Liraglutide (Hybio)

This review aims to evaluate the effectiveness of GLP-1 receptor agonists, and metabolic and bariatric surgery in managing childhood obesity and associated conditions. It discusses current trends, challenges, and the potential of these treatments to improve cardiometabolic health in children and adolescents.

Lifestyle modifications, though recommended as first-line therapy, show modest efficacy in weight management. GLP-1 receptor agonists like liraglutide and semaglutide have demonstrated significant weight loss and improvement in metabolic outcomes. Bariatric surgery, particularly Roux-en-Y gastric bypass, and vertical sleeve gastrectomy have shown substantial long-term benefits in weight reduction and remission of comorbidities in adolescents with severe obesity. While early intervention with lifestyle changes is recommended for prevention and management of obesity in children, pharmacotherapy, and surgical options may be needed. Utilizing these approaches can optimize weight loss and improve long-term health outcomes, highlighting the need for a multidisciplinary strategy to address this growing public health issue.

Although some hypoglycaemic agents have been suggested to possess neuroprotective effects, their mechanisms and efficacy remain controversial. We aimed to investigate the effects of dapagliflozin, liraglutide or acarbose treatment on the directed functional connectivity (FC) of the primary olfactory cortex ( POC ) circuit and regional activation under odour stimulation in patients with type 2 diabetes (T2D).

The 16‐week randomised, prospective, parallel‐group, and open‐label trial included 36 patients with T2D inadequately controlled with metformin, who were randomised (1:1:1) to receive dapagliflozin, liraglutide or acarbose. Meanwhile, 36 healthy controls were recruited. All participants underwent olfactory task functional magnetic resonance imaging, along with a battery of olfactory and cognitive tests, both at baseline and postintervention.

After 16 weeks, dapagliflozin restored odour‐induced functional integration of the POC ‐sensorimotor cortex‐middle temporal cortex circuit (Gaussian random field correction applied), whereas liraglutide and acarbose did not. Dapagliflozin also tended to improve attention ( p  = 0.071). In contrast, liraglutide enhanced odour‐induced activation in the left hippocampus, which was not observed with dapagliflozin and acarbose. The decreased odour‐induced directed FC was associated with changes in lipid levels, olfactory threshold, executive function and memory performance (all p  < 0.05).

These results suggest that dapagliflozin and liraglutide exhibit distinct neuroprotective effects. While liraglutide enhances activation in local olfactory‐related regions, dapagliflozin facilitates functional integration within neural circuits. This highlights the importance of targeting both metabolic and neural pathways to manage diabetes‐related cognitive decline.