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Jensen SBK, Juhl CR, Janus C, Lundgren JR, Martinussen C, Wiingaard C, Knudsen C, Frikke-Schmidt R, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS. Weight loss maintenance with exercise and liraglutide improves glucose tolerance, glucagon response, and beta cell function. Obesity (Silver Spring) 2023; 31:977-989. [PMID: 36942420 DOI: 10.1002/oby.23715] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 03/23/2023]
Abstract
OBJECTIVE The aim of this study was to investigate glucose tolerance, glucagon response, and beta cell function during a 1-year maintenance period with either exercise, the glucagon-like peptide-1 receptor agonist liraglutide, or the combination after diet-induced weight loss. METHODS In this randomized placebo-controlled trial, adults with obesity (BMI: 32-43 kg/m2 ) without diabetes underwent an 8-week low-calorie diet (800 kcal/d) and were randomized to 52 weeks of aerobic exercise, liraglutide 3.0 mg/d, exercise and liraglutide combined, or placebo. Change in glucose and glucagon response to a 3-hour mixed meal test and disposition index, as a measure of beta cell function, were measured. RESULTS A total of 195 participants were randomized. After 1 year of treatment, the combination group had decreased postprandial glucose response by -9% (95% CI: -14% to -3%; p = 0.002), improved beta cell function by 49% (95% CI: 16% to 93%; p = 0.002), and decreased glucagon response by -18% (95% CI: -34% to -3%; p = 0.024) compared with placebo. Compared with placebo, liraglutide alone improved postprandial glucose response by -7% (95% CI: -12% to -1%; p = 0.018), but not beta cell function or glucagon. Exercise alone had similar postprandial glucose response, beta cell function, and glucagon response as placebo. CONCLUSIONS Only the combination of exercise and liraglutide improved glucose tolerance, beta cell function, and glucagon responses after weight loss.
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Affiliation(s)
- Simon B K Jensen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian R Juhl
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Cecilie Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente M Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- NNF Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark
| | - Signe S Torekov
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Sandsdal RM, Juhl CR, Jensen SBK, Lundgren JR, Janus C, Blond MB, Rosenkilde M, Bogh AF, Gliemann L, Jensen JEB, Antoniades C, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS. Combination of exercise and GLP-1 receptor agonist treatment reduces severity of metabolic syndrome, abdominal obesity, and inflammation: a randomized controlled trial. Cardiovasc Diabetol 2023; 22:41. [PMID: 36841762 PMCID: PMC9960425 DOI: 10.1186/s12933-023-01765-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/03/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Identifying and reducing cardiometabolic risks driven by obesity remains a healthcare challenge. The metabolic syndrome is associated with abdominal obesity and inflammation and is predictive of long-term risk of developing type 2 diabetes and cardiovascular disease in otherwise healthy individuals living with obesity. Therefore, we investigated the effects of adherent exercise, a glucagon-like peptide 1 receptor agonist (GLP-1 RA), or the combination on severity of metabolic syndrome, abdominal obesity, and inflammation following weight loss. METHODS This was a randomized, double-blinded, placebo-controlled trial. During an 8-week low-calorie diet (800 kcal/day), 195 adults with obesity and without diabetes lost 12% in body weight. Participants were then evenly randomized to four arms of one-year treatment with: placebo, moderate-to-vigorous exercise (minimum of 150 min/week of moderate-intensity or 75 min/week of vigorous-intensity aerobic physical activity or an equivalent combination of both), the GLP-1 RA liraglutide 3.0 mg/day, or a combination (exercise + liraglutide). A total of 166 participants completed the trial. We assessed the prespecified secondary outcome metabolic syndrome severity z-score (MetS-Z), abdominal obesity (estimated as android fat via dual-energy X-ray absorptiometry), and inflammation marker high-sensitivity C-reactive protein (hsCRP). Statistical analysis was performed on 130 participants adherent to the study interventions (per-protocol population) using a mixed linear model. RESULTS The diet-induced weight loss decreased the severity of MetS-Z from 0.57 to 0.06, which was maintained in the placebo and exercise groups after one year. MetS-Z was further decreased by liraglutide (- 0.37, 95% CI - 0.58 to - 0.16, P < 0.001) and the combination treatment (- 0.48, 95% CI - 0.70 to - 0.25, P < 0.001) compared to placebo. Abdominal fat percentage decreased by 2.6, 2.8, and 6.1 percentage points in the exercise, liraglutide, and combination groups compared to placebo, respectively, and hsCRP decreased only in the combination group compared with placebo (by 43%, P = 0.03). CONCLUSION The combination of adherent exercise and liraglutide treatment reduced metabolic syndrome severity, abdominal obesity, and inflammation and may therefore reduce cardiometabolic risk more than the individual treatments. Trial registration EudraCT number: 2015-005585-32, ClinicalTrials.gov: NCT04122716.
