ABSTRACT
AIM: Use of the glucagon-like peptide 1 receptor agonist liraglutide has been shown to reduce weight. Different types of anthropometric measurements can be used to measure adiposity. This study evaluated the effect of liraglutide on sagittal abdominal diameter, waist circumference, waist-to-hip ratio and adiponectin levels in people with type 2 diabetes (T2D) treated with multiple daily insulin injections (MDI). MATERIALS AND METHODS: In the multicentre, double-blind, placebo-controlled MDI-liraglutide trial, 124 individuals with T2D treated with MDI were randomized to either liraglutide or placebo. Basal values of weight, waist circumference, waist-to-hip ratio, sagittal abdominal diameter and adiponectin were compared with measurements at 12 and 24 weeks after randomization. RESULTS: Baseline-adjusted mean weight loss was 3.8 ± 2.9 kg greater in liraglutide than placebo-treated individuals (p < 0.0001). Waist circumference was reduced by 2.9 ± 4.3 cm and 0.2 ± 3.6 cm in the liraglutide and placebo groups, respectively, after 24 weeks (baseline-adjusted mean difference: 2.6 ± 4.0 cm, p = 0.0005). Corresponding reductions in sagittal abdominal diameter were 1.1 ± 1.7 cm and 0.0 ± 1.8 cm (baseline-adjusted mean difference: 1.1 ± 1.7 cm, p = 0.0008). Hip circumference was reduced in patients randomized to liraglutide (baseline-adjusted mean difference between treatment groups: 2.8 ± 3.8 cm, p = 0.0001), but there was no significant difference between the groups in either waist-to-hip ratio (baseline-adjusted mean difference: 0.0 ± 0.04 cm, p = 0.51) or adiponectin levels (baseline-adjusted mean difference: 0.8 ± 3.3 mg L-1, p = 0.17). Lower HbA1c and mean glucose levels measured by masked continuous glucose monitoring at baseline were associated with greater effects of liraglutide on reductions in waist circumference and sagittal abdominal diameter. CONCLUSIONS: In patients with T2D, adding liraglutide to MDI may reduce abdominal and hip obesity to a similar extent, suggesting an effect on both visceral and subcutaneous fat. Liraglutide had greater effects on reducing abdominal obesity in patients with less pronounced long-term hyperglycaemia but did not affect adiponectin levels.
ABSTRACT
AIM: To investigate referrals to a specialist clinic in endodontics in relation to previously root filled teeth and to determine how many of these teeth had a history of symptoms and the extent to which antibiotics were prescribed. METHODOLOGY: The total number of referrals to the specialist clinic in endodontics in Gothenburg, Sweden, in 2011 was investigated retrospectively by means of patient records. The endodontic status together with the presence or absence of symptoms was registered. The following variables were also examined: gender, age, tooth number and lower or upper jaw. Additionally for root filled teeth, the type of restoration, the technical quality of the root filling and the presence of apical periodontitis were registered. The use of antibiotics was examined for all of the included teeth. Statistical analysis was performed using generalized estimating equation methods applied to univariable and multivariable logistic regression. RESULTS: A total of 1117 patient records were investigated, including 1341 referred teeth. Pain and/or swelling were recorded for 658 (54.3%) teeth. Symptoms were significantly more associated with females (P < 0.0001) and molar teeth (P < 0.0001). Seven hundred twenty-nine (54.4%) of the referred teeth were root filled, and of these, 377 (56.0%) were associated with pain and/or swelling. Root filled teeth restored with a post and core were less frequently related to symptoms (P = 0.009). One hundred sixty-two (22.3%) root filled teeth were treated with antibiotics, which was significantly more frequent than for non-root filled teeth (P < 0.0001). Also, root filled teeth with an adequate root filling were significantly associated with more frequent antibiotics prescriptions (23.8%) than root filled teeth with an inadequate root filling (17.0%) (P = 0.0010). CONCLUSION: Root filled teeth constituted the majority of cases referred to this specialist clinic in endodontics. The majority of these teeth were associated with symptomatic conditions, and antibiotics were prescribed to approximately 20% of the patients referred for a root filled tooth. The findings suggest that symptomatic root filled teeth may be a substantial clinical problem in general dentistry and contribute to avoidable prescription of antibiotics.
