Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes
Open accessAbstract
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 HbA1c level (P = 0.60), reduction in VAT was significantly higher in the liraglutide arm than in the lifestyle arm (P = 0.028), in parallel with a greater improvement in β-index (P = 0.021). No differences were observed in SAT reduction (P = 0.64). IGF-II serum levels were significantly increased (P = 0.024) only with liraglutide administration, and the increase in IGF-II levels correlated with both a decrease in VAT (ρ = −0.435, P = 0.056) and an increase in the β-index (ρ = 0.55, P = 0.012). 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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Strong associations between subsequent reductions in body weight, HbA1c, and visceral fat and reductions in inflammatory biomarkers were found in several of the trials included in this evaluation.
“Strong associations between subsequent reductions in body weight, HbA1c, and visceral fat and reductions in inflammatory biomarkers were found in several of the trials included in our evaluation (7, 28, 35, 51, 52).”
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- Authors
- Santilli, F., Simeone, P. G., Guagnano, M. T., Leo, M., Maccarone, M. T., Di Castelnuovo, A., Sborgia, C., Bonadonna, R. C., Angelucci, E., Federico, V., Cianfarani, S., Manzoli, L., Davì, G., Tartaro, A., & Consoli, A.
- Affiliations
- University of Chieti-Pescara (IT)
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Mediterraneo, Pozzilli, Italy
- University of Parma (IT)
- Ospedale SS. Annunziata (IT)
- University of Rome Tor Vergata (IT)
- University of Ferrara (IT)
- Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
- Corresponding author
- Santilli, Francesca
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2017-09-14
- Volume
- 40
- Issue
- 11
- Pages
- 1556-1564
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2754605776
- Cited by
- 114
- References
- 10
- Citations by year
- 2026: 13 · 2025: 14 · 2024: 13 · 2023: 12 · 2022: 16 · 2021: 14 · 2020: 10 · 2019: 11 · 2018: 11
- FWCI
- 6.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, other-oa)
- Funders
- Italian Ministry of University and Research (2010JS3PMZ)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- liraglutide, glucagon-like peptide-1 analogues, obesity, prediabetes, type 2 diabetes, weight loss, visceral adipose tissue, subcutaneous adipose tissue, body fat distribution, beta-cell function, insulin sensitivity, insulin-like growth factor II, insulin-like growth factor I, lifestyle intervention, metformin, glycemic control
- MeSH terms
- Liraglutide, Blood Glucose, Diabetes Mellitus, Type 2, Female, Glucose Tolerance Test, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin-Like Growth Factor I, Insulin-Like Growth Factor II, Life Style, Longitudinal Studies, Male, Metformin, Middle Aged, Obesity, Prediabetic State, Risk Factors, Weight Loss, Body Mass Index, Adipocytes, Insulin-Secreting Cells, Glucagon-Like Peptide 1, Lost to Follow-Up
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