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Affiliation(s)
- Rasmus M Sandsdal
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Christian R Juhl
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Simon B K Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | | | - Mads Rosenkilde
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Adrian F Bogh
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Lasse Gliemann
- The August Krogh Section for Human Physiology, Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Erik B Jensen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Bente M Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark
| | - Signe S Torekov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, DK-2200, Copenhagen N, Denmark.
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Bogh AF, Jensen SBK, Juhl CR, Janus C, Sandsdal RM, Lundgren JR, Noer MH, Vu NQ, Fiorenza M, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS. Insufficient sleep predicts poor weight loss maintenance after one year. Sleep 2022; 46:6874808. [PMID: 36472579 PMCID: PMC10171640 DOI: 10.1093/sleep/zsac295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/21/2022] [Indexed: 12/12/2022] Open
Abstract
Abstract
Study objectives
Insufficient sleep may attenuate weight loss, but the role of sleep in weight loss maintenance is unknown. Since weight regain after weight loss remains a major obstacle in obesity treatment, we investigated whether insufficient sleep predicts weight regain during weight loss maintenance.
Methods
In a randomized, controlled, two-by-two factorial study, 195 adults with obesity completed an eight-week low-calorie diet and were randomly assigned to one-year weight loss maintenance with or without exercise and liraglutide 3.0mg/day or placebo. Sleep duration and quality were measured before and after the low-calorie diet and during weight maintenance using wrist-worn accelerometers (GENEActiv) and Pittsburgh Sleep Quality Index. To test associations between insufficient sleep and weight regain, participants were stratified at randomization into subgroups according to sleep duration (</≥6 h/night) or sleep quality (PSQI score ≤/>5).
Results
After a diet-induced 13.1 kg weight loss, participants with short sleep duration at randomization regained 5.3 kg body weight (P=.0008) and had less reduction in body fat percentage compared with participants with normal sleep duration (P=.007) during the one-year weight maintenance phase. Participants with poor sleep quality before the weight loss regained 3.5 kg body weight compared with good quality sleepers (P=.010). During the weight maintenance phase, participants undergoing liraglutide treatment displayed increased sleep duration compared with placebo after 26 weeks (5 vs. -15 min/night) but not after one year. Participants undergoing exercise treatment preserved the sleep quality improvements attained from the initial weight loss.
Conclusions
Short sleep duration or poor sleep quality was associated with weight regain after weight loss in adults with obesity.
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Affiliation(s)
- Adrian F Bogh
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Simon B K Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Christian R Juhl
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Rasmus M Sandsdal
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Mikkel H Noer
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Nhu Q Vu
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Matteo Fiorenza
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Bente M Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
- NovoNordisk Foundation Center for Basic Metabolic Research , University of Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre University Hospital , Copenhagen, Denmark
| | - Signe S Torekov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
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Andersen E, Juhl CR, Kjøller ET, Lundgren JR, Janus C, Saupstad M, Ingerslev LR, Jensen SBK, Holst JJ, Stallknecht BM, Madsbad S, Torekov SS, Barrès R. O-018 Sperm count is increased by diet-induced weight loss and maintained by exercise or GLP-1 analogue treatment: a randomised controlled trial. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Does diet-induced weight loss improve semen parameters, and are these possible improvements maintained with sustained weight loss?
