Squire Peter, Naude James, Zentner Ali, Bittman Jesse, Khan Nadia
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
University of British Columbia, Vancouver, British Columbia, Canada.
BMJ Open. 2025 Jan 15;15(1):e089477. doi: 10.1136/bmjopen-2024-089477.
The response to glucagon-like peptide-1 (GLP-1) analogues for weight loss varies significantly. We investigated the anthropometric, demographic and clinical characteristics associated with total body weight loss (TBWL) from subcutaneous GLP-1 analogue therapy in patients with obesity in a real-world setting.
Retrospective cohort analysis.
An urban, multidisciplinary obesity community clinic in Vancouver, Canada, from November 2018 to April 2021.
483 adults with a body mass index (BMI) of ≧30 kg/m who had filled a new prescription for subcutaneous semaglutide or liraglutide, with at least 6-month follow-up, were included (mean follow-up: 17.3 months). Individuals with prior bariatric surgery were excluded.
The primary outcome was the %TBWL over a mean follow-up period of 520 days. Participant's TWBL was categorised as non-response (<5% TBWL), moderate response (5%-15% TBWL) or hyper-response (>15% TBWL).
The average %TBWL in the cohort was 12.2%. Among the participants, 17.8% had a non-response, 48.4% had a moderate response and 33.8% had a hyper-response. In the multivariable regression analysis, being a woman was associated with hyper-response (adjusted OR 1.92, CI 1.01 to 3.65, p=0.048). Age, diabetes status, baseline BMI, being sedentary, anxiety and depression were not independently associated with TBWL in response to GLP-1 analogue therapy.
In a real-world setting, female sex was found to be associated with a hyper-response to GLP-1 analogue therapy for obesity management. Other clinical factors evaluated, including diabetes status, were not associated with the response. Future research should assess additional variables and support the development of novel biomarkers that are associated with weight loss response.
胰高血糖素样肽-1（GLP-1）类似物对体重减轻的反应差异很大。我们在现实环境中调查了肥胖患者接受皮下注射GLP-1类似物治疗后总体重减轻（TBWL）相关的人体测量学、人口统计学和临床特征。
回顾性队列分析。
2018年11月至2021年4月期间，加拿大温哥华一家城市多学科肥胖社区诊所。
纳入483名体重指数（BMI）≧30kg/m²且已开具皮下注射司美格鲁肽或利拉鲁肽新处方、随访至少6个月的成年人（平均随访17.3个月）。排除既往接受过减肥手术的个体。
主要结局是在平均520天的随访期内的TBWL百分比。参与者的TWBL被分类为无反应（<5%TBWL）、中度反应（5%-15%TBWL）或高反应（>15%TBWL）。
队列中的平均TBWL百分比为12.2%。参与者中，17.8%无反应，48.4%中度反应，33.8%高反应。在多变量回归分析中，女性与高反应相关（调整后OR 1.92，CI 1.01至3.65，p=0.048）。年龄、糖尿病状态、基线BMI、久坐不动、焦虑和抑郁与GLP-1类似物治疗后的TBWL无独立相关性。
在现实环境中，发现女性对GLP-1类似物治疗肥胖的反应较高。评估的其他临床因素，包括糖尿病状态，与反应无关。未来的研究应评估其他变量，并支持开发与体重减轻反应相关的新型生物标志物。
