Liraglutide causes large and rapid epicardial fat reduction
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OBJECTIVE: Epicardial adipose tissue (EAT), the visceral fat depot of the heart, is a modifiable cardiovascular risk factor and emerging therapeutic target. Liraglutide, an analog of glucagon-like peptide-1, is indicated for the treatment of type 2 diabetes mellitus. Liraglutide has recently been shown to reduce cardiovascular risk. Nevertheless, whether liraglutide could reduce EAT is unknown. METHODS: and hemoglobinA1c ≤8% on metformin monotherapy. Individuals were randomized in two groups to receive additional liraglutide up to 1.8 mg s.c. once daily (n = 54) or to remain on metformin up to 1,000 mg twice daily (n = 41). Ultrasound-measured EAT thickness was measured at baseline and at 3- and 6-month follow-ups. RESULTS: In the liraglutide group, EAT decreased from 9.6 ± 2 to 6.8 ± 1.5 and 6.2 ± 1.5 mm (P < 0.001), accounting for a -29% and -36% of reduction at 3 and 6 months, respectively, whereas there was no EAT reduction in the metformin group; BMI and hemoglobinA1c improved only in the liraglutide group after 6 months. CONCLUSIONS: Liraglutide causes a substantial and rapid EAT reduction. Liraglutide cardiometabolic effects may be EAT-mediated.
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Sitagliptin or liraglutide as add-on therapy in overweight/obese T2DM inadequately controlled on metformin significantly reduce EAT after six months, whereas no such result is detected in metformin groups.
“Recently, two randomized trials evaluating EAT changes induced after six months by sitagliptin or liraglutide as add-on therapy in overweight/obese T2DM individuals inadequately controlled on metformin monotherapy showed that both incretin-based therapies significantly reduced EAT, whereas no such result was detected in the metformin groups [122,123].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [123]
Liraglutide on top of metformin reduces EAT thickness by 29% at 3 months and 36% at 6 months in T2DM patients, with no change in those remaining on metformin.
“However, other authors underline that the cardio-metabolic advantage offered by liraglutide may be the substantial and rapid reduction of EAT thickness (29% at 3 months and 36% at 6 months), a result observed in a study with T2DM patients randomized to liraglutide on top of metformin versus metformin alone. In those remaining on metformin no change in EAT thickness was registered [123].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [123]
Liraglutide significantly decreased EAT thickness by almost 30% after 12 weeks in subjects with T2DM.
“We recently showed that add-on therapy with liraglutide, a once-daily GLP-1 receptor agonist, significantly decreased EAT thickness by almost 30% after 12 weeks in subjects with T2DM [16].”
From Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity (2020) · cites this paper as [16]
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- Iacobellis G, Lonn E, Lamy A, Singh N, Sharma AM. Epicardial fat thickness and CAD correlate independently of obesity. Int J Cardiol 2011;146:452-454.
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- Authors
- Iacobellis, G., Mohseni, M., Bianco, S. D., & Banga, P. K.
- Affiliations
- University of Miami (US)
- Corresponding author
- Iacobellis, Gianluca
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2017-01-26
- Volume
- 25
- Issue
- 2
- Pages
- 311-316
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2580189755
- Cited by
- 251
- References
- 33
- Citations by year
- 2026: 22 · 2025: 42 · 2024: 29 · 2023: 37 · 2022: 28 · 2021: 16 · 2020: 26 · 2019: 24 · 2018: 19 · 2017: 8
- FWCI
- 16.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- liraglutide, epicardial adipose tissue, visceral fat, GLP-1 receptor agonists, type 2 diabetes, metformin, cardiovascular risk, cardiometabolic effects, EAT thickness
- MeSH terms
- Liraglutide, Adipose Tissue, Adult, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Metformin, Middle Aged, Pericardium, Risk Factors, Body Mass Index, Intra-Abdominal Fat, Glucagon-Like Peptide 1
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