Prandial subcutaneous injections of glucagon-like peptide-1 cause weight loss in obese human subjects

Br J Nutr. 2004 Mar;91(3):439-46. doi: 10.1079/BJN20031064.

Abstract

Recombinant glucagon-like peptide-1 (7-36)amide (rGLP-1) was recently shown to cause significant weight loss in type 2 diabetics when administered for 6 weeks as a continuous subcutaneous infusion. The mechanisms responsible for the weight loss are not clarified. In the present study, rGLP-1 was given for 5 d by prandial subcutaneous injections (PSI) (76 nmol 30 min before meals, four times daily; a total of 302.4 nmol/24 h) or by continuous subcutaneous infusion (CSI) (12.7 nmol/h; a total of 304.8 nmol/24 h). This was performed in nineteen healthy obese subjects (mean age 44.2 (sem 2.5) years; BMI 39.0 (sem 1.2) kg/m(2)) in a prospective randomised, double-blind, placebo-controlled, cross-over study. Compared with the placebo, rGLP-1 administered as PSI and by CSI generated a 15 % reduction in mean food intake per meal (P=0.02) after 5 d treatment. A weight loss of 0.55 (sem 0.2) kg (P<0.05) was registered after 5 d with PSI of rGLP-1. Gastric emptying rate was reduced during both PSI (P<0.001) and CSI (P<0.05) treatment, but more rapidly and to a greater extent with PSI of rGLP-1. To conclude, a 5 d treatment of rGLP-1 at high doses by PSI, but not CSI, promptly slowed gastric emptying as a probable mechanism of action of increased satiety, decreased hunger and, hence, reduced food intake with an ensuing weight loss.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Over Studies
  • Double-Blind Method
  • Eating / drug effects
  • Feeding Behavior / drug effects
  • Female
  • Gastric Emptying / drug effects
  • Glucagon / administration & dosage
  • Glucagon / adverse effects
  • Glucagon / therapeutic use*
  • Glucagon-Like Peptide 1
  • Humans
  • Hunger / drug effects
  • Infusions, Parenteral
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Obesity / blood
  • Obesity / drug therapy*
  • Obesity / physiopathology
  • Peptide Fragments / administration & dosage
  • Peptide Fragments / adverse effects
  • Peptide Fragments / therapeutic use*
  • Protein Precursors / administration & dosage
  • Protein Precursors / adverse effects
  • Protein Precursors / therapeutic use*
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Satiation / drug effects
  • Thirst / drug effects
  • Weight Loss / drug effects*

Substances

  • Peptide Fragments
  • Protein Precursors
  • Recombinant Proteins
  • Glucagon-Like Peptide 1
  • Glucagon