The aim of the present study is to compare the efficacy of liraglutide vs. naltrexone/bupropion on metabolic and cardiovascular risk markers, weight loss, as well as the postprandial secretion of gastrointestinal hormones involved in hunger and satiety, after a test meal. The study will include 40 patients, who will further be divided into two treatment groups (20 patients on liraglutide vs. 20 patients on naltrexone/bupropion). The patients will be examined at baseline, 3 and 6 months after the treatment initiation.
This is a prospective study of patients aged ≥18 years, who are overweight (BMI ≥ 27 kg / m2 in the presence of dyslipidemia or hypertension or obstructive sleep apnea or fatty infiltration or prediabetes) or obese patients (BMI ≥ 30 kg / m2). Patients' data will be collected before starting medication (time 0) and at 3 and 6 months under treatment in the clinical practice of the selected drug, as described in the drug's package leaflet, along with a simultaneous dietary intervention and exercise. Patient groups will be comparable in age, gender and BMI. The aim of the study is the comparison of the efficacy of liraglutide vs. naltrexone/bupropion in metabolic and cardiovascular markers. The following parameters will be measured: * Weight, height, waist and hip circumference * 24-hour recording of blood pressure and heart rate * HbA1c, total cholesterol, LDL, HDL, urine albumin/creatinine ratio * Bioelectric impedance for determination of total and visceral fat and muscle mass Indirect calorimetry for the determination of resting metabolic rate and total energy expenditure * Determination of baroreflex sensitivity (BRS) and heart rate variability (HRV) to investigate the function of the autonomic nervous system * Blood sample test meal at 0, 30, 60, 90, 120, 150 and 180 min to determine insulin concentration and gastrointestinal hormones involved in hunger and satiety with modern indirect calorimetry to determine postprandial thermogenic analog scales (VAS) * Neuropathy tests * Assessment of quality of life with the SF-36 questionnaire and assessment of the feeling of hunger and satiety * Echocardiographic determination of the left systolic and telodiastolic diameter of the left ventricle, cardiac fat and the Tei index at times 0 and 6 months with medication * Pericardial fat
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
3 mg of sc liraglutide daily plus lifestyle intervention
32/360 mg of oral lnaltrexone-bupropion daily plus lifestyle intervention
First Department of Propaedeutic Internal Medicine
Athens, Greece
RECRUITINGChanges in blood pressure
Blood pressure as assessed by 24-hour recording (numerical scale)
Time frame: 3 and 6 months
Weight loss
Percentage of weight lost will be measured by an electronic scale (numerical scale)
Time frame: 3 and 6 months
Changes in glycemic
Measurement of HbA1c will be measured biochemically (numerical scale)
Time frame: 3 and 6 months
Changes in lipemic profile
Total cholesterol, Triglycerides, LDL-C, HDL-C will be measured biochemically (numerical scale)
Time frame: 3 and 6 months
Percentage of visceral fat
Measurement of visceral fat by bioimpedance analysis (numerical scale)
Time frame: 3 and 6 months
Fat mass
Measurement of fat mass by bioimpedance analysis (numerical scale)
Time frame: 3 and 6 months
Fat free mass
Measurement of fat free mass by bioimpedance analysis (numerical scale)
Time frame: 3 and 6 months
Autonomic nervous system function
Measurement of heart rate variability will be measured through Ewing score and Spectral analysis testing (numerical scale)
Time frame: 3 and 6 months
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TREATMENT
Masking
NONE
Enrollment
40
Changes in meal induced thermogenesis
Measurement through indirect calorimetry and assessment of changes in Resting Metabolic Rate (RMR) (numerical scale)
Time frame: 3 and 6 months
Changes in gut hormones involved in appetite regulation
Measurement in plasma before and after the intervention during a mixed meal test will be measured through ELISA kits (numerical scale)
Time frame: 3 and 6 months