ENDOCRINE AND METABOLIC EFFECTS OF DEXFENFLURAMINE IN PATIENTS WITH ANDROID OBESITY

The effects of dexfenfluramine on 24-hour profiles of ACTH, GH, norepi nephrine, insulin and FFA were studied in a group of obese male patien ts. A controlled comparison trial under metabolic ward conditions was conducted. Dexfenfluramine (15 mg twice daily) was given for 8 days, w hile patients adhered to a weight maintaining diet. 9 obese patients w ere treated with dexfenfluramine. 9 obese patients who were randomized on the basis one after another served as a control group. After a 3 d ay run-in period at 8 am, 10 am, and 4 pm, 8 pm and 12 pm, and 8 am of the following day ACTH, GH, norepinephrine, insulin and FFA were meas ured before and during the 8th day of dexfenfluramine treatment. Durin g the study body weight slightly decreased in both groups. In the DF g roup systolic and diastolic blood pressure declined during treatment. The norepinephrine levels were depressed during DF treatment over the entire day. The 24-hour profile of ACTH levels changed in the treatmen t group to a more distinct circadian rhythm with slightly higher level s in the morning and lower levels at night. The 24-hour profile of GH changed in the drug treated group with a diminished peak of GH secreti on at night. Serum concentrations of insulin and FFA were decreased du ring DF treatment. The hormonal changes during dexfenfluramine treatme nt suggest that the drug affects endocrine mechanisms that may be invo lved in regulation of energy balance. Treatment with dexfenfluramine r esults in decrease of FFA. The mechanisms by which dexfenfluramine ope rates and displays its various effects on hormones and lipolysis have not been studied.