Summary answer
An 8-week low-calorie diet-induced weight loss was associated with improved sperm count, which was maintained after one year in men who maintained weight loss.
What is known already
Obesity is associated with impaired semen parameters. Weight loss improves metabolic health in obesity, but there is a lack of knowledge on the acute and long-term effects of weight loss on semen parameters.
Study design, size, duration
This is a substudy of men with obesity enrolled in a randomised, controlled, double-blinded trial (the S-LITE trial). The trial was conducted between August 2016 and November 2019. A total of 56 men was included in the study and assigned to an initial 8-week low-calorie diet (800 kcal/day) followed by randomisation to 52 weeks of either: placebo, exercise training, and placebo (exercise), the GLP-1 analogue liraglutide (liraglutide) or liraglutide in combination with exercise training (combination).
Participants/materials, setting, methods
Inclusion criteria were men who delivered semen samples, 18 to 65 years of age and a body mass index between 32 to 43 kg/m2, but otherwise healthy. The study was carried out at Hvidovre Hospital and at the University of Copenhagen, and the participants were from the Greater Copenhagen Area. We assessed semen parameters, anthropometrics and collected blood samples before (T0) and after the 8-week low-calorie dietary intervention (T1) and after 52 weeks (T2).
Main results and the role of chance
The men lost on average 16.5 kg (95% CI: 15.2-17.8) bodyweight during the low-calorie diet, which increased sperm concentration 1.49 fold (95% CI: 1.18-1.88, P<0.01) and sperm count 1.41 fold (95% CI: 1.07-1.87, P<0.01). These improvements were maintained for 52 weeks in men who maintained the weight loss but not in men who regained weight. Semen volume, sperm motility and motile sperm count did not change.
Limitations, reasons for caution
The S-LITE trial was a randomised controlled trial of weight loss maintenance. Analysis of semen was preregistered to explore the effects of weight loss and weight loss maintenance on semen parameters. Due to the small sample size, definite inferences cannot be made.
Wider implications of the findings
This study shows that sperm concentration and sperm count were improved after a diet-induced weight loss in men with obesity. Our findings indicate that both liraglutide and exercise as weight maintenance strategies may be used to maintain the improvements in sperm concentration and count.
Trial registration number
H-16027082
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Affiliation(s)
- E Andersen
- Novo Nordisk Foundation Center for Basic Metabolic Research- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - C R Juhl
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - E T Kjøller
- Novo Nordisk Foundation Center for Basic Metabolic Research- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - J R Lundgren
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - C Janus
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - M Saupstad
- Novo Nordisk Foundation Center for Basic Metabolic Research- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - L R Ingerslev
- Novo Nordisk Foundation Center for Basic Metabolic Research- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - S B K Jensen
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - J J Holst
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - B M Stallknecht
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - S Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre , Denmark
| | - S S Torekov
- Department of Biomedical Sciences- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
| | - R Barrès
- Novo Nordisk Foundation Center for Basic Metabolic Research- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen , Denmark
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Andersen E, Juhl CR, Kjøller ET, Lundgren JR, Janus C, Dehestani Y, Saupstad M, Ingerslev LR, Duun OM, Jensen SBK, Holst JJ, Stallknecht BM, Madsbad S, Torekov SS, Barrès R. Sperm count is increased by diet-induced weight loss and maintained by exercise or GLP-1 analogue treatment: a randomized controlled trial. Hum Reprod 2022; 37:1414-1422. [PMID: 35580859 PMCID: PMC9247415 DOI: 10.1093/humrep/deac096] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/25/2022] [Indexed: 01/11/2023] Open
