Endocrine Abstracts

Introduction: Childhood obesity is associated with various complications and medical treatment options are limited. Liraglutide, a GLP-1 receptor agonist, has shown improvement in body mass index (BMI) in clinical trials and has been licensed for clinical use in adolescents >12 years of age. The aim of our study is to evaluate the effect of liraglutide treatment on cardiometabolic variables, quality-of-life (QoL) and satiety levels in adolescents with severe obesity. To our knowledge, this is the first study reporting the use of continuous glucose monitoring (CGM) to assess the treatment effects on glycaemic variation in obesity.

Methods: 24 patients aged 12-17.9 years with severe obesity completed a 3-month course of subcutaneous liraglutide treatment (maximum dose 3mg daily), along with multidisciplinary support in a tier-3 weight management service. Clinical measurements, body composition, biochemical profile and questionnaires (PedsQL 4.0 generic scale and Three-factor Eating Questionnaire R18) were collected, along with CGM insertion (blinded Dexcom G6 devices), at baseline and 3-months.

Results: Significant improvements were shown in weight [-2.95kg, P=0.001], BMI [-1.38kg/m2; P<0.001], BMI standard deviation scores [-0.09; P=0.003], percentage body fat [-2.09%; P=0.043] and fat mass [-4.00kg; P=0.011] following liraglutide treatment. Significant reductions in HbA1c (-1.35mmol/mol; P=0.025), triglycerides (-0.122mmol/L; P=0.010) and cholesterol (-0.28mmol/L; P=0.029) were also observed. CGM revealed a significant increase in the percentage time of glucose levels within the normal range (3.9-7.8mmol/L) from 91.76 to 94.18% [Z=-1.98; P=0.048]. The percentage time spent over 10mmol/L reduced from 0.08 to 0.02% [Z=-1.50; P=0.133]. The QoL total scores were noted to improve in parent and child-reported questionnaires. Uncontrolled eating behaviours reduced significantly (P=0.006) and improvements in cognitive restraint and emotional eating were observed.

Conclusion: Liraglutide treatment has shown significant improvement in metabolic parameters, along with improved satiety levels and QoL. CGM has highlighted the evidence of glycaemic dysregulation in adolescents with obesity, compared to peers without diabetes or obesity, and its significant improvement following liraglutide treatment. Liraglutide could be an important treatment option for young people with severe obesity to improve physical health, eating behaviours and QoL, and CGM could be a useful tool to assess glycaemic dysregulation in adolescents with severe obesity.