• Production Rate (PR) of HDL ApoA-I and A-II, (FCR) of HDL ApoA-II [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• PR and FCR of VLDL1 and VLDL2 Apo B, VLDL1 and VLDL2 TG, IDL Apo B and LDL Apo B [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in ApoA-I, ApoA-II, Lp-AI, Lp-AII, pre-beta-HDL HDL2a, HDL2b, HDL3a, HDL3b, HDL3c, Apo B, Apo C III, TG, LDL-C, HDL-C levels [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in Glucose, insulin, HbA1c, leptin, adiponectin [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in hs-CRP, TNF-alpha, CETP, PLTP and LCAT activities, lipoprotein and hepatic lipase activities in post-heparin plasma [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in whole body fat [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in abdominal sub-cutaneous and visceral fat [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in liver fat [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in blood pressure [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Variation in body weight, waist circumference, waist/hip ratio [ Time Frame: From the beginning to the end of the study ] [ Designated as safety issue: No ]
• CE/TG ratio in HDL [ Time Frame: All across the study ] [ Designated as safety issue: No ]
• Adverse events [ Time Frame: From the beginning to the end of the study ] [ Designated as safety issue: Yes ]

• Production Rate (PR) of HDL ApoA-I and A-II, (FCR) of HDL ApoA-II
• PR and FCR of VLDL1 and VLDL2 Apo B, VLDL1 and VLDL2 TG, IDL Apo B and LDL Apo B
• Variation in ApoA-I, ApoA-II, Lp-AI, Lp-AII, pre-beta-HDL HDL2a, HDL2b, HDL3a, HDL3b, HDL3c, Apo B, Apo C III, TG, LDL-C, HDL-C levels
• Variation in Glucose, insulin, HbA1c, leptin, adiponectin
• Variation in hs-CRP, TNF-alpha, CETP, PLTP and LCAT activities, lipoprotein and hepatic lipase activities in post-heparin plasma
• Variation in whole body fat
• Variation in abdominal sub-cutaneous and visceral fat
• Variation in liver fat
• Variation in blood pressure
• Variation in body weight, waist circumference, waist/hip ratio

The objective of the study is to evaluate the effect of Rimonabant 20mg in comparison to placebo, on HDL and VLDL lipoprotein kinetics, over a 12 months period.

Primary objectives:

• To assess effect of Rimonabant on HDL ApoA-I fractional catabolic rate (FCR).

Secondary objectives:

• To assess effect of Rimonabant on HDL ApoA-I production rate (PR) and on other lipoprotein kinetics.
• To assess effect of Rimonabant on lipids, glycemic and inflammatory parameters
• To assess effect of Rimonabant on body composition
• To assess safety of Rimonabant

• Drug: Placebo
• Drug: Rimonabant

• Placebo Comparator: Administration of one rimonabant placebo tablet once daily in the morning
• Experimental: Administration of one tablet containing 20 mg of active rimonabant once daily in the morning

Inclusion Criteria:

• Abdominally obese patients with additional cardiometabolic risk factors
• Females must be post-menopausal
• BMI > 27 kg/m² and < 40 kg/m²
• Men or women with abdominal obesity according to NCEP/ATPIII criteria: Waist Circumference > 88 cm in women; > 102 cm in men
• With at least one lipid abnormality defined as:
• Fasting Triglycerides level > 1.7 mmol/L (150 mg/dL) and < 4.5 mmol/L (400 mg/dL)
• HDL < 1.03 mmol/L (40 mg/dL) in men and < 1.29 mmol/L (50 mg/dL) in women

Exclusion Criteria:

• HDL ≤ 0.60 mmol/L (23 mg/dl)
• Plasma LDL-Cholesterol > 155 mg/dl (4.00 mmol/L) or total cholesterol 250 mg/dl (> 6.5mmol/L) or genetic hyperlipidaemia
• Fasting triglycerides > 400 mg/dL (4.5 mmol/L)
• Known heterozygous or homozygous familial hypercholesterolaemia or know type III hyperlipoproteinaemia (familial dysbetalipoproteinaemia)
• ApoE2/E2 homozygosity, Apo E4/E4 homozygosity
• Type 2 diabetes treated with oral agents and/or insulin
• Diet treated type 2 diabetic patients with HbA1c ≥ 7%
• History of cardio vascular disease
• Systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 95 mmHg.
• Very low-calorie diet (1200 calories a day or less) or history of surgical procedures for weight loss (e.g., stomach stapling, bypass)
• Body weight fluctuation > 5 Kg during the previous 3 months
• History of bulimia or anorexia nervosa by DSM-IV criteria
• Presence of any clinically significant endocrine disease according to the investigator, Cushing syndrome, obesity secondary to hypothalamic/pituitary disorder.
• Abnormal TSH and free T4 at baseline (Patients treated with thyroid replacement therapy must be on fixed and stable dose for at least 3 months prior to screening and must be in euthyroïd status.)
• Severe hepatic impairment known by the investigator or AST or ALT > 3 times the ULN at screening.
• Known severe renal dysfunction (creatinine clearance < 30 ml/min) or urine analysis (performed at screening by dipstick) showing 2+ or more protein
• Presence of any condition (medical, including clinically significant abnormal laboratory test, psychological, social or geographical) actual or anticipated that the investigator feels would compromise the patient safety or limit his/her successful participation to the study
• Patient treated for epilepsy
• Ongoing major depressive illness
• Uncontrolled psychiatric illness
• History of alcohol and/or drug abuse
• Smoker or smoking cessation within the past 3 months
• Marijuana or hashish users
• Previous participation in a Rimonabant study or to any other clinical trial within 4 weeks to study start
• Hypersensitivity/intolerance to the active substance or to any of the excipients such as lactose
• Blood donation within the past 3 months prior to the study or planned during the study or within the 3 months from the study completing
• Recent history of active peptic ulcer
• Willebrand disease or other hemorrhagic diatheses
• Administration of any of the following within 3 months prior to screening visit and susceptible to be prescribed during the study treatment period:
• Lipid-lowering drugs intake
• Anti obesity drugs
• Other drugs for weight reduction (phentermine, amphetamines)
• Herbal preparations for weight reduction
• Other drugs known to affect lipid metabolism: retinoids, antiretroviral, estrogens and hormone replacement therapy, cyclosporine, glitazones, benfluorex, fish oils, plant sterols.
• Thiazids (including fixed combination) at daily dose higher than 12.5 mg
• Unselective beta-blockers
• Prolonged use (more than one week) of systemic corticosteroids, neuroleptics
• Anticoagulants
• Ongoing antidepressive treatment

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.