Abstract
STUDY QUESTION Does diet-induced weight loss improve semen parameters, and are these possible improvements maintained with sustained weight loss? SUMMARY ANSWER An 8-week low-calorie diet-induced weight loss was associated with improved sperm concentration and sperm count, which were maintained after 1 year in men who maintained weight loss. WHAT IS KNOWN ALREADY Obesity is associated with impaired semen quality. Weight loss improves metabolic health in obesity, but there is a lack of knowledge on the acute and long-term effects of weight loss on semen parameters. STUDY DESIGN, SIZE, DURATION This is a substudy of men with obesity enrolled in a randomized, controlled, double-blinded trial (the S-LITE trial). The trial was conducted between August 2016 and November 2019. A total of 56 men were included in the study and assigned to an initial 8-week low-calorie diet (800 kcal/day) followed by randomization to 52 weeks of either: placebo and habitual activity (placebo), exercise training and placebo (exercise), the Glucagon Like Peptide 1 (GLP-1) analogue liraglutide and habitual activity (liraglutide) or liraglutide in combination with exercise training (combination). PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria were men who delivered semen samples, 18 to 65 years of age, and a body mass index between 32 and 43 kg/m2, but otherwise healthy. The study was carried out at Hvidovre Hospital and at the University of Copenhagen, and the participants were from the Greater Copenhagen Area. We assessed semen parameters and anthropometrics and collected blood samples before (T0), after the 8-week low-calorie dietary intervention (T1), and after 52 weeks (T2). MAIN RESULTS AND THE ROLE OF CHANCE The men lost on average 16.5 kg (95% CI: 15.2-17.8) body weight during the low-calorie diet, which increased sperm concentration 1.49-fold (95% CI: 1.18-1.88, P < 0.01) and sperm count 1.41-fold (95% CI: 1.07-1.87, P < 0.01). These improvements were maintained for 52 weeks in men who maintained the weight loss, but not in men who regained weight. Semen volume, sperm motility and motile sperm count did not change. LIMITATIONS, REASONS FOR CAUTION The S-LITE trial was a randomized controlled trial of weight loss maintenance. Analysis of semen was preregistered to explore the effects of weight loss and weight loss maintenance on semen parameters, but definite inferences cannot be made. WIDER IMPLICATIONS OF THE FINDINGS This study shows that sperm concentration and sperm count were improved after a diet-induced weight loss in men with obesity. Our findings indicate that either or both liraglutide and exercise as weight maintenance strategies may be used to maintain the improvements in sperm concentration and count. STUDY FUNDING/COMPETING INTEREST(S) This work is supported by an excellence grant from the Novo Nordisk Foundation (NNF16OC0019968), a Challenge Programme Grant from the Novo Nordisk Foundation (NNF18OC0033754) and a grant from Helsefonden. The Novo Nordisk Foundation Center for Basic Metabolic Research is an independent research centre at the University of Copenhagen, partially funded by an unrestricted donation from the Novo Nordisk Foundation (NNF18CC0034900). Saxenda (liraglutide) and placebo pens were provided by Novo Nordisk. Cambridge Weight Plan diet products for the 8-week low-calorie diet were provided by Cambridge Weight Plan. E.A.: shareholder, employee of ExSeed Health Ltd. Grant Recipient from ExSeed Health Ltd and listed on Patents planned, issued or pending with ExSeed Health Ltd; J.J.H.: consultant for Eli Lilly A/S and Novo Nordisk A/S. Lecture fees for Novo Nordisk A/S. Listed on Patents planned, issued or pending with the University of Copenhagen, Advocacy group for Antag Therapeutics and Bainan Biotech; S.M.: lecture fees for Novo Nordisk A/S. Recipient of Support for attending meetings from Novo Nordisk A/S. Advisory boards of Novo Nordisk A/S; Sanofi Aventis and Merck Sharp & Dohme. S.S.T.: research grant recipient Novo Nordisk. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER The trial was approved by the Ethical Committee of the Capital Region of Denmark (H-16027082) and the Danish Medicines Agency (EudraCT Number: 2015-005585-32). ClinicalTrials.gov identifier (NCT number): NCT04122716. TRIAL REGISTRATION DATE 11 May 2016. DATE OF FIRST PATIENT’S ENROLMENT August 2016.
