Improvement of serum adiponectin and leptin concentrations: effects of a low-calorie or isocaloric diet combined with metformin or orlistat – a prospective randomized open-label trial

Abstract. – OBJECTIVE: We compared the effects
of three weight loss interventions on
serum concentrations of adiponectin and leptin
in obese premenopausal women.
PATIENTS AND METHODS: 114 obese Caucasian
women were randomized into three
groups receiving a low-calorie diet (LC; n = 39),
an isocaloric diet with 500 mg of metformin
twice a day (IM; n = 38), and an isocaloric diet
with 120 mg of orlistat three times a day (IO; n =
37), for three months. Serum concentrations of
adiponectin and leptin were evaluated, along
with anthropometric and body composition parameters,
at baseline and after the study.
RESULTS: Both IO and LC, but not IM, caused
an increase in serum adiponectin concentration (p
< 0.01, p < 0.05 respectively). A decrease in serum leptin level was documented in the LC (p < 0.001), IM (p < 0.01), and IO group (p < 0.01). Beneficial changes in anthropometric and body composition values were observed following all interventions with the greatest advantage seen in the IO group. The strongest correlations, of ∆adiponectin with ∆body weight (r = -0.54), ∆BMI (r = -0.49), ∆FAT [%] (r = -0.48), ∆FAT [kg] (r = -0.48), and ∆lean [%] (r = 0.48); and of ∆leptin with ∆body weight, ∆BMI, ∆waist, ∆fat, and ∆lean, were documented in the IO group. CONCLUSIONS: Beneficial effects were observed on serum leptin concentration, weight loss, and body composition for all interventions and in all examined groups, with the greatest advantage being associated with the orlistat treatment. Improvements in serum adiponectin concentrations resulted from the low-calorie and isocaloric diets with orlistat, but not from the isocaloric diet with metformin. We find these strategies more promising for the treatment of obesity and its related complications in obese premenopausal women.

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