Endocrine Abstracts

Introduction: Liraglutide 3.0 mg could be effective option for obesity management. It is known that patients who have ≥5% weight loss in 16 weeks (‘early responders’ (ERs)) will have ≥10% weight loss in 56 weeks [1]. Predictors of this early response (ER) in 16 weeks are unknown.

Methods: 22 obese patients (30% men; median age 40.0 [33.0; 48.5]) were recruited. The exclusion criteria were diabetes, psychotic disorders, obesity due to secondary causes, deconditioning of concomitant diseases and current or 3-month prior usage of anti-obesity medications. Contraindications for liraglutide were excluded in all participants. Baseline body weight (BBW), BMI, waist circumference (WC) and eating behavior regulator levels in fasting state such as leptin, ghrelin, obestatin and GLP-1 (ELISA) were evaluated. Patients were prescribed liraglutide with standard dose escalation from 0.6 to 3.0 mg per day. In 16 weeks re-examination was performed. Statistical analysis include Wilcoxon and Mann-Whitney tests and linear regression analysis.

Results: Baseline plasma level for active ghrelin was 6.07 [3.41; 9.22] fmol/ml, for obestatin 1.85 [1.73; 2.26] ng/ml, for GLP-1 3.98 [2.91; 4.89] ng/ml and for leptin 66.49 [29.83; 108.12] ng/ml. The median (Me) of BBWchange was –7.30 [–11.50; –4.50] kg, Me BMI change –2.51 [–4.05; –1.39], Me WC change –6.00 [–9.50; –4.00]. All changes were statistically significant (P < 0.007, Wilcoxon test). 14 patients (64%) lose ≥5% and 8 patients did not have ER. To identify predictor(s) of ER, baseline characteristics of ERs and non-ERs were compared. There was statistical tendency for smaller BBW in ERs (P = 0.019, Mann-Whitney test). Since the study had limited number of observations, multivariate analysis was not used. With the method of linear regression analysis AUC for combinations of BBW with baseline plasma eating behavior regulating-peptides were evaluated. The best AUC was for combination of BBW with active ghrelin level (0.893, 95% CI [0.708–0.989]). The mathematical model for result prediction was created. The quality of model due to the Hosmer-Lemeshov criteria was good (3.987; P = 0.858). The sensitivity of model was 86%, 95% CI [65%; 97%], specificity 63%, 95% CI [41%;83%], predictive value of positive result 80%, 95% CI [60%; 95%], predictive value of negative result 71%, 95% CI [49%; 89%].

Conclusion: In our study, mathematical model including BBWin combination with plasma fasting active ghrelin level was a good tool for predicting probability of the effectiveness of liraglutide 3.0 mg therapy in patients with obesity with the sensitivity 86%. However, further studies with a larger sample of patients are required.