Stimulation of the CB 1 receptors in fat cells promotes lipogenesis and inhibits the production of adiponectin, 3,10 a cytokine derived from adipose tissue that has potentially important antidiabetic and antiatherosclerotic properties. 11 Rimonabant, the first specific CB 1 -receptor blocker to enter clinical development, has been shown to reduce food intake and body weight in treated animals and to alter metabolic activity in adipose tissue 12 while inducing the expression of the adiponectin gene. 13 The results of a phase 3 study involving obese patients (Rimonabant in Obesity–Europe [RIOEurope] study) showed that rimonabant induces significant weight loss and improves metabolic risk factors for diabetes and cardiovascular disease. 14 However, the patients enrolled in the study were selected only on the basis of excess weight. Therefore, we examined the effects of rimonabant in persons at higher risk of cardiovascular disease, such
as patients with dyslipidemia who were overweight or obese. Also, since only traditional risk factors for cardiovascular disease were measured in the RIO-Europe study, we explored the effect of rimonabant on other key metabolic risk markers for cardiovascular disease such as the size of particles of low-density lipoprotein (LDL) and the plasma levels of C-reactive protein and adiponectin