Effect of liraglutide therapy on biochemical parameters of carbohydrate metabolism and amylase activity in adolescents with obesity

Background: Obesity in adolescence is accompanied by the development of carbohydrate metabolism disorders, subclinical inflammation and changes in the functional activity of the pancreas. Glucagon-like peptide-1 (GLP-1) receptor agonists, such as liraglutide, are currently widely used to treat obesity in adolescents; however, their effects on biochemical markers of metabolic processes, in particular glucose levels, amylase activity, and inflammatory parameters, remain poorly understood.

Objective: Evaluation of the effect of 24-week liraglutide therapy on fasting glucose levels, amylase activity, C-reactive protein (CRP), and high-sensitivity CRP (hs-CRP) in obese adolescents.

Materials and methods: A single-center, open-label, prospective observational study was conducted at the State Autonomous Healthcare Institution of the Sverdlovsk Region “Children’s City Clinical Hospital No. 11” (Yekaterinburg). The study included 40 adolescents aged 12–15 years with exogenous-constitutional obesity. The main group (n=20) received liraglutide in addition to diet and physical activity, the control group (n=20) received only non-drug treatment. Laboratory parameters were assessed at baseline, after 12 and 24 weeks of therapy. To assess the therapeutic effect, the analysis of covariance (ANCOVA) model was used taking into account the group, gender, baseline glycemia level and stage of puberty.

Results: A statistically significant decrease in SDS of the body mass index was noted in the main group compared with the control group (-0.44±0.19 versus -0.07±0.14; p<0.001). Against the background of 24-week therapy with liraglutide, a statistically significant decrease in fasting glucose level was recorded in the main group compared with the control group: -0.2±0.45 mmol/l versus 0.13±0.38 mmol/l, respectively (p<0.001). Amylase activity significantly decreased in the main group (-2.05±15.19 U/L), while no changes were observed in the control group (9.85±17.46 U/L); however, the difference between the groups in changes in amylase activity was at the border of statistical significance (p=0.037; confidence interval included 0). The concentration of CRP and hs-CRP decreased in both groups, but no statistically significant differences were found between them (p>0.05).

Conclusion: Liraglutide therapy in obese adolescents for 24 weeks led to an improvement in carbohydrate metabolism parameters, expressed in a decrease in fasting glucose levels, and affected amylase activity, while changes in inflammatory markers require further study. The obtained results indicate that liraglutide can have a complex metabolic effect that goes beyond weight loss: improvement of carbohydrate metabolism, possible reduction of the metabolic load on the pancreas and modification of the inflammatory status. This emphasizes the prospects of using liraglutide as a tool for multilevel correction of metabolic disorders in adolescents with obesity.