Jesper Fleischer

Liraglutide-Induced Weight Loss May be Affected by Autonomic Regulation in Type 1 Diabetes

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  • Christian Stevns Hansen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Christian Seerup Frandsen, Københavns Universitet
  • ,
  • Jesper Fleischer
  • Dorte Vistisen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Jens Juul Holst, Københavns Universitet
  • ,
  • Lise Tarnow, Københavns Universitet
  • ,
  • Filip Krag Knop, Københavns Universitet
  • ,
  • Sten Madsbad, Københavns Universitet
  • ,
  • Henrik Ullits Andersen, Steno Diabet Ctr Copenhagen, Steno Diabetes Center
  • ,
  • Thomas Fremming Dejgaard, Københavns Universitet

The role of the autonomic nervous system in the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in patients with type 1 diabetes is unknown. We assessed the association between autonomic function and weight loss induced by the GLP-1 RA liraglutide.

Methods: Lira-1 was a randomized, double-blind, placebo-controlled trial assessing the efficacy and safety of 1.8 mg liraglutide once-daily for 24 weeks in overweight patients with type 1 diabetes. Autonomic function was assessed by heart rate response to deep breathing (E/I ratio), to standing (30/15 ratio), to the Valsalva maneuver and resting heart rate variability (HRV) indices. Associations between baseline the cardiovascular autonomic neuropathy (CAN) diagnosis (> 1 pathological non-resting test) and levels of test outcomes on liraglutide-induced weight loss was assessed by linear regression models.

Results: Ninety-nine patients with mean age 48 (SD 12) years, HbA(1c) 70 (IQR 66;75) mmol/mol and BMI of 30 (SD 3) kg/m(2) were assigned to liraglutide (N = 50) or placebo (N = 49). The CAN diagnosis was not associated with weight loss. A 50% higher baseline level of the 30/15 ratio was associated with a larger weight reduction by liraglutide of -2.65 kg during the trial (95% CI: -4.60; -0.69; P = 0.009). Similar significant associations were found for several HRV indices.

Conclusions: The overall CAN diagnosis was not associated with liraglutide-induced weight loss in overweight patients with type 1 diabetes. Assessed separately, better outcomes for several CAN measures were associated with higher weight loss, indicating that autonomic involvement in liraglutide-induced weight loss may exist.

TidsskriftFrontiers in Endocrinology
Antal sider9
StatusUdgivet - 12 apr. 2019

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