Liraglutide-induced weight loss may be affected by autonomic regulation in type 1 diabetes

Christian Stevns Hansen, Christian Seerup Frandsen, Jesper Fleischer, Dorte Vistisen, Jens Juul Holst, Lise Tarnow, Filip Krag Knop, Sten Madsbad, Henrik Ullits Andersen, Thomas Fremming Dejgaard

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstrakt

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, HbA1c 70 (IQR 66;75) mmol/mol and BMI of 30 (SD 3) kg/m2were 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.

OriginalsprogEngelsk
Artikelnummer242
Sider (fra-til)242
TidsskriftFrontiers in Endocrinology
Vol/bind10
Udgave nummerAPR
DOI
StatusUdgivet - 1 jan. 2019
Udgivet eksterntJa

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