June 24, 2015
GLP-1 Treatment Reduces Diet-Related Bone Loss in Women

Copenhagen, Denmark—Rapid weight loss can lead to loss of bone mass and an increased risk of bone fractures. Using the intestinal hormone GLP-1 in obesity treatment prevents that loss, however, according to a new study.

The study, published recently in the Journal of Clinical Endocrinology and Metabolism and also presented earlier this month at the American Diabetes Association’s Scientific Sessions in Boston, found that GLP-1 therapy also had other positive effects on the formation of new bone and on blood sugar levels.

“GLP-1 analogues like liraglutide are today widely used in the treatment of type 2 diabetes and have been shown not to increase the risk of bone fractures, unlike other diabetes drugs,” explained lead author Eva Winning Jepsen, MD, from the Department of Biomedical Sciences and the Novo Nordisk Foundation Center for Basic Metabolic Research at the University of Copenhagen. “Liraglutide has just been approved for obesity treatment because of its appetite-inhibiting effects, but its effect on the bones of overweight patients who are not suffering from type 2 diabetes has so far been unknown.”

For the study, researchers focused on 37 women who achieved a large weight loss of 12 kg by eating a low-calorie diet. Participants were divided into two groups: a control group and one receiving the GLP-1 analogue liraglutide.

Over a 1-year study period, the women were offered dietary advice to help them maintain their weight loss and given the opportunity to replace up to two meals with a low-calorie powder if their weight went up. Both groups had maintained their weight loss after a year.

Total, pelvic and arm-leg bone mineral content (BMC) and bone markers (CTX-1 and P1NP) were investigated before and after weight loss and after 52 weeks weight maintenance. The control group was found to have lost bone mass, while the liraglutide group not only maintained bone mass but had also increased blood levels of bone formation markers 16%.

In fact, results indicate that total and arm-leg BMC loss was four times greater in the control group compared to the liraglutide group, which did now show significant bone loss.

“Menopausal women have an increased risk of osteoporosis and bone fractures. If they try to lose weight and thus lose even more bone mass, they are at an even higher risk,” said Associate Professor Signe Soerensen Torekov, who is heading the University of Copenhagen study. “The study shows that overweight women can now lose weight with liraglutide without increasing the risk of losing bone mass. At the same time, they also achieve a number of other positive effects on their sugar metabolism which are not achieved through a diet-induced weight loss alone.”

Torekov noted that the importance of intestinal hormones on bone formation and breakdown has long been a focus area, adding, “Overweight is a protective factor for osteoporosis and bone fractures, but it increases the risk of other diseases such as cardiovascular diseases and type 2 diabetes. It appears that treatment with liraglutide makes it possible to lose weight and maintain the beneficial effect on the bones, while at the same time reducing the risk of cardiovascular disease and type 2 diabetes. This may have a significant bearing on our future approach to obesity treatment.”

U.S. Pharmacist Social Connect