Effect of phentermine on hepatic steatosis in patients undergoing
bariatric surgery. A pilot randomized controlled study
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.