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Affiliation(s)
| | | | - Emma T Kjøller
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yasmin Dehestani
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marte Saupstad
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars R Ingerslev
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Olivia M Duun
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon B K Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente M Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Signe S Torekov
- Correspondence address. Mærsk Tower 7.7, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. Tel: +45-35-33-72-88; E-mail: (R.B.); Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Panum 12.4.08, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark. Tel: +45-22-98-38-27; E-mail: (S.S.T.)
| | - Romain Barrès
- Correspondence address. Mærsk Tower 7.7, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. Tel: +45-35-33-72-88; E-mail: (R.B.); Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Panum 12.4.08, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark. Tel: +45-22-98-38-27; E-mail: (S.S.T.)
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Lundgren JR, Janus C, Jensen SBK, Juhl CR, Olsen LM, Christensen RM, Svane MS, Bandholm T, Bojsen-Møller KN, Blond MB, Jensen JEB, Stallknecht BM, Holst JJ, Madsbad S, Torekov SS. Healthy Weight Loss Maintenance with Exercise, Liraglutide, or Both Combined. N Engl J Med 2021; 384:1719-1730. [PMID: 33951361 DOI: 10.1056/nejmoa2028198] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Weight regain after weight loss is a major problem in the treatment of persons with obesity. METHODS In a randomized, head-to-head, placebo-controlled trial, we enrolled adults with obesity (body-mass index [the weight in kilograms divided by the square of the height in meters], 32 to 43) who did not have diabetes. After an 8-week low-calorie diet, participants were randomly assigned for 1 year to one of four strategies: a moderate-to-vigorous-intensity exercise program plus placebo (exercise group); treatment with liraglutide (3.0 mg per day) plus usual activity (liraglutide group); exercise program plus liraglutide therapy (combination group); or placebo plus usual activity (placebo group). End points with prespecified hypotheses were the change in body weight (primary end point) and the change in body-fat percentage (secondary end point) from randomization to the end of the treatment period in the intention-to-treat population. Prespecified metabolic health-related end points and safety were also assessed. RESULTS After the 8-week low-calorie diet, 195 participants had a mean decrease in body weight of 13.1 kg. At 1 year, all the active-treatment strategies led to greater weight loss than placebo: difference in the exercise group, -4.1 kg (95% confidence interval [CI], -7.8 to -0.4; P = 0.03); in the liraglutide group, -6.8 kg (95% CI, -10.4 to -3.1; P<0.001); and in the combination group, -9.5 kg (95% CI, -13.1 to -5.9; P<0.001). The combination strategy led to greater weight loss than exercise (difference, -5.4 kg; 95% CI, -9.0 to -1.7; P = 0.004) but not liraglutide (-2.7 kg; 95% CI, -6.3 to 0.8; P = 0.13). The combination strategy decreased body-fat percentage by 3.9 percentage points, which was approximately twice the decrease in the exercise group (-1.7 percentage points; 95% CI, -3.2 to -0.2; P = 0.02) and the liraglutide group (-1.9 percentage points; 95% CI, -3.3 to -0.5; P = 0.009). Only the combination strategy was associated with improvements in the glycated hemoglobin level, insulin sensitivity, and cardiorespiratory fitness. Increased heart rate and cholelithiasis were observed more often in the liraglutide group than in the combination group. CONCLUSIONS A strategy combining exercise and liraglutide therapy improved healthy weight loss maintenance more than either treatment alone. (Funded by the Novo Nordisk Foundation and others; EudraCT number, 2015-005585-32; ClinicalTrials.gov number, NCT04122716.).
