Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes

Sep 16, 2017Diabetes care

Liraglutide's effects on weight, fat distribution, and insulin-producing cell function in obese people with prediabetes or early type 2 diabetes

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Abstract

Reduction in visceral adipose tissue (VAT) was significantly higher in the liraglutide group compared to the lifestyle counseling group after comparable weight loss.

Sixty-two metformin-treated obese subjects with prediabetes or early type 2 diabetes were studied.
Weight loss of 7% of initial body weight was achieved in both liraglutide and lifestyle groups.
The liraglutide group showed a greater improvement in β-cell function compared to the lifestyle group.
No significant difference in subcutaneous adipose tissue (SAT) reduction was observed between the two groups.
Liraglutide administration was associated with a significant increase in IGF-II serum levels.
The increase in IGF-II levels correlated with a decrease in VAT and an improvement in β-cell function.

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OBJECTIVE: Obesity is associated with an increased risk of type 2 diabetes and cardiovascular complications. The risk depends significantly on adipose tissue distribution. Liraglutide, a glucagon-like peptide 1 analog, is associated with weight loss, improved glycemic control, and reduced cardiovascular risk. We determined whether an equal degree of weight loss by liraglutide or lifestyle changes has a different impact on subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) in obese subjects with prediabetes or early type 2 diabetes.

RESEARCH DESIGN AND METHODS: Sixty-two metformin-treated obese subjects with prediabetes or newly diagnosed type 2 diabetes, were randomized to liraglutide (1.8 mg/day) or lifestyle counseling. Changes in SAT and VAT levels (determined by abdominal MRI), insulin sensitivity (according to the Matsuda index), and β-cell function (β-index) were assessed during a multiple-sampling oral glucose tolerance test; and circulating levels of IGF-I and IGF-II were assessed before and after a comparable weight loss (7% of initial body weight).

RESULTS: After comparable weight loss, achieved by 20 patients per arm, and superimposable glycemic control, as reflected by HbAlevel (= 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm (= 0.028), in parallel with a greater improvement in β-index (= 0.021). No differences were observed in SAT reduction (= 0.64). IGF-II serum levels were significantly increased (= 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = -0.435,= 0.056) and an increase in the β-index (ρ = 0.55,= 0.012). 1c P P P P P P P

CONCLUSIONS: Liraglutide effects on visceral obesity and β-cell function might provide a rationale for using this molecule in obese subjects in an early phase of glucose metabolism dysregulation natural history.

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Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes

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