1002/art.20902.

    Article  PubMed  Google Scholar 

  • Wadden TA, Foreyt JP, Foster GD, et al. Weight loss with naltrexoneSR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial. Obesity. 2011;19:110–120.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Wadden TA, Hollander P, Klein S, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE Maintenance randomized study. Int J Obes (Lond). 2013;37(11):1443–1451. doi: 10.1038/ijo.2013.120. Epub 2013 Jul 1. Erratum in: Int J Obes (Lond). 2015;39(1):187; Int J Obes (Lond). 2015;39(1):187; Int J Obes (Lond). 2013;37(11):1514

    Article  Google Scholar 

  • Wannamethee SG, Shaper AG, Walker M. Overweight and obesity and weight change in middle aged men: impact on cardiovascular disease and diabetes. J Epidemiol Community Health. 2005;59(2):134–139. doi:10.1136/jech.2003.015651.

    Article  PubMed Central  PubMed  Google Scholar 

  • Watanabe S, Tagawa T, Yamakawa K, Shimabukuro M, Ueda S. Inhibition of the renin-angiotensin system prevents free fatty acid-induced acute endothelial dysfunction in humans. Arterioscler Thromb Vasc Biol. 2005;25(11):2376–2380. doi:10.1161/01.ATV.0000187465.55507.85.

    Article  CAS  PubMed  Google Scholar 

  • Weber MA, Jamerson K, Bakris GL, et al. Effects of body size and hypertension treatments on cardiovascular event rates: subanalysis of the ACCOMPLISH randomised controlled trial. Lancet. 2013;381(9866):537–545. doi:10.1016/S0140-6736(12)61343-9.

    Article  PubMed  Google Scholar 

  • Zambon A, Gervois P, Pauletto P, Fruchart JC, Staels B. Modulation of hepatic inflammatory risk markers of cardiovascular diseases by PPAR-alpha activators: clinical and experimental evidence. Arterioscler Thromb Vasc Biol. 2006;26(5):977–986. doi:10.1161/01.ATV.0000204327.96431.9a.

    Article  CAS  PubMed  Google Scholar 

  • Zanella MT, Uehara MH, Ribeiro AB, Bertolami M, Falsetti AC, Yunes MA. Orlistat and cardiovascular risk profile in hypertensive patients with metabolic syndrome: the ARCOS study. Arq Bras Endocrinol Metabol. 2006;50(2):368–376. doi:/S0004-27302006000200023

    Google Scholar 

  • Zappe DH, Sowers JR, Hsueh WA, et al. Metabolic and antihypertensive effects of combined angiotensin receptor blocker and diuretic therapy in prediabetic hypertensive patients with the cardiometabolic syndrome. J Clin Hypertens. 2008;10(12):894–903. doi:10.1111/j.1751-7176.2008.00054.x.

    Article  CAS  Google Scholar 

  • Zreikat HH, Harpe SE, Slattum PW, Mays DP, Essah PA, Cheang KI. Effect of Renin-Angiotensin system inhibition on cardiovascular events in older hypertensive patients with metabolic syndrome. Metab Clin Exp. 2014;63(3):392–399. doi:10.1016/j.metabol.2013.11.006.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

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  1. Division of Endocrinology, Diabetes and Metabolism, and the Institute for Diabetes, Obesity and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Rexford S. Ahima

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    Rexford S. Ahima

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Ahima, R.S. (2015). Pharmacotherapy of Obesity and Metabolic Syndrome. In: Ahima, R. (eds) Metabolic Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-319-12125-3_44-1

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    Pharmacotherapy of Obesity and Metabolic Syndrome
    Published:
    14 September 2023

    DOI: https://doi.org/10.1007/978-3-319-12125-3_44-2

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    Pharmacotherapy of Obesity and Metabolic Syndrome
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    DOI: https://doi.org/10.1007/978-3-319-12125-3_44-1

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