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Affiliation(s)
- Julie R Lundgren
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Charlotte Janus
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Simon B K Jensen
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Christian R Juhl
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Lisa M Olsen
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Rasmus M Christensen
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Maria S Svane
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Thomas Bandholm
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Kirstine N Bojsen-Møller
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Martin B Blond
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Jens-Erik B Jensen
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Bente M Stallknecht
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Jens J Holst
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Sten Madsbad
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
| | - Signe S Torekov
- From the Department of Biomedical Sciences (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., M.B.B., B.M.S., J.J.H., S.S.T.), the Novo Nordisk Foundation Center for Basic Metabolic Research (J.R.L., C.J., S.B.K.J., C.R.J., L.M.O., R.M.C., J.J.H., S.S.T.), the Department of Clinical Medicine (T.B., J.-E.B.J.), University of Copenhagen, and the Departments of Endocrinology (M.S.S., K.N.B.-M., J.-E.B.J., S.M.) and Clinical Research (T.B.), Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, and the Steno Diabetes Center Copenhagen, Gentofte (M.B.B.) - all in Denmark
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7
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Lundgren JR, Færch K, Witte DR, Jonsson AE, Pedersen O, Hansen T, Lauritzen T, Holst JJ, Vistisen D, Jørgensen ME, Torekov SS, Johansen NB. Greater glucagon-like peptide-1 responses to oral glucose are associated with lower central and peripheral blood pressures. Cardiovasc Diabetol 2019; 18:130. [PMID: 31586493 PMCID: PMC6778378 DOI: 10.1186/s12933-019-0937-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/27/2019] [Indexed: 12/25/2022] Open
Abstract
Background and aim Cardiovascular diseases (CVDs) are globally the leading cause of death and hypertension is a significant risk factor. Treatment with glucagon-like peptide-1 (GLP-1) receptor agonists has been associated with decreases in blood pressure and CVD risk. Our aim was to investigate the association between endogenous GLP-1 responses to oral glucose and peripheral and central haemodynamic measures in a population at risk of diabetes and CVD. Methods This cross-sectional study included 837 Danish individuals from the ADDITION-PRO cohort (52% men, median (interquartile range) age 65.5 (59.8 to 70.7) years, BMI 26.1 (23.4 to 28.5) kg/m2, without antihypertensive treatment and known diabetes). All participants received an oral glucose tolerance test with measurements of GLP-1 at 0, 30 and 120 min. Aortic stiffness was assessed by pulse wave velocity (PWV). The associations between GLP-1 response and central and brachial blood pressure (BP) and PWV were assessed in linear regression models adjusting for age and sex. Results A greater GLP-1 response was associated with lower central systolic and diastolic BP of − 1.17 mmHg (95% confidence interval (CI) − 2.07 to − 0.27 mmHg, P = 0.011) and − 0.74 mmHg (95% CI − 1.29 to − 0.18 mmHg, P = 0.009), respectively, as well as lower brachial systolic and diastolic BP of − 1.27 mmHg (95% CI − 2.20 to − 0.33 mmHg, P = 0.008) and − 1.00 (95% CI − 1.56 to − 0.44 mmHg, P = 0.001), respectively. PWV was not associated with GLP-1 release (P = 0.3). Individuals with the greatest quartile of GLP-1 response had clinically relevant lower BP measures compared to individuals with the lowest quartile of GLP-1 response (central systolic BP: − 4.94 (95% CI − 8.56 to − 1.31) mmHg, central diastolic BP: − 3.05 (95% CI − 5.29 to − 0.80) mmHg, brachial systolic BP: − 5.18 (95% CI − 8.94 to − 1.42) mmHg, and brachial diastolic BP: − 2.96 (95% CI − 5.26 to − 0.67) mmHg). Conclusion Greater glucose-stimulated GLP-1 responses were associated with clinically relevant lower central and peripheral blood pressures, consistent with beneficial effects on the cardiovascular system and reduced risk of CVD and mortality. Trial registration ClinicalTrials.gov Identifier: NCT00237549. Retrospectively registered 10 October 2005
