Nigro Stefania, Vinciguerra Federica, Guccione Fabio, Alibrandi Angela, Filannino Ruggiero, Navarra Giuseppe
Department of Human Pathology, Azienda Ospedaliera Universitaria Policlinico ''G. Martino'', Messina, Italy.
Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Obes Surg. 2025 Aug 8. doi: 10.1007/s11695-025-08155-2.
Endoscopic sleeve gastroplasty (ESG) has been shown to be effective for inducing weight loss. Liraglutide, a glucagon-like peptide-1 agonist, has been successfully used for weight loss and remission of comorbidities in patients with obesity. So far, there are no clinical studies comparing short-term outcomes in patients treated with ESG or Liraglutide. The aim of the study is to assess the efficacy and safety of ESG versus Liraglutide in patients with obesity over a 12 months follow-up period.
A prospective, randomized controlled, monocentric study was performed. A total of 43 patients with class I and II obesity were included in the study. Twenty-three patients underwent ESG, and 20 patients were treated with Liraglutide. All participants received standardized follow-up protocols with assessments by both surgeon and nutritionist in the bariatric ambulatory setting. Weight loss outcomes, including the percentage of excess weight loss (%EWL), total weight loss (%TWL), and resolution of obesity-related comorbidities were assessed at 3, 6, and 12 months post-intervention.
After 3 and 6 months, %EWL and %TWL were greater in the ESG group (P = 0.001). However, at 12 months, these differences were no longer statistically significant, suggesting that the ESG group was experiencing some weight regain, while the Liraglutide group had a slower but more consistent weight loss. Regarding the resolution of comorbidities, there were no statistically significant differences at 3, 6 and 12 months between the two groups. None of the patients had major complications or significant side effects.
Both ESG and Liraglutide guarantee weight loss and remission of comorbidities in class I and II obesity patients. However, ESG induces a more rapid weight loss in the first six months, after which two patients seem experience weight regain. Liraglutide provides a slower weight loss in terms of %EWL and %TWL but patients continue losing weight also after six months. Larger samples with a longer follow-up are needed to confirm our results.
内镜下袖状胃成形术（ESG）已被证明对诱导体重减轻有效。利拉鲁肽是一种胰高血糖素样肽-1激动剂，已成功用于肥胖患者的体重减轻和合并症缓解。到目前为止，尚无比较ESG或利拉鲁肽治疗患者短期结局的临床研究。本研究的目的是评估ESG与利拉鲁肽在肥胖患者12个月随访期内的疗效和安全性。
进行了一项前瞻性、随机对照、单中心研究。共有43例I级和II级肥胖患者纳入研究。23例患者接受了ESG治疗，20例患者接受了利拉鲁肽治疗。所有参与者在减重门诊接受了由外科医生和营养师进行评估的标准化随访方案。在干预后3、6和12个月评估体重减轻结局，包括超重减轻百分比（%EWL）、总体重减轻百分比（%TWL）以及肥胖相关合并症的缓解情况。
3个月和6个月后，ESG组的%EWL和%TWL更高（P = 0.001）。然而，在12个月时，这些差异不再具有统计学意义，这表明ESG组出现了一些体重反弹，而利拉鲁肽组体重减轻较慢但更持续。关于合并症的缓解情况，两组在3、6和12个月时均无统计学显著差异。所有患者均未出现严重并发症或明显副作用。
ESG和利拉鲁肽均可保证I级和II级肥胖患者体重减轻和合并症缓解。然而，ESG在前六个月诱导体重减轻更快，之后有两名患者似乎出现体重反弹。就%EWL和%TWL而言，利拉鲁肽体重减轻较慢，但患者在六个月后仍继续减重。需要更大样本量和更长随访时间来证实我们的结果。
