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Published in: Obesity Surgery 1/2021

01-01-2021 | Sleep Apnea | Original Contributions

Liraglutide Augments Weight Loss After Laparoscopic Sleeve Gastrectomy: a Randomised, Double-Blind, Placebo-Control Study

Authors: Uttam Thakur, Anil Bhansali, Rajesh Gupta, Ashu Rastogi

Published in: Obesity Surgery | Issue 1/2021

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Abstract

Purpose

Both laparoscopic sleeve gastrectomy (LSG) and liraglutide cause a significant weight loss. We evaluated the effect of liraglutide in comparison with placebo on total weight loss (TWL) and excess body weight loss (EWL) and when added in initial weight loss period after LSG in obese individuals.

Material and Methods

Participants with BMI > 30 kg/m2 undergoing LSG were randomised to receive either liraglutide (subcutaneous) in increasing does of 0.6 mg/day until maximum tolerated dose of 3.0 mg (L-L group) or placebo (L-P group) from 6 weeks post-operative until 6 months. Weight, BMI, %TWL, %EWL, HbA1c, fasting plasma glucose, HOMA-IR, resolution of type 2 diabetes mellitus, hypertension, dyslipidaemia, sleep apnea and quality of life were evaluated. Primary end point was %TWL and % EWL at post-operative 6 months.

Results

Thirty participants underwent LSG, and 23 were randomised to receive liraglutide (n = 12) or placebo (n = 11).The mean dose of liraglutide in L-L group was 1.41 ± 0.49 mg/day. Patients in L-L group had %TWL of 28.2 ± 5.7 and %EWL of 58.7 ± 14.3 as compared with 23.2 ± 6.2 (p = 0.116) and 44.5 ± 8.6 (p = 0.043) in L-P group at 24 weeks, respectively. BMI decreased by 11.7 ± 3.5 in L-L group compared with 9.5 ± 4.0 in L-P group (p = 0.287). All patients with diabetes or pre-diabetes had resolution of dysglycemia in the L-L group as compared with 50% in L-P group. However, there was no significant difference in resolution of other obesity-related comorbidities between two groups at 24-week follow-up.

Conclusion

Liraglutide added early after LSG significantly augments weight loss from LSG in obese individuals.

