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GLP-1 Receptor Agonists Reduce Bone Loss During Weight Loss

A new study shows liraglutide mitigates the bone loss common with low calorie diets…

Weight loss is frequently tied to reduced bone mass in adults who embark on a low calorie diet, putting them at increased risk of fractures following significant weight reduction. Furthermore, the reduction in bone mass does not reverse if weight is regained. A new study from the University of Copenhagen shows that liraglutide reduced bone loss when given daily for one year following significant weight loss.

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Thirty-seven women who had lost an average of 12% body weight over the previous eight weeks were studied, with 18 receiving 1.2 mg of liraglutide daily, along with weight maintenance counseling, while 19 received weight maintenance counseling only. After one year, both groups had maintained their weight loss, but the control group had lost a significant amount of total bone mineral content (BMC) from baseline (-35.8 ± 73.8 g, p<0.0001), while the liraglutide group did not (-9.2 ± 7.5 g, p = 0.2).

“The total BMC loss was four times greater in the control group compared to the liraglutide group, indicating that the sustained weight loss had a negative impact on bone, which was diminished in the liraglutide group,” the authors write.

Serum levels of bone formation markers P1NP and osteocalcin increased in the liraglutide group by 16% (p = 0.02) and 11% (p = 0.048) respectively, while the control group experienced insignificant changes in these markers (p values were 0.8 and 0.1 respectively). Furthermore, the reduction of BMC was dependent on the increase in P1NP levels, leading researchers to suggest that liraglutide’s positive BMC effects were due to increasing bone formation.

Author Signe S. Torekov, an associate professor at the University of Copenhagen, states, “The study shows that overweight women can now lose weight with liraglutide without increasing the risk of losing bone mass. At the same times, they also achieve a number of other positive effects on their sugar metabolism, which are not achieved through a diet-induced weight loss alone.”

While diabetics were not included in the study, liraglutide and other GLP-1 receptor agonists can play an important role in treating obesity occurring with type 2 diabetes, as they have the triple benefit of improving glycemic control, helping with weight loss, and preventing its associated bone loss.

Practice Pearls:

  • Losing weight often comes with the side effect of losing bone mass.
  • Loss of bone mass puts patients at risk of fractures, osteoporosis and their ensuing complications.
  • GLP-1 RAs may help patients lose weight without losing bone mass.

Iepsen EW, Lundgren JR. “GLP-1 receptor agonist treatment increases bone formation and prevents bone loss in weight-reduced obese women.” J Clin Endocrinol Metab. Published online 04 June 2015.