Research in brief

Abstract

Liraglutide for weight lossResearchers have investigated the effects of liraglutide on weight loss in overweight and obese people without diabetes. In a double-blind clinical trial, researchers randomly assigned 2487 participants to liraglutide (3 mg daily) and 1244 to placebo. Counselling about lifestyle modification was delivered to both groups. At the end of the 56 week trial, mean change in body weight was −8·4 kg (SD 7·3) with liraglutide and −2·8 kg (SD 6·5) in the placebo group (difference −5·6 kg, 95% CI −6·0 to −5·1, p<0·001). The proportion of patients achieving a reduction in bodyweight of at least 5% or of more than 10% of their bodyweight was greater in the active treatment group than in the placebo group (63·2% vs 27·1% and 33·1% vs 10·6%; p<0·001 for both comparisons). Gastrointestinal adverse events led to 159 (6·4%) of 2481 participants who received liraglutide to withdraw from the study compared with 9 (0·7%) of 1242 participants who received placebo.Pituitary tumours in MEN1The authors of a Dutch cohort study provide insight into the long-term course of multiple endocrine neoplasia type 1 (MEN1)-associated pituitary tumours. From a total of 323 patients with MEN1, researchers identified 123 as having pituitary tumours. Almost half of the tumour cases (57 of 123) were diagnosed before MEN1 was diagnosed. More than half (66 of 123) of the tumours were diagnosed at screening. 52 pituitary tumours were non-functioning, 35 of which were detected at screening. Most (32 of 35) of the non-functioning tumours identified at screening did not need any treatment during a median of 5·3 years follow-up. Of 71 hypersecreting pituitary tumours diagnosed, 52 (73%) were prolactinomas, 34 of which were treated at diagnosis, with more than 90% of patients attaining hormonal control during a median of 13·8 years follow-up.Cardiovascular safety of sitagliptinResearchers for the TECOS study have investigated the long term effects of sitagliptin on cardiovascular outcomes. In the trial, patients with type 2 diabetes and cardiovascular disease were randomly allocated placebo (n=7339) or sitagliptin (n=7332), with open-label use of other glucose lowering therapy as appropriate. After a median follow-up of 3 years (IQR 2·3–3·8), there was no significant difference between the groups with respect to the primary endpoint of composite cardiovascular outcome (hazard ratio 0·98, 95% CI 0·88–1·09, p<0·001 for non-inferiority). Rates of hospital admission for heart failure did not differ between the two groups.Fracture risk and serotonergic antidepressantsThe risks of fracture in association with SSRI and SNRIs are highlighted in a cohort study using data from a Taiwanese health insurance database. The population consisted of people who had received three or more prescriptions for an antidepressant. Data for 8250 fracture cases and 33 000 matched controls were analysed. Current users of SSRIs or SNRIs had a higher risk of fracture than did non-users—ie, those with no prescription for antidepressants within 1 year before the index date (adjusted odds ratio 1·16, 95% CI 1·07–1·25, p<0·001). In crude analysis, current users of only SSRIs or SNRIs alone were at increased risk of fracture compared with controls, although significance was lost in the adjusted analysis.Healthy environments and type 2 diabetesUsing data from the MESA cohort, researchers have assessed associations between neighbourhood environments and development of type 2 diabetes. During a median of 8·9 years follow-up, of the 5124 individuals who were free from diabetes at baseline, 616 (12%) developed type 2 diabetes. In models also adjusted for socioeconomic status, exposure to a neighbourhood environment with more resources for physical activity (assessed by survey methods) was associated with a reduced risk of incident type 2 diabetes (adjusted hazard ratio per interquartile range increase in exposure 0·80, 95% CI 0·70–0·92). Increased exposure to healthy food resources (assessed by survey methods) was also associated with a reduced risk of type 2 diabetes (0·88, 0·78–0·98). The authors noted that the results varied according to the method of exposure assessment.The DALI lifestyle pilot trialThe effects of different lifestyle interventions for prevention of gestational diabetes were investigated in a multicentre pilot trial. 