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Affiliation(s)
- Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark. .,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
| | | | - Daniel R Witte
- Aarhus University, Aarhus, Denmark.,Danish Diabetes Academy, Odense, Denmark
| | - Anna E Jonsson
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Signe S Torekov
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark. .,Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
| | - Nanna B Johansen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark.,Danish Diabetes Academy, Odense, Denmark
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8
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Iepsen EW, Lundgren JR, Hartmann B, Pedersen O, Hansen T, Jørgensen NR, Jensen JEB, Holst JJ, Madsbad S, Torekov SS. GLP-1 Receptor Agonist Treatment Increases Bone Formation and Prevents Bone Loss in Weight-Reduced Obese Women. J Clin Endocrinol Metab 2015; 100:2909-17. [PMID: 26043228 DOI: 10.1210/jc.2015-1176] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT Recent studies indicate that glucagon-like peptide (GLP)-1 regulates bone turnover, but the effects of GLP-1 receptor agonists (GLP-1 RAs) on bone in obese weight-reduced individuals are unknown. OBJECTIVE To investigate the role of GLP-1 RAs on bone formation and weight loss-induced bone mass reduction. DESIGN Randomized control study. SETTING Outpatient research hospital clinic. PARTICIPANTS Thirty-seven healthy obese women with body mass index of 34 ± 0.5 kg/m(2) and age 46 ± 2 years. INTERVENTION After a low-calorie-diet-induced 12% weight loss, participants were randomized to treatment with or without administration of the GLP-1 RA liraglutide (1.2 mg/d) for 52 weeks. In case of weight gain, up to two meals per day could be replaced with a low-calorie-diet product to maintain the weight loss. MAIN OUTCOME MEASURES Total, pelvic, and arm-leg bone mineral content (BMC) and bone markers [C-terminal telopeptide of type 1 collagen (CTX-1) and N-terminal propeptide of type 1 procollagen (P1NP)] were investigated before and after weight loss and after 52-week weight maintenance. Primary endpoints were changes in BMC and bone markers after 52-week weight maintenance with or without GLP-1 RA treatment. RESULTS Total, pelvic, and arm-leg BMC decreased during weight maintenance in the control group (P < .0001), but not significantly in the liraglutide group. Thus, total and arm-leg BMC loss was four times greater in the control group compared to the liraglutide group (estimated difference, 27 g; 95% confidence interval, 5-48; P = .01), although the 12% weight loss was maintained in both groups. In the liraglutide group, the bone formation marker P1NP increased by 16% (7 ± 3 μg/L) vs a 2% (-1 ± 4 μg/L) decrease in the control group (P < .05). The bone resorption marker CTX-1 collagen did not change during the weight loss maintenance phase. CONCLUSIONS Treatment with a long-acting GLP-1 RA increased bone formation by 16% and prevented bone loss after weight loss obtained through a low-calorie diet, supporting its role as a safe weight-lowering agent.
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Affiliation(s)
- Eva W Iepsen
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Bolette Hartmann
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Oluf Pedersen
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Torben Hansen
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Niklas R Jørgensen
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Jens-Erik B Jensen
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Sten Madsbad
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
| | - Signe S Torekov
- Department of Biomedical Sciences (E.W.I., J.R.L., B.H., J.J.H., S.S.T.), and NNF Center for Basic Metabolic Research (E.W.I., J.R.L., B.H., O.P., T.H., J.J.H., S.S.T.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark; Department of Endocrinology (J.-E.B.J., S.M.), Hvidovre University Hospital, 2650 Hvidovre, Denmark; Department of Diagnostics (N.R.J.), Glostrup University Hospital, DK-2600 Glostrup, Denmark; and Institute of Clinical Medicine (N.R.J.), Faculty of Health and Medical Sciences, University of Copenhagen, DKK-2200 Copenhagen, Denmark
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