Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Nutrition and Dietetics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Clin Obes. 2024 Jun;14(3):e12649. doi: 10.1111/cob.12649. Epub 2024 Mar 4.
UK guidelines recommend liraglutide 3.0 mg in adults treated within specialist weight management services with BMI ≥35 kg/m, prediabetes and high cardiovascular disease risk. We aimed to clinically evaluate liraglutide 3.0 mg in specialist weight management services. We evaluated liraglutide 3.0 mg in weight management services at Guys and St Thomas' NHS Foundation Trust. Objective body weight (BW) was measured at baseline and 4 months, allowing classification as 'responders' (≥5% BW reduction) and 'non-responders' (<5% BW reduction). One hundred and twenty-one patients were evaluated. At 4 months, 76.0% attended follow-up (82.6% responders, 17.4% non-responders); BW (-8.6 kg, 95%CI:-9.8, -7.4 kg), BMI (-3.2 kg/m, 95%CI: -3.6, -2.8) and %-BW (-6.6%, IQR: -8.8%, -5.2%) significantly reduced. In responders, HbA1c reduced by -5.0 mmol/mol (IQR: -7.0. -4.0 mmol/mol). In responders BW continued to reduce up to 12 months (4 m: -10.2 kg, p < .0001; 6 m: -15.6 kg, p < .0001; 9 m: -16.5 kg, p < .0001; 12 m: -16.7 kg, p < .01). Those of Black African and Caribbean ethnicity experienced less BW loss than those of white ethnicity (4.12 kg, p = .017) and had a greater attrition rate. In adults with obesity and prediabetes who are treated within specialist weight management services, liraglutide 3.0 mg reduces BW and HbA1c. Those of Black African and Caribbean ethnicity experienced less BW reduction and greater attrition at 4 months. Further evaluation of the ethnic differences in response to obesity pharmacotherapy is required.
英国指南建议，在专科体重管理服务中，BMI≥35kg/m2、合并糖尿病前期和心血管疾病高危因素的成年人，应用利拉鲁肽 3.0mg。本研究旨在评估专科体重管理服务中利拉鲁肽 3.0mg 的临床疗效。
我们在英国盖伊和圣托马斯国民保健信托基金会评估了利拉鲁肽 3.0mg 在体重管理服务中的应用。基线和 4 个月时测量患者的实际体重（Objective Body Weight，OBW），根据体重下降百分比将患者分为“应答者（减重≥5%）”和“无应答者（减重＜5%）”。共 121 例患者接受了评估。4 个月时，76.0%患者完成了随访（应答率 82.6%，无应答率 17.4%）；体重（-8.6kg，95%CI：-9.8，-7.4kg）、BMI（-3.2kg/m2，95%CI：-3.6，-2.8）和%体重（-6.6%，IQR：-8.8%，-5.2%）均显著下降。应答者的糖化血红蛋白（HbA1c）降低了 5.0mmol/mol（IQR：-7.0，-4.0mmol/mol）。应答者的体重持续下降，至 12 个月时（4 个月：-10.2kg，p＜0.0001；6 个月：-15.6kg，p＜0.0001；9 个月：-16.5kg，p＜0.0001；12 个月：-16.7kg，p＜0.01），体重仍在持续下降。黑种人和加勒比裔患者的体重下降幅度小于白种人（4.12kg，p=0.017），且脱落率更高。在专科体重管理服务中接受治疗的肥胖合并糖尿病前期成年人中，应用利拉鲁肽 3.0mg 可降低体重和糖化血红蛋白（HbA1c）。黑种人和加勒比裔患者在 4 个月时体重下降幅度更小，脱落率更高。需要进一步评估肥胖症药物治疗的种族差异。
