Abstract
To clarify the distinct effects of a long-acting (liraglutide) and a short-acting (lixisenatide) glucagon-like peptide-1 receptor agonist (GLP-1 RA) on macronutrient intake, gastrointestinal side effects and pancreas function. Fifty participants were randomized to either lixisenatide or liraglutide for a treatment period of 10 weeks. Appetite, satiety, macronutrient intake, gastrointestinal symptoms and variables related to pancreatic function and gastric emptying were assessed at baseline and after treatment. Both GLP-1 RAs reduced macronutrient intake similarly. Weight loss and appetite reduction were not related to the delay in gastric emptying or gastrointestinal side effects (P> .05). Lipase increased significantly with liraglutide treatment (by 18.3± 4.1U/L; P= .0001), but not with lixisenatide (-1.8± 2.4U/L; P= .46). Faecal elastase and serum ß-carotin levels (indicators for exocrine pancreas function) improved in both groups (P< .05). Changes in lipase activities did not correlate with gastrointestinal symptoms (P> .05 for each variable). Both GLP-1 RAs comparably affected body weight, energy and macronutrient intake. Both treatments were associated with indicators of improved exocrine pancreas function. Reductions in appetite and body weight as a result of treatment with short- or long-acting GLP-1 RAs are not driven by changes in gastric emptying or gastrointestinal side effects.
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