150 women (less than 20 weeks gestation) with a BMI of 29 kg/m2 or more before pregnancy were randomly allocated to five coaching sessions of healthy eating, physical activity, or a combination of both—four optional telephone sessions were offered to all participants. At 35–37 weeks gestation, compared with the physical activity group, weight gain (adjusted difference −1·6 kg, 95% CI −3·0 to −0·2, p=0·02) and fasting glucose (−0·3 mmol/L, −0·4 to −0·1, p=0.01) were lower in the healthy eating group. No differences between the combined treatment and the individual treatments were identified. Liraglutide for weight lossResearchers have investigated the effects of liraglutide on weight loss in overweight and obese people without diabetes. In a double-blind clinical trial, researchers randomly assigned 2487 participants to liraglutide (3 mg daily) and 1244 to placebo. Counselling about lifestyle modification was delivered to both groups. At the end of the 56 week trial, mean change in body weight was −8·4 kg (SD 7·3) with liraglutide and −2·8 kg (SD 6·5) in the placebo group (difference −5·6 kg, 95% CI −6·0 to −5·1, p<0·001). The proportion of patients achieving a reduction in bodyweight of at least 5% or of more than 10% of their bodyweight was greater in the active treatment group than in the placebo group (63·2% vs 27·1% and 33·1% vs 10·6%; p<0·001 for both comparisons). Gastrointestinal adverse events led to 159 (6·4%) of 2481 participants who received liraglutide to withdraw from the study compared with 9 (0·7%) of 1242 participants who received placebo. Researchers have investigated the effects of liraglutide on weight loss in overweight and obese people without diabetes. In a double-blind clinical trial, researchers randomly assigned 2487 participants to liraglutide (3 mg daily) and 1244 to placebo. Counselling about lifestyle modification was delivered to both groups. At the end of the 56 week trial, mean change in body weight was −8·4 kg (SD 7·3) with liraglutide and −2·8 kg (SD 6·5) in the placebo group (difference −5·6 kg, 95% CI −6·0 to −5·1, p<0·001). The proportion of patients achieving a reduction in bodyweight of at least 5% or of more than 10% of their bodyweight was greater in the active treatment group than in the placebo group (63·2% vs 27·1% and 33·1% vs 10·6%; p<0·001 for both comparisons). Gastrointestinal adverse events led to 159 (6·4%) of 2481 participants who received liraglutide to withdraw from the study compared with 9 (0·7%) of 1242 participants who received placebo. Pituitary tumours in MEN1The authors of a Dutch cohort study provide insight into the long-term course of multiple endocrine neoplasia type 1 (MEN1)-associated pituitary tumours. From a total of 323 patients with MEN1, researchers identified 123 as having pituitary tumours. Almost half of the tumour cases (57 of 123) were diagnosed before MEN1 was diagnosed. More than half (66 of 123) of the tumours were diagnosed at screening. 52 pituitary tumours were non-functioning, 35 of which were detected at screening. Most (32 of 35) of the non-functioning tumours identified at screening did not need any treatment during a median of 5·3 years follow-up. Of 71 hypersecreting pituitary tumours diagnosed, 52 (73%) were prolactinomas, 34 of which were treated at diagnosis, with more than 90% of patients attaining hormonal control during a median of 13·8 years follow-up. The authors of a Dutch cohort study provide insight into the long-term course of multiple endocrine neoplasia type 1 (MEN1)-associated pituitary tumours. From a total of 323 patients with MEN1, researchers identified 123 as having pituitary tumours. Almost half of the tumour cases (57 of 123) were diagnosed before MEN1 was diagnosed. More than half (66 of 123) of the tumours were diagnosed at screening. 52 pituitary tumours were non-functioning, 35 of which were detected at screening. Most (32 of 35) of the non-functioning tumours identified at screening did not need any treatment during a median of 5·3 years follow-up. Of 71 hypersecreting pituitary tumours diagnosed, 52 (73%) were prolactinomas, 34 of which were treated at diagnosis, with more than 90% of patients attaining hormonal control during a median of 13·8 years follow-up. Cardiovascular safety of sitagliptinResearchers for the TECOS study have investigated the long term effects of sitagliptin on cardiovascular outcomes. In the trial, patients with type 2 diabetes and cardiovascular disease were randomly allocated placebo (n=7339) or sitagliptin (n=7332), with open-label use of other glucose lowering therapy as appropriate. After a median follow-up of 3 years (IQR 2·3–3·8), there was no significant difference between the groups with respect to the primary endpoint of composite cardiovascular outcome (hazard ratio 0·98, 95% CI 0·88–1·09, p<0·001 for non-inferiority). Rates of hospital admission for heart failure did not differ between the two groups. Researchers for the TECOS study have investigated the long term effects of sitagliptin on cardiovascular outcomes. In the trial, patients with type 2 diabetes and cardiovascular disease were randomly allocated placebo (n=7339) or sitagliptin (n=7332), with open-label use of other glucose lowering therapy as appropriate. After a median follow-up of 3 years (IQR 2·3–3·8), there was no significant difference between the groups with respect to the primary endpoint of