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Effect of phentermine on hepatic steatosis in patients undergoing bariatric surgery. A pilot randomized controlled study
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  • ELIZABETH PEREZ-CRUZ,
  • MARTHA GUEVARA-CRUZ,
  • SALVADOR ORTIZ-GUTIERREZ,
  • YURITZY LUNA-CAMACHO,
  • RAFAEL GUZMAN-AGUILAR,
  • GIUSEPPE BRICEÑO-SAENZ,
  • LUIS EDUARDO GONZALEZ-SALAZAR,
  • ADRIANA FLORES-LOPEZ
ELIZABETH PEREZ-CRUZ
Hospital Juarez de Mexico

Corresponding Author:pece_liz@hotmail.com

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MARTHA GUEVARA-CRUZ
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
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SALVADOR ORTIZ-GUTIERREZ
Hospital Juarez de Mexico
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YURITZY LUNA-CAMACHO
Hospital Juarez de Mexico
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RAFAEL GUZMAN-AGUILAR
Hospital Juarez de Mexico
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GIUSEPPE BRICEÑO-SAENZ
Hospital Juarez de Mexico
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LUIS EDUARDO GONZALEZ-SALAZAR
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
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ADRIANA FLORES-LOPEZ
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
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Abstract

Background: Hepatic steatosis is associated with increased surgical complications in patients undergoing bariatric surgery. The aim of this study was to evaluate the effect of phentermine in reducing hepatic steatosis, adipose tissue and surgical complications in patients undergoing bariatric surgery. Methods: This study is a two-arm, double-blind, randomized, controlled pilot trial of 64 adult subjects with BMI >35 kg/m2 selected for bariatric surgery randomized to phentermine 15 mg once daily for 8 week or placebo. Both groups adhered to a hypocaloric diet and individualized exercise program. The primary end point was the reduce frequency of hepatic steatosis measured by ultrasound and the reduce adipose tissue through fat mass in total kilograms or percentage. Key secondary points were the prevalence of surgical complications. Baseline and final biochemical parameters and blood pressure too were assessments. Results: Phentermine group the frequency of hepatic steatosis decreased 19%, and the percentage of patients with a normal ultrasound increased from 9% to 20% (p= 0.053). Likewise, the decrease in fat mass in kilograms was greater in the phentermine group (56.1 kg vs. 51.8 kg, p=0.02), and a significant decrease in the HOMA-IR index was observed regardless of weight loss. No differences in surgical complications were observed between groups. Phentermine was well tolerated; no differences were observed in the frequency of adverse events between the groups. Conclusions: Phentermine decreased the proportion of individuals with hepatic steatosis by 19%, promoted a greater loss of fat mass in kilograms, and decreased insulin resistance among candidates for bariatric surgery.