Trial Registration

The study protocol was registered at clinical trials.​gov.​in with NCT: 04325581.
Literature
1.
go back to reference International Institute for Population Sciences. National Family Health Survey (NFHS-4) 2015–16 India. International Institute for Population Sciences (IIPS) and ICF; 2017 International Institute for Population Sciences. National Family Health Survey (NFHS-4) 2015–16 India. International Institute for Population Sciences (IIPS) and ICF; 2017
2.
go back to reference Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes. 2011;35:167–87.CrossRef Misra A, Khurana L. Obesity-related non-communicable diseases: South Asians vs White Caucasians. Int J Obes. 2011;35:167–87.CrossRef
3.
go back to reference Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653.CrossRef Albeladi B, Bourbao-Tournois C, Huten N. Short- and midterm results between laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy for the treatment of morbid obesity. J Obes. 2013;2013:934653.CrossRef
4.
go back to reference Peterli R, Wölnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265:466–73.CrossRef Peterli R, Wölnerhanssen BK, Vetter D, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265:466–73.CrossRef
5.
go back to reference Shoar S, Saber LA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Sur Obes Related Dis. 2017;13:170–80.CrossRef Shoar S, Saber LA. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Sur Obes Related Dis. 2017;13:170–80.CrossRef
6.
go back to reference Sista F, AbruzzeseV CM, Carandina S, et al. Effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study. Sur Obes Related Dis. 2017;13:7–14.CrossRef Sista F, AbruzzeseV CM, Carandina S, et al. Effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study. Sur Obes Related Dis. 2017;13:7–14.CrossRef
7.
go back to reference Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. ObesSurg. 2005;15:1024–9. Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. ObesSurg. 2005;15:1024–9.
9.
go back to reference Pi-Sunyer X, Astrup A, Fujoko K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373:11–22.CrossRef Pi-Sunyer X, Astrup A, Fujoko K, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med. 2015;373:11–22.CrossRef
10.
go back to reference Palikhe G, Gupta R, Behera BN, et al. Efficacy of laparoscopic sleeve gastrectomy and intensive medical management in obese patients with type 2 diabetes mellitus. ObesSurg. 2014;24:529. Palikhe G, Gupta R, Behera BN, et al. Efficacy of laparoscopic sleeve gastrectomy and intensive medical management in obese patients with type 2 diabetes mellitus. ObesSurg. 2014;24:529.
12.
go back to reference Rye P, Modi R, Cawsey S, et al. Efficacy of high-dose liraglutide as an adjunct for weight loss in patients with prior bariatric surgery. Obes Surg. 2018;28:3553–8.CrossRef Rye P, Modi R, Cawsey S, et al. Efficacy of high-dose liraglutide as an adjunct for weight loss in patients with prior bariatric surgery. Obes Surg. 2018;28:3553–8.CrossRef
13.
go back to reference Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRef Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRef
14.
go back to reference Chowbey PK, Dhawan K, Khullar R, et al. Laparoscopic sleeve gastrectomy: an Indian experience-surgical technique and early results. Obes Surg. 2010;20:1340–7.CrossRef Chowbey PK, Dhawan K, Khullar R, et al. Laparoscopic sleeve gastrectomy: an Indian experience-surgical technique and early results. Obes Surg. 2010;20:1340–7.CrossRef
15.
go back to reference Prasad P, Tantia O, Patle N, et al. An analysis of 1-3-year follow-up results of laparoscopic sleeve gastrectomy: an Indian perspective. Obes Surg. 2012;22:507–14.CrossRef Prasad P, Tantia O, Patle N, et al. An analysis of 1-3-year follow-up results of laparoscopic sleeve gastrectomy: an Indian perspective. Obes Surg. 2012;22:507–14.CrossRef
16.
go back to reference Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.CrossRef Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22:721–31.CrossRef
17.
go back to reference Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196:56–9.CrossRef Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196:56–9.CrossRef
18.
go back to reference Sarela A, Dexter SP, O’Kane M, et al. Long-term follow up after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2012;8:679–84.CrossRef Sarela A, Dexter SP, O’Kane M, et al. Long-term follow up after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2012;8:679–84.CrossRef
19.
go back to reference Dimitriadis GK, Randeva MS, Miras AD. Potential hormone mechanisms of bariatric surgery. CurrObes Rep. 2017;6:253–65. Dimitriadis GK, Randeva MS, Miras AD. Potential hormone mechanisms of bariatric surgery. CurrObes Rep. 2017;6:253–65.
20.
go back to reference Santilli F, Simeone PG, Guagnano MT, et al. Effect of liraglutide on weight loss, fat distribution, and beta cell function in obese subjects with prediabetes or early type 2 diabetes. Diabetes Care. 2017;40:1556–64.CrossRef Santilli F, Simeone PG, Guagnano MT, et al. Effect of liraglutide on weight loss, fat distribution, and beta cell function in obese subjects with prediabetes or early type 2 diabetes. Diabetes Care. 2017;40:1556–64.CrossRef
21.
go back to reference Mehta A, Marso SP, Neeland IJ. Liraglutide for weight management: a critical review of the evidence. Obes Sci Prac. 2017;3:3–14.CrossRef Mehta A, Marso SP, Neeland IJ. Liraglutide for weight management: a critical review of the evidence. Obes Sci Prac. 2017;3:3–14.CrossRef
22.
go back to reference Agarwal S, Garg H, Priyadarshini P, et al. Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: a case control study. WJGE. 2017;9:162.PubMed Agarwal S, Garg H, Priyadarshini P, et al. Comparative study of outcomes following laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in morbidly obese patients: a case control study. WJGE. 2017;9:162.PubMed
24.
go back to reference Gill RS, Birch DW, Shi X, et al. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis. 2010;6:707–13.CrossRef Gill RS, Birch DW, Shi X, et al. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis. 2010;6:707–13.CrossRef
25.
go back to reference Sarkhosh K, Birch DW, Shi X, et al. The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg. 2012;22:832–7.CrossRef Sarkhosh K, Birch DW, Shi X, et al. The impact of sleeve gastrectomy on hypertension: a systematic review. Obes Surg. 2012;22:832–7.CrossRef
26.
go back to reference Wihelm SM, Young J, Kale-Pradhan PB. The effect of bariatric surgery on hypertension. Ann Pharmacother. 2014;48:674–82.CrossRef Wihelm SM, Young J, Kale-Pradhan PB. The effect of bariatric surgery on hypertension. Ann Pharmacother. 2014;48:674–82.CrossRef
27.
go back to reference Alvarenga ES, Menzo EL, Szomstein S, et al. Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surg Endo. 2016;30:2673–8.CrossRef Alvarenga ES, Menzo EL, Szomstein S, et al. Safety and efficacy of 1020 consecutive laparoscopic sleeve gastrectomies performed as a primary treatment modality for morbid obesity. A single-center experience from the metabolic and bariatric surgical accreditation quality and improvement program. Surg Endo. 2016;30:2673–8.CrossRef
28.
go back to reference Zhao X, Huang K. Effect of liraglutide on blood pressure: a meta-analysis of liraglutide randomized controlled trials. BMC Endocr Disord. 2019;19:4.CrossRef Zhao X, Huang K. Effect of liraglutide on blood pressure: a meta-analysis of liraglutide randomized controlled trials. BMC Endocr Disord. 2019;19:4.CrossRef
29.
go back to reference Zhang F, Strain GW, Lei W, et al. Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2011;21:305–9.CrossRef Zhang F, Strain GW, Lei W, et al. Changes in lipid profiles in morbidly obese patients after laparoscopic sleeve gastrectomy (LSG). Obes Surg. 2011;21:305–9.CrossRef
30.
go back to reference Rastogi A, Bhansali A. SGLT2 inhibitors through the windows of EMPA-REG and CANVAS trials: a review. Diabetes Ther. 2017;8:1245–51.CrossRef Rastogi A, Bhansali A. SGLT2 inhibitors through the windows of EMPA-REG and CANVAS trials: a review. Diabetes Ther. 2017;8:1245–51.CrossRef
31.
go back to reference Bobowicz M, Lehmann A, Orlowski M, et al. Preliminary outcomes 1 year after laparoscopic sleeve gastrectomy based on Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 2011;21:1843–8.CrossRef Bobowicz M, Lehmann A, Orlowski M, et al. Preliminary outcomes 1 year after laparoscopic sleeve gastrectomy based on Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg. 2011;21:1843–8.CrossRef
Metadata
Title
Liraglutide Augments Weight Loss After Laparoscopic Sleeve Gastrectomy: a Randomised, Double-Blind, Placebo-Control Study
Authors
Uttam Thakur
Anil Bhansali
Rajesh Gupta
Ashu Rastogi
Publication date
01-01-2021
Publisher
Springer US
Published in
Obesity Surgery / Issue 1/2021
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04850-4

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