Ouyang Yuqin, Xiang Xinyue, Hu Xinyun, Chu Xuehui, Tang Wenjuan, Feng Wenhuan
Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China.
Branch of National Clinical Research Center for Metabolic Diseases, Nanjing, China.
Front Endocrinol (Lausanne). 2025 May 22;16:1580159. doi: 10.3389/fendo.2025.1580159. eCollection 2025.
Liraglutide effectively manages mild obesity, but individual weight loss outcomes vary significantly. We aimed to identify clinical predictors influencing differential treatment responses in patients with mild obesity.
A retrospective analysis was conducted on 64 adults (BMI 28-32.5 kg/m²) undergoing a 12-week liraglutide intervention. Participants were categorized based on therapeutic success: those achieving composite endpoints (≥5% total weight loss [TWL] and BMI normalization to <28 kg/m²) versus suboptimal responders. Comprehensive biometric and biochemical assessments were performed, and multivariate predictive modeling was applied.
Responders (n=37, 75.7% female) showed significantly better metabolic outcomes than non-responders (n=27, 77.8% female), with notable differences in %TWL (11.0 ± 3.6% vs 4.2 ± 2.6%), total weight loss (9.04 ± 3.32 kg vs 3.55 ± 2.20 kg), and BMI reduction (3.3 ± 1.1 vs 1.4 ± 0.9 kg/m²) (all p's <.01). Responders also demonstrated improved glucolipid metabolism, and reduced metabolic-associated fatty liver disease (p <.05). Regression analysis identified a history metabolic surgery (MS) and a baseline BMI ≥30.5 kg/m² as significant negative predictors of success. Adjusted odds ratios indicated strong inverse associations, with MS history showing an OR of 6.78 (95% CI: 1.95-23.61; p <.01) and elevated BMI (≥30.5 kg/m²) yielding an OR of 4.79 (95% CI: 1.46-15.71; p <.01).
A history of MS significantly affects liraglutide's responsiveness in patients with mild obesity, emphasizing the need for personalized therapeutic strategies in post-surgical patients. These findings highlight the importance of a comprehensive medical history in guiding obesity pharmacotherapy.
利拉鲁肽可有效治疗轻度肥胖症，但个体减重效果差异显著。我们旨在确定影响轻度肥胖症患者不同治疗反应的临床预测因素。
对64名接受12周利拉鲁肽干预的成年人（BMI 28 - 32.5 kg/m²）进行回顾性分析。参与者根据治疗效果进行分类：达到复合终点（总体重减轻[TWL]≥5%且BMI恢复正常至<28 kg/m²）者与反应欠佳者。进行了全面的生物特征和生化评估，并应用多变量预测模型。
反应者（n = 37，75.7%为女性）的代谢结果显著优于无反应者（n = 27，77.8%为女性），在TWL百分比（11.0 ± 3.6%对4.2 ± 2.6%）、总体重减轻（9.04 ± 3.32 kg对3.55 ± 2.20 kg）和BMI降低（3.3 ± 1.1对1.4 ± 0.9 kg/m²）方面存在显著差异（所有p值<.01）。反应者还表现出糖脂代谢改善，代谢相关脂肪性肝病减轻（p <.05）。回归分析确定有代谢手术（MS）史和基线BMI≥30.5 kg/m²是成功的显著负预测因素。调整后的比值比表明存在强负相关，有MS史者的OR为6.78（95% CI：1.95 - 23.61；p <.01），BMI升高（≥30.5 kg/m²）者的OR为4.79（95% CI：1.46 - 15.71；p <.01）。
MS史显著影响轻度肥胖症患者对利拉鲁肽的反应，强调了对手术患者采取个性化治疗策略的必要性。这些发现凸显了全面病史在指导肥胖症药物治疗中的重要性。
