Endocrine Abstracts

Background: Obesity is a significant risk factor for type 2 diabetes mellitus (T2D), hypertension and ischemic heart disease development. Moreover, in patients with already diagnosed T2D, obesity puts a crimp in achievement of glycemic target. Thus, body weight reduction is important both to prevent T2D and to treat it successfully. However lifestyle habits, diet and physical activity are the key factors of T2D prevention and treatment, eating disorders and disturbed appetite control decrease compliance to these efforts. Liraglutide is successfully used for such cases leading to significant weight reduction, followed by improvement of hypertension and dyslipidemia. However its efficacy varies a lot, and its cost negatively influence treatment compliance. The aim of this study was to reveal patients’ parameters likely leading to higher treatment efficacy.

Methods: We tested 41 patient with obesity with mean (± s.d.) BMI of 39.63 ± 7.59 kg/m²: 27 injecting liraglutide up to 1.8 mg/day and 14–3.0 mg/day for 6 months. We gathered demographic and anthropometric data, parameters of glycemic control, insulin, C-peptide GLP-1, GIP and leptin blood concentration, results of Dutch Eating Behavior Questionnaire and answers to questions about hunger with the use of visual analogous scale at fasting state. We considered a therapy response as ≥ 7% bodyweight reduction after 6 months of treatment. We used Mann-Whitney U-test to compare responders and non-responders in terms of gathered parameters and linear regression model (LRM) to reveal parameters possibly associated with better weight-reduction response.

Results: We confirmed a dose-dependent liraglutide efficacy in routine clinical practice (more responders in 3.0 mg/day group, P = 0.007). Responders without T2D had a 1.7-fold lower leptin concentration as compared to non-responders (P = 0.018). LRM was not statistically significant due to a small sample (P = 0.098), however regression coefficient was –0.50. In responders without T2D GLP-1 level before therapy initiation positively correlated with body weight reduction (B = 0.84; r = 0.60; P = 0.031). Questions about hunger (‘how gorged are you’ and ‘how much could you eat now’) showed r = 0.51 and –0.46, respectively, however were not statistically significant (P = 0.064 and 0.097, respectively). Liraglutide was ineffective in BMI > 45 kg/m². Other factors were not significant for our data.

Conclusion: Lower leptin and higher GLP-1 concentrations might predict better weight-loss response to liraglutide. Questions about hunger at fasting state might be strong response predictors (need for evaluation at bigger sample). Liraglutide is probably more effective in BMI 30–45 kg/m².