Effect of glucagon‐like peptide‐1 receptor agonists on fat distribution in patients with type 2 diabetes: A systematic review and meta‐analysis

Feb 22, 2022Journal of diabetes investigation

How diabetes medicines called GLP-1 receptor agonists affect body fat distribution in type 2 diabetes

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Abstract

GLP-1 receptor agonists (GLP-1Ras) resulted in a significant reduction in (VAT) by a standard mean difference of -0.54.

GLP-1Ras are associated with reductions in both visceral and .
The reduction in VAT was statistically significant with a confidence interval of -0.92 to -0.17.
Subcutaneous adipose tissue also showed a significant decrease, with a confidence interval of -0.60 to -0.27.
Patients experienced an average body weight reduction of 3.59 kg, with a confidence interval of -4.30 to -2.88.
Waist circumference decreased by an average of 3.09 cm, indicating changes in fat distribution.
The overall level of evidence for these findings was assessed as low to moderate.

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AIMS/INTRODUCTION: Glucagon-like peptide-1 receptor agonists (GLP-1Ras) are widely used to treat type 2 diabetes. They not only reduce glucose, but also have a positive effect on weight loss. However, few studies have reported the effect of GLP-1Ras on fat distribution.

MATERIALS AND METHODS: PubMed, Cochrane, Embase and ClinicalTrials.gov were searched for randomized controlled trials on GLP-1Ras and type 2 diabetes, published from inception to June 2021. Our main outcomes were the reductions of (VAT) and (SAT). Other anthropometric outcomes were also assessed. We used the Cochrane Collaboration tools to assess the risk of bias in the included studies. The quality of the evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation profiler version 3.6. Review Manager 5.4.1 and Stata 16.0 were used for data analysis.

RESULTS: A total of 10 studies involving 541 patients were included. Compared with the control groups, the GLP-1Ras groups showed reductions in VAT (standard mean difference -0.54, 95% confidence interval [CI] -0.92, -0.17, I = 79%, P = 0.005) and SAT (standard mean difference -0.44, 95% CI -0.60, -0.27, I = 44%, P < 0.00001). In addition, bodyweight (weighted mean difference -3.59, 95% CI -4.30, -2.88, I = 0%, P < 0.00001), waist circumference (weighted mean difference -3.09, 95% CI -4.66, -1.52, I = 70%, P = 0.0001) and body mass index (weighted mean difference -1.11, 95% CI -1.35, -0.86, I = 47%, P < 0.00001) were significantly decreased. According to the Grades of Recommendation, Assessment, Development and Evaluation approach, the level of evidence was low or moderate. 2 2 2 2 2

CONCLUSION: This study highlights that GLP-1Ras, especially liraglutide and exenatide, might play an active role in fat distribution in patients with type 2 diabetes. After treatment with GLP-1Ras, both VAT and SAT decreased, and the decrease of VAT was numerically greater than that of SAT.

Key numbers

-0.54

Reduction (SMD)

Standard mean difference comparing GLP-1Ras vs. control groups.

-0.44

Reduction (SMD)

Standard mean difference comparing GLP-1Ras vs. control groups.

-3.59

Body Weight Reduction (WMD)

Weighted mean difference comparing GLP-1Ras vs. control groups.

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Effect of glucagon‐like peptide‐1 receptor agonists on fat distribution in patients with type 2 diabetes: A systematic review and meta‐analysis

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