Real-world clinical outcomes and predictors of glycaemic and weight response to exenatide once weekly in patients with type 2 diabetes: The CIBELES project.

AIMS: To evaluate in a real-world setting the effectiveness of exenatide once-weekly (ExQW) in patients with T2D and to determine predictors of glycaemic and weight response to this drug at 6 months. METHODS: Observational, retrospective, multicenter study in adult patients with T2D and BMI ≥30 kg/m2 from 4 tertiary Spanish hospitals who started ExQW therapy at least 6 months before the inclusion and had not achieved adequate glycaemic control on oral therapies or other GLP-1 receptor agonists. Glycaemic response was defined as an A1C reduction ≥1.0% and weight response as a weight loss ≥3% 6 months after ExQW. The best predictive models of glycaemic and weight response were estimated by binary logistic regression. RESULTS: One hundred and forty eight patients were included, mean age 58.0 years, A1C 7.7%, weight 105.9 kg and BMI 38.4 kg/m2 . A1C (-1.1%), weight (-3.9 kg), systolic blood pressure (-4.0 mm Hg), diastolic blood pressure (-2.9 mm Hg), LDL-cholesterol (-14.2 mg/dL) and triglycerides (-31.0 mg/dL) significantly decreased 6 months after ExQW. 41.5% of patients had an A1C reduction ≥1.0% and 53.1% lost ≥3% of baseline weight. Glycaemic and weight reductions were sustained in patients completing 1 and 2 years of follow-up. The best predictive model of glycaemic response only included higher A1C levels (OR 3.9), whereas higher BMI (OR 1.1) and prior DPP-4i therapy (OR 3.1) were associated to weight response in the multivariate analysis. CONCLUSIONS: In a real-world setting, ExQW significantly decreased A1C, weight, blood pressure and lipids at 6 months. Our study identified higher baseline A1C as the sole independent predictor of glycaemic response to ExQW and higher BMI and previous DDP4i treatment as predictive factors of meaningful weight response.

[Oncologic risk of obesity]. / Riesgo oncológico de la obesidad.

This article presents an update of scientific evidence about the relation of obesity with the incidence or mortality by cancer. Almost all large epidemiological studies agree about the oncological risk of obesity, especially with regard to some types of cancers. Different physiopathological theories to explain this association have been proposed, from simple mechanical or dietetical causes to genetic or immunologic factors, including a possible role of hormones or adipocyte humoral factors. Moreover, obesity can play a role in the prognosis of certain cancers. Prevention of obesity must be included among the strategies to fight cancer.

Riesgo oncológico de la obesidad / Oncologic risk of obesity

En este artículo se presenta una actualización de la evidencia científica disponible sobre la vinculación de la obesidad con la aparición o la mortalidad por cáncer. De forma casi unánime, los grandes estudios epidemiológicos han coincidido en que la obesidad tiene un riesgo oncológico, fundamentalmente para cierto tipo de cánceres. Las diversas teorías fisiopatológicas que se han postulado para explicar esta asociación van desde simples causas mecánicas o dietéticas hasta genéticas o inmunológicas, pasando por el papel que puedan desempeñar factores hormonales o productos de secreción del adipocito. Además, la obesidad puede tener un papel en el pronóstico de ciertos cánceres, por lo que la repercusión final de la obesidad en la mortalidad por cáncer puede llegar, en ciertas poblaciones, hasta el 20%. Por tanto, entendiendo la obesidad como un agente cancerígeno más, su prevención debe incluirse entre las medidas a adoptar en la lucha contra el cáncer

This article presents an update of scientific evidence about the relation of obesity with the incidence or mortality by cancer. Almost all large epidemiological studies agree about the oncological risk of obesity, especially with regard to some types of cancers. Different physiopathological theories to explain this association have been proposed, from simple mechanical or dietetical causes to genetic or immunologic factors, including a possible role of hormones or adipocyte humoral factors. Moreover, obesity can play a role in the prognosis of certain cancers. Prevention of obesity must be included among the strategies to fight cancer