Francesca Santilli1, Paola G Simeone2, Maria T Guagnano2, Marika Leo2, Marica T Maccarone3, Augusto Di Castelnuovo4, Cristina Sborgia2, Riccardo C Bonadonna5, Ermanno Angelucci6, Virginia Federico7, Stefano Cianfarani8,9, Lamberto Manzoli10, Giovanni Davì2, Armando Tartaro3, Agostino Consoli2. 1. Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy f.santilli@unich.it. 2. Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy. 3. Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy. 4. Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Mediterraneo, Pozzilli, Italy. 5. Department of Clinical and Experimental Medicine, University of Parma, and Division of Endocrinology, Azienda Ospedaliera-Universitaria di Parma, Parma, Italy. 6. Department of Clinica Medica, "SS. Annunziata" Chieti Hospital, Chieti, Italy. 7. Department of Clinical Pathology, "SS. Annunziata" Chieti Hospital, Chieti, Italy. 8. Dipartimento Pediatrico Universitario Ospedaliero, "Bambino Gesù" Children's Hospital-Tor Vergata University, Rome, Italy. 9. Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 10. Department of Medicine Sciences, University of Ferrara, Ferrara, Italy.
Abstract
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.
RCT Entities:
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.
Authors: Francesco Vadini; Paola G Simeone; Andrea Boccatonda; Maria T Guagnano; Rossella Liani; Romina Tripaldi; Augusto Di Castelnuovo; Francesco Cipollone; Agostino Consoli; Francesca Santilli Journal: Int J Obes (Lond) Date: 2020-01-21 Impact factor: 5.095
Authors: Jean-Pierre Després; André C Carpentier; André Tchernof; Ian J Neeland; Paul Poirier Journal: J Am Coll Cardiol Date: 2021-08-03 Impact factor: 27.203