Predictors of weight-loss response with glucagon-like peptide-1 receptor agonist treatment among adolescents with severe obesity.
Predictors of weight-loss response with glucagon-like peptide-1 receptor agonist treatment among adolescents with severe obesity.
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DOI：
10.1111/cob.12128
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发表时间：
2016-02
期刊：
影响因子：
3.3
通讯作者：
Kelly AS
中科院分区：
文献类型：
--
作者：
Nathan BM;Rudser KD;Abuzzahab MJ;Fox CK;Coombes BJ;Bomberg EM;Kelly AS
在之前的两项独立的临床试验中，我们证明了艾塞那肽对严重肥胖青少年的BMI有显著降低。在本研究中，我们汇集了这些几乎相同的试验的数据，以评估可能预测3个月时BMI下降的因素。数据来自32例患者（平均年龄14.3±2.2岁，69%为女性，平均BMI 39.8±5.8 kg/m2）。艾塞那肽治疗包括5微克，每天两次，持续1个月，随后增加到10微克，每天两次，再持续2个月。预测变量包括基线BMI、1个月BMI变化百分比、恶心/呕吐发生率、基线食欲和饱腹感测量。在预测子组中，使用广义估计方程估计BMI从基线变化百分比的治疗效果，该方程具有可交换的工作相关性和可靠方差估计置信区间和p值，以解释成对观察。与安慰剂相比，合并数据治疗对3个月时绝对BMI的影响为- 3.42% [95% CI: - 5.41%, - 1.42%]。在接受治疗的参与者中，基线时的食欲（治疗效果高[- 4.28%]vs.低[1.02%],p=0.028）和性别（女性治疗效果[- 4.78%]vs.男性治疗效果[0.76%],p=0.007）是3个月时BMI变化的显著预测因素。基线BMI、1个月时BMI百分比变化、年龄、恶心、呕吐或其他胃肠道症状的发生率和饱腹感评分不能预测3个月的反应。性别和食欲指标可作为严重肥胖青少年胰高血糖素样肽-1受体激动剂治疗反应的有用预测因子。
In two previous, separate clinical trials, we demonstrated significant reductions in BMI with exenatide in adolescents with severe obesity. In the present study, we pooled data from these near identical trials to evaluate factors that may predict BMI reduction at 3 months. Data from 32 patients (mean age 14.3±2.2 years; 69% female; mean BMI 39.8±5.8 kg/m2) were included. Exenatide treatment consisted of 5 mcg twice daily for 1 month, followed by an increase to 10 mcg twice daily for 2 additional months. Predictor variables included baseline BMI, BMI percent change at 1 month, incidence of nausea/vomiting, and baseline appetite and satiety measures. Treatment effects of percent change in BMI from baseline were estimated within predictor subgroups using generalized estimating equations with exchangeable working correlation and robust variance estimation for confidence intervals and P-values to account for paired observations. The pooled data treatment effect on absolute BMI at 3 months was −3.42% [95% CI: −5.41%, −1.42%] compared to placebo. Within treated participants, appetite at baseline (treatment effect in high [−4.28%] vs. low [1.02%], p=0.028) and sex (treatment effect in female [−4.78%] vs. male [0.76%], p=0.007) were significant predictors of change in BMI at 3 months. Baseline BMI, BMI percent change at 1 month, age, incidence of nausea, vomiting, or other gastrointestinal symptoms, and satiety scores did not predict 3 month responses. Sex and measures of appetite may serve as useful predictors of glucagon-like peptide-1 receptor agonist treatment response among adolescents with severe obesity.