composite cardiovascular outcome (hazard ratio 0·98, 95% CI 0·88–1·09, p<0·001 for non-inferiority). Rates of hospital admission for heart failure did not differ between the two groups. Fracture risk and serotonergic antidepressantsThe risks of fracture in association with SSRI and SNRIs are highlighted in a cohort study using data from a Taiwanese health insurance database. The population consisted of people who had received three or more prescriptions for an antidepressant. Data for 8250 fracture cases and 33 000 matched controls were analysed. Current users of SSRIs or SNRIs had a higher risk of fracture than did non-users—ie, those with no prescription for antidepressants within 1 year before the index date (adjusted odds ratio 1·16, 95% CI 1·07–1·25, p<0·001). In crude analysis, current users of only SSRIs or SNRIs alone were at increased risk of fracture compared with controls, although significance was lost in the adjusted analysis. The risks of fracture in association with SSRI and SNRIs are highlighted in a cohort study using data from a Taiwanese health insurance database. The population consisted of people who had received three or more prescriptions for an antidepressant. Data for 8250 fracture cases and 33 000 matched controls were analysed. Current users of SSRIs or SNRIs had a higher risk of fracture than did non-users—ie, those with no prescription for antidepressants within 1 year before the index date (adjusted odds ratio 1·16, 95% CI 1·07–1·25, p<0·001). In crude analysis, current users of only SSRIs or SNRIs alone were at increased risk of fracture compared with controls, although significance was lost in the adjusted analysis. Healthy environments and type 2 diabetesUsing data from the MESA cohort, researchers have assessed associations between neighbourhood environments and development of type 2 diabetes. During a median of 8·9 years follow-up, of the 5124 individuals who were free from diabetes at baseline, 616 (12%) developed type 2 diabetes. In models also adjusted for socioeconomic status, exposure to a neighbourhood environment with more resources for physical activity (assessed by survey methods) was associated with a reduced risk of incident type 2 diabetes (adjusted hazard ratio per interquartile range increase in exposure 0·80, 95% CI 0·70–0·92). Increased exposure to healthy food resources (assessed by survey methods) was also associated with a reduced risk of type 2 diabetes (0·88, 0·78–0·98). The authors noted that the results varied according to the method of exposure assessment. Using data from the MESA cohort, researchers have assessed associations between neighbourhood environments and development of type 2 diabetes. During a median of 8·9 years follow-up, of the 5124 individuals who were free from diabetes at baseline, 616 (12%) developed type 2 diabetes. In models also adjusted for socioeconomic status, exposure to a neighbourhood environment with more resources for physical activity (assessed by survey methods) was associated with a reduced risk of incident type 2 diabetes (adjusted hazard ratio per interquartile range increase in exposure 0·80, 95% CI 0·70–0·92). Increased exposure to healthy food resources (assessed by survey methods) was also associated with a reduced risk of type 2 diabetes (0·88, 0·78–0·98). The authors noted that the results varied according to the method of exposure assessment. The DALI lifestyle pilot trialThe effects of different lifestyle interventions for prevention of gestational diabetes were investigated in a multicentre pilot trial. 150 women (less than 20 weeks gestation) with a BMI of 29 kg/m2 or more before pregnancy were randomly allocated to five coaching sessions of healthy eating, physical activity, or a combination of both—four optional telephone sessions were offered to all participants. At 35–37 weeks gestation, compared with the physical activity group, weight gain (adjusted difference −1·6 kg, 95% CI −3·0 to −0·2, p=0·02) and fasting glucose (−0·3 mmol/L, −0·4 to −0·1, p=0.01) were lower in the healthy eating group. No differences between the combined treatment and the individual treatments were identified. The effects of different lifestyle interventions for prevention of gestational diabetes were investigated in a multicentre pilot trial. 150 women (less than 20 weeks gestation) with a BMI of 29 kg/m2 or more before pregnancy were randomly allocated to five coaching sessions of healthy eating, physical activity, or a combination of both—four optional telephone sessions were offered to all participants. At 35–37 weeks gestation, compared with the physical activity group, weight gain (adjusted difference −1·6 kg, 95% CI −3·0 to −0·2, p=0·02) and fasting glucose (−0·3 mmol/L, −0·4 to −0·1, p=0.01) were lower in the healthy eating group. No differences between the combined treatment and the individual treatments were identified.