Skip to main content
SpringerLink
Log in

Liraglutide and obesity in elderly: efficacy in fat loss and safety in order to prevent sarcopenia. A perspective case series study

  • Original Article
  • Published:
Aging Clinical and Experimental Research Aims and scope Submit manuscript

Abstract

Background

For the growing numbers of obese elderly with diabetes, the glucagon-like peptide-1 (GLP-1) receptor analogue (liraglutide) appears a safe way to promote and maintain substantial weight loss. Given this background, the aim of this study was to assess the effect of the liraglutide treatment, at doses up to 3.0 mg per day, on the body composition, focusing on sarcopenia, in overweight and obese elderly with type 2 diabetes mellitus (T2DM).

Methods

A perspective study was carried out in overweight and obese T2DM patients with HbA1c equal to 7.0 % (53 mmol/mol) ~10.0 % (86), under 3-month treatment (at least) of maximal dose of metformin at stable regime, and additional liraglutide at doses up to 3.0 mg per day. Body composition markers such as skeletal muscle index (SMI), android and gynoid fat mass, and arms and legs fat free mass, was measured by dual-energy X-ray densitometry (DXA) at baseline and after 24 weeks of liraglutide treatment. Glucose control was also carried out by glucose and HbA1c.

Results

Nine subjects (male/female 6/3, mean age 68.22 ± 3.86 years, BMI 32.34 ± 4.89 kg/m2) were evaluated. We noted a median decrease in BMI (−0.78 kg/m2), weight (−2000 g), fat mass (−1498 g) and android fat (−0.9 %), and a increase in SMI (+0.03 kg/m2) from baseline. Glycemic control also improved, with a median change HbA1c of −0.80 %.

Conclusions

Twenty-four weeks of liraglutide treatment was associated with reductions in fat mass and android fat. In addition, in order to prevent sarcopenia, it preserved the muscular tropism.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Han TS, Wu FCW, Lean MEJ (2003) Obesity and weight management in the elderly: a focus on men. Best Pract Res Clin Endocrinol Metab 27:509–525

    Article  Google Scholar 

  2. Drucker DJ, Philippe J, Mojsov S et al (1987) Glucagon-like peptide I stimulates insulin gene expression and increases cyclic AMP levels in a rat islet cell line. Proc Natl Acad Sci 84:3434–3438

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Stoffers DA, Kieffer TJ, Hussain MA et al (2000) Insulinotropic glucagon-like peptide 1 agonists stimulate expression of homeodomain protein IDX-1 and increase islet size in mouse pancreas. Diabetes 49:741–748

    Article  CAS  PubMed  Google Scholar 

  4. Doyle ME, Egan JM (2007) Mechanisms of action of glucagon-like peptide 1 in the pancreas. Pharmacol Ther 113:546–593

    Article  CAS  PubMed  Google Scholar 

  5. Buteau J (2008) GLP-1 receptor signaling: effects on pancreatic beta-cell proliferation and survival. Diab Metab 34:73–77

    Article  Google Scholar 

  6. Werner U, Haschke G, Herling AW et al (2010) Pharmacological profile of lixisenatide: a new GLP-1 receptor agonist for the treatment of type 2 diabetes. Rev Regulat Peptides 164:58–64

    Article  CAS  Google Scholar 

  7. Nikolaidis LA, Elahi D, Hentosz T et al (2004) Recombinant glucagonlike peptide-1 increases myocardial glucose uptake and improves left ventricular performance in conscious dogs with pacing-induced dilated cardiomyopathy. Circulation 110:955–961

    Article  CAS  PubMed  Google Scholar 

  8. Zhao T, Parikh P, Bhashyam S et al (2006) Direct effects of glucagonlike peptide-1 on myocardial contractility and glucose uptake in normal and postischemic isolated rat hearts. J Pharmacol Exp Ther 317:1106–1113

    Article  CAS  PubMed  Google Scholar 

  9. Basu A, Charkoudian N, Schrage W et al (2007) Beneficial effects of GLP-1 on endothelial function in humans: dampening by glyburide but not by glimepiride. Am J Physiol Endocrinol Metab 293:E1289–E1295

    Article  CAS  PubMed  Google Scholar 

  10. Nyström T (2008) The potential beneficial role of glucagon-like peptide-1 in endothelial dysfunction and heart failure associated with insulin resistance. Horm Metab Res 40:593–606

    Article  CAS  PubMed  Google Scholar 

  11. Chai W, Dong Z, Wang N et al (2012) Glucagon-like peptide. Recruits microvasculature and increases glu cose use in muscle via a nitric oxide-dependent mechanism. Diabetes 61:888–896

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Luque MA, González N, Márquez L et al (2002) Glucagon-like peptide-1 (GLP-1) and glucose metabolism in human myocytes. J Endocrinol 173:465–473

    Article  CAS  PubMed  Google Scholar 

  13. Acitores A, Gonzalez N, Sancho V et al (2004) Cell signalling of glucagon-like peptide-1 action in rat skeletal muscle. J Endocrinol 180:389–398

    Article  CAS  PubMed  Google Scholar 

  14. Gonzalez N, Acitores A, Sancho V et al (2005) Effect of GLP-1 on glucose transport and its cell signalling in human myocytes. Regul Pept 126:203–211

