Long-term impact of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on body weight and glycemic control in Japanese type 2 diabetes: an observational study

Abstract

Background: Liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, has been shown to possess pleiotropic effects including body weight reduction. However, long-term effect of liraglutide on body weight and glycemic control has not been elucidated in Japanese type 2 diabetes (T2D) subjects. Present study investigates whether liraglutide treatment maintains the body weight-decreasing and glucose-lowering effects for 2 years in Japanese T2D subjects.

Methods: The enrolled subjects were 86 T2D patients [age; 59.8 ± 12.8 years, duration of diabetes; 15.8 ± 9.5 years, glycated hemoglobin (HbA1c); 8.5 ± 1.5%, body mass index (BMI); 27.3 ± 5.4 kg/m(2) (15.8 - 46.5 kg/m(2)), mean ± SD]. Among 86 subjects, liraglutide was introduced in 25 inpatients and 61 outpatients, and 46 subjects were followed for 2 years. Clinical parameters were measured at baseline and 3, 6, 9, 12, and 24 months after liraglutide introduction. The increase in liraglutide dosage and the additional usage of glucose-lowering agents depended on each attending physician.

Results: At 1 year after liraglutide introduction, 69 patients (80.2%) decreased body weight and 58 patients (67.4%) improved glycemic control. Body mass index (BMI) was changed 27.3 ± 5.4 kg/m(2) to 25.9 ± 4.8 kg/m(2) and percent reduction of body weight was significant and maintained over 4% at 2 years after liraglutide introduction. HbA1c was significantly decreased from 8.5 ± 1.5% to 7.7 ± 1.2% for 2 years. Liraglutide treatment tended to ameliorate lipid profile and hepatic enzymes. Stepwise regression analysis demonstrated that baseline BMI and previous insulin dose were positively associated with body weight reduction and baseline HbA1c was positively associated with reduction of HbA1c at 2 years after liraglutide introduction.

Conclusions: Long-term liraglutide treatment effectively maintained the reduction of body weight and the fair glycemic control, and also improved lipid profile and liver enzymes in Japanese T2D subjects.

Keywords: Diabetes; Eating behavior; Glucagon-like peptide-1; Liraglutide; Metabolic syndrome; Obesity.

Figure 1

Scatter plot of changes in body weight and HbA1c from baseline to 1 year after liraglutide introduction.

Figure 2

Changes in body weight and HbA1c for 2 years after liraglutide introduction. A, % Change of body weight. B, Change in HbA1c. Data are mean ± SE of 86 patients (0, 3, 6, 9, and 12 months) or 46 patients (24 months). **P < 0.01, ***P < 0.001, compared with the values at 0 month.

Figure 3

Changes in lipids for 2 years after liraglutide introduction. Data are mean ± SE of 86 patients (0, 3, 6, 9, and 12 months) or 46 patients (24 months). LDL-C, low-density lipoprotein-cholesterol; TG, triglyceride; HDL-C, high-density lipoprotein-cholesterol. *P < 0.05, compared with the values at 0 month.

Figure 4

Changes in liver enzymes for 2 years after liraglutide introduction. Data are mean ± SE of 86 patients (0, 3, 6, 9, and 12 months) or 46 patients (24 months). AST, aspartate aminotransferase; ALT, alanine aminotransferase. *P < 0.05, compared with the values at 0 month.