Efectividad de la liraglutida en el tratamiento de la obesidad del adolescente

Abstract

Introduction

In the management of adolescent obesity, therapeutic options are limited and the outcomes of lifestyle modification (LM) alone are poor. Liraglutide, a GLP-1 receptor agonist, was the first drug approved in Spain for the management of obesity in adolescents aged 12 years or older.

Objective

To evaluate the effectiveness of liraglutide combined with LM in adolescents with obesity compared to LM alone.

Methods

Retrospective observational study of 62 adolescents (12-18 years) with a body mass index (BMI) at or above the 95th percentile. The intervention group (n = 31) received liraglutide plus LM, while controls (n = 31) matched for age, sex and treatment duration were managed with LM alone. We analyzed anthropometric, cardiovascular and body composition variables at three time points: baseline (T1), end of treatment (T2: mean, 6.9 months; SD, 4.7), and followup (T3: mean, 12.5 months; SD, 4.9 months). Comparisons between groups were performed using adjusted analysis of covariance model for changes in quantitative variables and logistic regression for BMI reductions of 5% or greater and 10% or greater.

Results

In the intervention group, the BMI z score decreased significantly (mean, −1.09 [SD, 0.24] vs −0.10 [SD, 0.25] in controls; P = .001). This corresponded to a BMI reduction of 5% or greater in 48.4% of patients and 10% or greater in 29%, compared to 3% and 1%, respectively, in the control group (P < .05). The weight loss was maintained at six months of followup (T3). There was a significant reduction in insulin levels, the HOMA-IR, triglyceride levels, systolic hypertension, and the number of prediabetic patients.

Conclusions

Liraglutide combined with LM achieved a greater reduction in the BMI z score, waist/height ratio and cardiometabolic parameters compared to the LM alone. Further research is needed to assess its long-term effects and difficulties in its implementation.