Grannell Andrew, Martin William P, Dehestani Babak, Al-Najim Werd, Murphy John C, le Roux Carel W
Diabetes Complications Research Centre, Conway Institute, School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland.
MedFit Proactive Healthcare, Blackrock, Dublin, Ireland.
Obesity (Silver Spring). 2021 Mar;29(3):529-534. doi: 10.1002/oby.23098. Epub 2021 Feb 2.
This study aimed to examine fat-free mass (FFM) loss between successful responders to lifestyle intervention alone compared with lifestyle intervention plus liraglutide 3.0 mg. An additional objective was to examine the effects of varying resistance training frequencies (days per week) on FFM retention.
This prospective study examined patients with BMI ≥ 35 kg/m receiving treatment in a tertiary care obesity clinic. Body composition (dual-energy x-ray absorptiometry) was captured at baseline and after 16 weeks of treatment. Exercise-related data (aerobic minutes per week and resistance training frequency) were captured at week 16. A total of 78 individuals were examined in two groups, the first with lifestyle intervention alone (n = 19) and the second with lifestyle intervention plus liraglutide 3.0 mg (n = 59). Linear mixed-effects models were used to examine between-group differences.
Compared with lifestyle intervention alone, participants on liraglutide lost more weight (-12.2 kg vs. -9.7 kg, P = 0.048) and FFM (-2.3 kg vs. -1.5 kg, P = 0.06). After controlling for weight loss, there was no difference in FFM loss between groups (0.14 kg/wk vs. -0.09 kg/wk, P = 0.12). Absolute weight loss (kilograms) was associated with FFM loss (kilograms) (ρ = 0.58, P < 0.0001). Exercise did not increase weight loss, and resistance training frequency (days per week) did not attenuate FFM loss.
Liraglutide does not have effects on FFM beyond what can be expected from total weight loss. Resistance training did not attenuate FFM loss in the liraglutide or lifestyle-alone groups. To ameliorate FFM loss after liraglutide, a new strategy may be needed that may combine exercise with specific nutritional interventions.
本研究旨在比较单纯生活方式干预的成功应答者与生活方式干预加3.0毫克利拉鲁肽的应答者之间的去脂体重(FFM)损失情况。另一个目的是研究不同的抗阻训练频率(每周天数)对FFM保留的影响。
这项前瞻性研究对一家三级医疗肥胖诊所中体重指数(BMI)≥35 kg/m²的患者进行了检查。在基线和治疗16周后测量身体成分(双能X线吸收法)。在第16周收集与运动相关的数据(每周有氧运动分钟数和抗阻训练频率)。两组共检查了78名个体,第一组仅进行生活方式干预(n = 19),第二组进行生活方式干预加3.0毫克利拉鲁肽(n = 59)。使用线性混合效应模型来检查组间差异。
与单纯生活方式干预相比,使用利拉鲁肽的参与者体重减轻更多(-12.2千克对-9.7千克,P = 0.048),FFM也更多(-2.3千克对-1.5千克,P = 0.06)。在控制体重减轻后,两组之间的FFM损失没有差异(0.14千克/周对-0.09千克/周,P = 0.12)。绝对体重减轻(千克)与FFM损失(千克)相关(ρ = 0.58,P < 0.0001)。运动并没有增加体重减轻,抗阻训练频率(每周天数)也没有减轻FFM损失。
利拉鲁肽对FFM的影响不超过总体重减轻所预期的范围。抗阻训练在利拉鲁肽组或单纯生活方式组中均未减轻FFM损失。为了改善使用利拉鲁肽后的FFM损失,可能需要一种新的策略,即将运动与特定的营养干预相结合。