ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1580159
This article is part of the Research TopicIncretin-based Therapies in the Treatment of Metabolic Syndrome: Expanding Roles Beyond Weight ManagementView all articles
Prior Metabolic Surgery Attenuates the Weight-Loss Efficacy of Liraglutide in Patients with Mild Obesity
Provisionally accepted
- 1Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
- 2Branch of National Clinical Research Center for Metabolic Diseases,, Nanjing, China
- 3Department of General Surgery, Drum Tower Hospital Affiliated to Nanjing Medical University, Nanjing, China
- 4Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Affiliated Drum Tower Hospital, Medical School, Nanjing University, Nanjing, China
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Background: Liraglutide effectively manages mild obesity, but individual weight loss outcomes vary significantly. We aimed to identify clinical predictors influencing differential treatment responses in patients with mild obesity. Methods: A retrospective analysis was conducted on 64 adults (BMI 28-32.5 kg/m²) undergoing a 12-week liraglutide intervention. Participants were categorized based on therapeutic success: those achieving composite endpoints (≥5% total weight loss [TWL] and BMI normalization to <28 kg/m²) versus suboptimal responders. Comprehensive biometric and biochemical assessments were performed, and multivariate predictive modeling was applied. Results: Responders (n=37, 75.7% female) showed significantly better metabolic outcomes than non-responders (n=27, 77.8% female), with notable differences in %TWL (11.0±3.6% vs 4.2±2.6%), total weight loss (9.04±3.32 kg vs 3.55±2.20 kg), and BMI reduction (3.3±1.1 vs 1.4±0.9 kg/m²) (all p's <.01). Responders also demonstrated improved glucolipid metabolism, and reduced metabolic-associated fatty liver disease (p <.05). Regression analysis identified a history metabolic surgery (MS) and a baseline BMI ≥30.5 kg/m² as significant negative predictors of success. Adjusted odds ratios indicated strong inverse associations, with MS history showing an OR of 6.78 (95% CI:1.95-23.61; p <.01) and elevated BMI (≥30.5 kg/m²) yielding an OR of 4.79 (95% CI: 1.46-15.71; p <.01). Conclusion: A history of MS significantly affects liraglutide's responsiveness in patients with mild obesity, emphasizing the need for personalized therapeutic strategies in post-surgical patients.These findings highlight the importance of a comprehensive medical history in guiding obesity pharmacotherapy.
Keywords: Glucagon-like peptide-1 receptor agonist, metabolic surgery, weight loss variability, Body Mass Index, metabolic adaptation
Received: 20 Feb 2025; Accepted: 30 Apr 2025.
Copyright: © 2025 Yuqin, Xiang, Hu, Chu, Tang and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhuan Feng, Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, China
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