Medical Bulletin 27/ January/ 2025 - Video

Glucagon-like peptide 1 receptor agonists (GLP1RA)—medications for type 2 diabetes and obesity that have recently been making headlines due to a rise in popularity as weight loss agents—have been linked with behavioral side effects. A large population-based analysis in Diabetes, Obesity and Metabolism assessed whether certain genetic variants might help explain these effects.

GLP1RA mimic the GLP-1 hormone in the body that helps control insulin and blood glucose levels and promotes feelings of satiety. GLP-1 binds to GLP1R on cells in the brain and pancreas.

For the analysis, investigators examined common genetic variants in the GLP1R gene in 408,774 white British, 50,314 white European, 7,667 South Asian, 10,437 multiple ancestry, and 7,641 African-Caribbean individuals.

Variants in the GLP1R gene had consistent associations with cardiometabolic traits (body mass index, blood pressure, and type 2 diabetes) across ancestries. GLP1R variants were also linked with risk-taking behavior, mood instability, chronic pain, and anxiety in most ancestries, but the results were less consistent. The genetic variants influencing cardiometabolic traits were separate from those influencing behavioral changes and separate from those influencing expression levels of the GLP1R gene.

The findings suggest that any observed behavioral changes with GLP1RA are likely not acting directly through GLP1R.

“Whilst it is not possible to directly compare genetic findings to the effects of a drug, our results suggest that behavioral changes are unlikely to be a direct result of the GLPRAs. Exactly how these indirect effects are occurring is currently unclear,” said corresponding author Rona J. Strawbridge, PhD, of the University of Glasgow, in the UK.

Reference: Hayman MME, Jones W, Aman A, et al. Association of GLP1R locus with mental ill-health endophenotypes and cardiometabolic traits: A trans-ancestry study in UK Biobank. Diabetes Obes Metab. 2025; 1-14. doi:10.1111/dom.16178

Sleepiness at the wheel is a significant contributing factor to motor vehicle accidents. A new analysis published in Otolaryngology–Head and Neck Surgery reveals that for people with sleep apnea, getting surgery for their condition may lessen their risk of such accidents compared with using a Continuous Positive Airway Pressure (CPAP) device at night or receiving no treatment.

In the analysis of data on 2,832,437 patients with obstructive sleep apnea, 3.4% of patients who underwent surgery were in a car accident at any point following their diagnosis, compared with 6.1% of those using a CPAP and 4.7% of those not receiving any treatment.

Patients receiving no treatment had 21% higher odds of motor vehicle accidents compared with the surgery group. The surgery group had 45% lower odds compared with the CPAP group.

Patients with obstructive sleep apnea who experienced accidents were more likely to have comorbidities such as hypertension, diabetes, and heart failure following the accident.

“Our findings underscore the profound impact that inadequately managed obstructive sleep apnea can have on individual health and public safety,” said corresponding author Elliott M. Sina, BA, a medical student at the Sidney Kimmel Medical College at Thomas Jefferson University. “This work adds to the growing body of evidence supporting surgical interventions such as hypoglossal nerve stimulation as an effective alternative treatment for select patients with obstructive sleep apnea.”

Reference: Sina, E.M., Shankar, S., Boon, M.S. and Huntley, C.T. (2025), Risk of Motor Vehicle Accidents in Obstructive Sleep Apnea: Comparative Analysis of CPAP Versus Surgery. Otolaryngol Head Neck Surg. https://doi.org/10.1002/ohn.1131

Actively preparing for major surgery by exercising and improving diet (known as “prehabilitation”) is associated with fewer complications, less time in hospital, and improved recovery and quality of life in adults, finds an analysis of clinical trials published by The BMJ.

The researchers stress that the certainty of evidence for all comparisons was generally low to very low, but they say prehabilitation based on exercise, nutrition, or exercise combined with other components, may be beneficial.

Researchers in Canada trawled databases for any randomised controlled trial involving adults preparing for major surgery who received prehabilitation interventions or usual care.

They found 186 relevant trials involving 15,684 participants (average age 62; 45% women) that investigated individual or combinations of prehabilitation components (exercise, nutritional, cognitive, and psychosocial support) for seven or more days before surgery.

Critical outcomes of interest were complications up to 30 days after surgery, length of hospital stay, and health related quality of life and physical recovery (based on widely used tests) up to 90 days after surgery.

The trials were of varying quality, but the researchers were able to assess their risk of bias and the certainty of evidence using established tools.

After accounting for other potentially influential factors including surgery type, they found that exercise was associated with a 50% reduced risk of complications compared with usual care, while nutritional support was associated with a 38% reduced risk. Combined exercise, nutritional, and psychosocial support was associated with a 36% reduced risk.

Compared with usual care, combined exercise and psychosocial support was associated with 2.44 fewer days in hospital, while combined exercise and nutritional support was associated with 1.22 fewer days. Individually, exercise and nutrition were associated with 0.93 and 0.99 fewer days, respectively.

Combined exercise, nutritional and psychosocial prehabilitation was most likely to improve health related quality of life and physical recovery. Individually, exercise and nutrition were most likely to improve all critical outcomes.

Reference: McIsaac D I, Kidd G, Gillis C, Branje K, Al-Bayati M, Baxi A et al. Relative efficacy of prehabilitation interventions and their components: systematic review with network and component network meta-analyses of randomised controlled trials BMJ 2025; 388 :e081164 doi:10.1136/bmj-2024-081164

Researchers in the Epi4Health group at the Universitat Oberta de Catalunya (UOC) have found that turmeric and its related products, such as curcumin, may be able to reduce muscle damage and inflammation in the musculoskeletal system following vigorous physical exercise. Findings are published in the Journal of the International Society of Sports Nutrition.

Hundreds of scientific studies have demonstrated the benefits and potential of curcumin, particularly as regards its properties. In fact, this supplement is well-known for its antioxidant and anti-inflammatory properties. However, the experts' novel contribution is the confirmation of these findings in the realm of sports through a review of the scientific literature, which was

According to the authors, the possible benefits of curcumin include mitigating and combating various issues, such as local muscle inflammation and systemic inflammation, as well as oxidative damage resulting from the increased production of free radicals during physical exercise and muscle pain, thus improving the individual's subjective perception of pain and the affected muscle group's range of movement.

Specifically, the experts estimate that a daily curcumin intake of 1-4 grams is enough for people in good health to enjoy these benefits, particularly in relation to eccentric exercise, which tends to be the most damaging to athletes.

However, despite these proven benefits, the experts emphasized that factors that must be taken into account include hormonal effects and individual patient or consumer characteristics, as well as the time of intake and the exact formulation used.

"Curcumin could greatly enhance the well-being of those who engage in regular physical training. It may even play a significant role in reducing inflammation biomarkers and improving antioxidant capacity, among other health benefits," researchers concluded, while warning that further research into formulation, absorption, bioavailability and other factors remains necessary to properly evaluate the effects described.

Reference: Daniel Vasile, P. R., Patricia, M. L., Marta, M. S., & Laura, E. (2024). Evaluation of curcumin intake in reducing exercise-induced muscle damage in athletes: a systematic review. Journal of the International Society of Sports Nutrition, 21(1). https://doi.org/10.1080/15502783.2024.2434217