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Smoking Cessation Using Varenicline Alters Basic Metabolism, Body Weight, and Insulin Resistance and Secretion FREE TO VIEW

Vasiliki Vasileiou, MD; Ioanna Nikoloutsou, PhD; Spyridon Zakynthinos, PhD; Stauroula Kolokytha, MD; Theodoros Vassilakopoulos, PhD; Paraskevi Katsaounou, PhD
Chest. 2011;140(4_MeetingAbstracts):1057A. doi:10.1378/chest.1114062
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PURPOSE: It is known that nicotine increases energy expenditure, basic metabolism and has appetite-suppressing properties, which likely explains why smokers tend to have lower body weight than non-smokers and why smoking cessation is followed by weight gain up to 12 kgr. Varenicline is a nicotinic-cholinergic receptor partial agonist and therefore should share nicotine’s properties The purpose is to compare basic resting metabolism, weight and adipose tissue percentage before (BSC) and after smoking cessation(ASC). Additionally to compare basic resting metabolism, weight, and adipose tissue percentage, leptin, insulin levels, index of insulin resistance and index of insulin secretion before and after smoking cessation in smokers who used varenicline.

METHODS: We enrolled 15 smokers that visited our smoking cessation clinic and succeeded in quitting smoking.8 used Varenicline. We measured Basic resting metabolism, body weight, adipose tissue percentage, leptin and insulin levels BSC and 1 month ASC. Indices of insulin resistance (HOMA-IR=Glu x Insulin/ 405) and insulin secretion and insulin secretion (HOMA-β= [360 x Insulin/ Glucose-63] %) were calculated.The homeostatic model assessment (HOMA) is a method used to quantify insulin resistance and beta-cell function

RESULTS: 1. Basic metabolism was 1418.4 ± 202 kcal/d BSC and 1489.2±183 kcal/d ASC in smokers that took varenicline and 1390,8 ± 220 kcal/d BSC and 1250 ± 240 kcal/d ASC in smokers that did not use the drug. Body weight was 79.4± 5 kg BSC and 81.3 ± 6 kg in the varenicline group and 74± 6 kg BSC and 78±5 kg ASC in the non varenicline group. The percentage of adipose tissue was higher after smoking cessation (from 24,1% to 31,5%). Both levels of leptin and leptin/fat mass were higher ASC (from 3318,156 pg/ml to 3384,1pg/ml) Index of insulin resistance (HOMA IR) is higher ASC(HOMA IR: from 140.8 to 167,56) Index of insulin secretion (HOMA B) is higher ASC(HOMA B: from 951,54 to 1022,75).

CONCLUSIONS: Smokers that used varenicline had lower body weight,less percentage of adipose tissue and higher resting metabolic rate compared to the ones that did not use varenicline 1 month ASC.

CLINICAL IMPLICATIONS: Considering that tobacco and obesity are the two leading causes of preventable death, and since the relationship between tobacco smoke and metabolic syndrome is confirmed, we should help smokers to quit, increase the succession rates, decrease the relapse rates and maximise the benefits of smoking cessation by preventing post cessation metabolic syndrome.

DISCLOSURE: The following authors have nothing to disclose: Vasiliki Vasileiou, Ioanna Nikoloutsou, Spyridon Zakynthinos, Stauroula Kolokytha, Theodoros Vassilakopoulos, Paraskevi Katsaounou

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