    Article  CAS  PubMed  Google Scholar 

  15. Green CJ, Henriksen TI, Pedersen BK et al (2012) Glucagon-like peptide-1-induced glucose metabolism in differentiated human muscle satellite cells is attenuated by hyperglycemia. PloS One 7:e44284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Washburn RA, Smith KW, Jette AM et al (1993) The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol 46:153–162

    Article  CAS  PubMed  Google Scholar 

  17. Janssen I, Baumgartner RN, Ross R et al (2004) Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol 159:413–421

    Article  PubMed  Google Scholar 

  18. Baumgartner RN, Koehler KM, Gallagher D et al (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147:755–763

    Article  CAS  PubMed  Google Scholar 

  19. Lu N, Sun H, Yu J et al (2015) Glucagon-like peptide-1 receptor agonist Liraglutide has anabolic bone effects in ovariectomized rats without diabetes. PloSone 10:e0132744

    Article  CAS  Google Scholar 

  20. Cetrone M, Mele A, Tricarico D (2104) Effects of the antidiabetic drugs on the age-related atrophy and sarcopenia associated with diabetes type II. Curr diabetes rev 10:231–237

    Article  CAS  Google Scholar 

  21. Green CJ, Henriksen TI, Pedersen BK et al (2012) Glucagon like peptide-1-induced glucose metabolism in differentiated human muscle satellite cells is attenuated by hyperglycemia. PloS One 7:e44284

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Yamamoto K, Amako M, Yamamoto Y et al (2013) therapeutic effect of exendin-4, a long-acting analogue of glucagon-like peptide-1 receptor agonist, on nerve regeneration after the crush nerve injury. Biomed Res Int 2013:315848

    PubMed  PubMed Central  Google Scholar 

  23. Jendle J, Nauck MA, Matthews DR et al (2009) Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue. Diabetes Obes Metab 11:1163–1172

    Article  CAS  PubMed  Google Scholar 

  24. Inoue K, Maeda N, Kashine S et al (2011) Short-term effects of liraglutide on visceral fat adiposity, appetite, and food preference: a pilot study of obese Japanese patients with type 2 diabetes. Cardiovasc Diabetol 10:109

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Nauck M, Frid A, Hermansen K et al (2009) Efficacy and safety comparison of liraglutide, glimepiride, and placebo, all in combination with metformin, in type 2 diabetes: the LEAD (liraglutide effect and action in diabetes)-2 study. Diabetes Care 32:84–90

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Li CJ, Yu Q, Yu P et al (2014) Changes in liraglutide-induced body composition are related to modifications in plasma cardiac natriuretic peptides levels in obese type 2 diabetic patients. Cardiovasc Diabetol 13:36

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Wannamethee SG, Shaper AG, Lennon L et al (2007) Decreased muscle mass and increased central adiposity are independently related to mortality in older men. Am J Clin Nutr 86:1339–1346

    CAS  PubMed  Google Scholar 

  28. Bode BW, Brett J, Falahati A et al (2011) Comparison of the efficacy and tolerability profile of liraglutide, a once-daily human GLP-1 analog, in patients with type 2 diabetes ≥65 and <65 years of age: a pooled analysis from phase III studies. Am J Geriatr Pharmacother 9:423–433

    Article  CAS  PubMed  Google Scholar 

  29. Peters KR (2013) Liraglutide for the treatment of type 2 diabetes: a clinical update. Am J Ther 20:178–188

    Article  PubMed  Google Scholar 

  30. Elashoff M, Matveyenko AV, Gier B et al (2011) Pancreatitis, pancreatic, and thyroid cancer with glucagon-like peptide-1-based therapies. Gastroenterology 141:150–156

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Knezevich E, Crnic T, Kershaw S et al (2012) Liraglutide-associated acute pancreatitis. Am J Health Syst Pharm 69:386–389

    Article  CAS  PubMed  Google Scholar 

  32. Korkmaz H, Araz M, Alkan S et al (2015) Liraglutide-related cholelithiasis. Aging Clin Exp

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Public Health, Experimental and Forensic Medicine, Section of Human Nutrition, Endocrinology and Dietetics, University of Pavia, Azienda di Servizi alla Persona di Pavia ‘‘Istituto Santa Margherita’’, Via Emilia 12, Pavia, Italy

    Simone Perna, Davide Guido, Chiara Bologna, Antonio Isu & Mariangela Rondanelli

  2. Department of Internal Medicine, Section of Geriatrics and Gerontology, University of Pavia, Azienda di Servizi alla Persona ‘‘Istituto Santa Margherita’’, Pavia, Italy

    Sebastiano Bruno Solerte & Fabio Guerriero

  3. Department of Public Health, Experimental and Forensic Medicine, Biostatistics and Clinical Epidemiology Unit, University of Pavia, Pavia, Italy

    Davide Guido

Authors
  1. Simone Perna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Davide Guido
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Bologna
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sebastiano Bruno Solerte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fabio Guerriero
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonio Isu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mariangela Rondanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simone Perna.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interests regarding the publication of this paper.

Ethical approval

The study was approved by the regional ethics committee at University of Pavia and was therefore performed in accordance with the ethical standards laid own in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All subjects provided written consent to participate.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perna, S., Guido, D., Bologna, C. et al. Liraglutide and obesity in elderly: efficacy in fat loss and safety in order to prevent sarcopenia. A perspective case series study. Aging Clin Exp Res 28, 1251–1257 (2016). https://doi.org/10.1007/s40520-015-0525-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-015-0525-y

Keywords

Search

Navigation