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一项关于利拉鲁肽治疗肥胖青少年胃袖状切除术后 16 周的开放性研究。

An open-label 16-week study of liraglutide in adolescents with obesity post-sleeve gastrectomy.

机构信息

Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, Maryland, USA.

Department of Pediatrics, University of Washington, Seattle, Washington, USA.

出版信息

Pediatr Obes. 2024 Nov;19(11):e13154. doi: 10.1111/ijpo.13154. Epub 2024 Aug 5.

Abstract

BACKGROUND

Up to 50% of adolescents who undergo metabolic and bariatric surgery (MBS) have obesity 3 years post-MBS, placing them at continued risk for the consequences of obesity.

OBJECTIVES

We conducted an open-label, 16-week pilot study of liraglutide in adolescents with obesity after sleeve gastrectomy (SG) to investigate liraglutide effects on weight and body mass index (BMI) post-SG.

METHODS

Adolescents aged 12-20.99 years with obesity and a history of SG ≥1 year prior were enrolled. Liraglutide was initiated at 0.6 mg/day, escalated weekly to a maximum of 3 mg/day, with treatment duration 16 weeks. Fasting laboratory assessments and an oral glucose tolerance test were performed at baseline and end-treatment.

RESULTS

A total of 43 participants were screened, 34 initiated liraglutide (baseline BMI 41.2 ± 7.7 kg/m), and 31 (91%) attended the end-treatment visit. BMI decreased by 4.3% (p < 0.001) with liraglutide. Adolescents who had poor initial response to SG (<20% BMI reduction at BMI nadir) had less weight loss with liraglutide. Fasting glucose and haemoglobin A1C concentrations significantly decreased. There were no serious treatment-emergent adverse events reported.

CONCLUSIONS

Liraglutide treatment was feasible and associated with a BMI reduction of 4.3% in adolescents who had previously undergone SG, quantitatively similar to results obtained in adolescents with obesity who have not undergone MBS.

摘要

背景

高达 50%的接受代谢和减重手术(MBS)的青少年在 MBS 后 3 年内仍患有肥胖症,使他们继续面临肥胖相关后果的风险。

目的

我们对袖状胃切除术(SG)后肥胖的青少年进行了一项开放标签、16 周的利拉鲁肽先导研究,以调查利拉鲁肽对 SG 后体重和体重指数(BMI)的影响。

方法

纳入了年龄在 12-20.99 岁之间、有肥胖症病史且 SG 时间≥1 年的青少年。利拉鲁肽起始剂量为 0.6mg/天,每周递增至最大 3mg/天,治疗持续时间为 16 周。在基线和治疗结束时进行空腹实验室评估和口服葡萄糖耐量试验。

结果

共筛选了 43 名参与者,34 名开始接受利拉鲁肽治疗(基线 BMI 为 41.2±7.7kg/m²),31 名(91%)参加了治疗结束时的访视。与基线相比,BMI 降低了 4.3%(p<0.001)。SG 初始反应较差(BMI 最低时 BMI 减少<20%)的青少年,利拉鲁肽治疗的减重效果较差。空腹血糖和糖化血红蛋白浓度显著降低。没有报告严重的治疗相关不良事件。

结论

利拉鲁肽治疗是可行的,与之前接受过 SG 的青少年 BMI 降低 4.3%相关,与未接受过 MBS 的肥胖青少年的结果相当。

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