Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospective study

Rizzo M, Rizvi AA, Patti AM, et al.
Cardiovasc Diabetol. 2016 Dec 3;15(1):162

Background

Liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, stimulates glucose-dependent insulin secretion and the suppression of glucagon secretion, and is used for the treatment of T2DM [1].
Moreover, data suggest that liraglutide improves the cardio-metabolic profile of T2DM patients and obese individuals who were at risk for progression to T2DM and the development of cardiovascular disease. Liraglutide also decreases the prevalence of both metabolic syndrome (MetS) and prediabetes in obese, nondiabetic individuals, suggesting that this antidiabetic drug might be beneficial in patients with MetS [2,3].

In this real-world, 18-month, prospective study, the effect of liraglutide on cardio-metabolic parameters in subjects with T2DM and MetS (n=121) was evaluated.

Main results

Liraglutide was associated with significant reductions in:

• waist circumference (109 to 102 cm, P = 0.0052)
• BMI (32 to 30 kg/m², P = 0.0303)
• fasting glycemia (9.38 to 7.21 mmol/L, P < 0.0001)
• HbA1c (8.76 to 6.79%, P < 0.0001)
• plasma lipids: total cholesterol (4.67 to 4.21 mmol/L, P = 0.0017), triglycerides (1.87 to 1.51 mmol/L, P = 0.0061), LDL-c (2.71 to 2.29 mmol/L, P = 0.0039)
• carotid intima media thickness (0.97 to 0.78 mm, P < 0.0001)

The reduction in HbA1c was significantly correlated with changes in:  

• body weight (r = 0.203, P = 0.025)
• waist circumference (r = 0.272, P = 0.003)
• BMI (r = 0.187, P = 0.040)
• fasting glycemia (r = 0.407, P < 0.0001)
• HDL-c (r = −0.225, P = 0.013)
• Total cholesterol (r = 0.233, P = 0.010)
• Triglycerides (r = 0.207, P = 0.022)
• LDL-c (r = 0.242, P = 0.008)

The prevalence of MetS significantly reduced during the study (P < 0.0001), and 26% of subjects no longer fulfilled the criteria for MetS after 18 months of liraglutide treatment.

Conclusion

In a study prospectively evaluating the effects of liraglutide on cardio-metabolic risk factors in subjects with MetS, liraglutide improved waist circumference, glucose parameters, plasma lipids
and carotid intima media thickness in an 18-month follow-up. These data suggest that liraglutide may be beneficial for MetS patients, but larger, controlled studies are necessary to support this hypothesis.

Find this article online at Cardiovasc. Diabetol.

References

1. Montanya E, Sesti G. A review of efficacy and safety data regarding the use of liraglutide, a once-daily human glucagon-like peptide 1 analogue, in the treatment of type 2 diabetes mellitus. Clin Ther. 2009;31:2472–88.
2. Burgmaier M, Heinrich C, Marx N. Cardiovascular effects of glp-1 and glp-1-based therapies: implications for the cardiovascular continuum in diabetes? Diabet Med. 2013;30:289–99.
3. Rizzo M, Chandalia M, Patti AM, et al. Liraglutide decreases carotid intima-media thickness in patients with type 2 diabetes: 8-month prospective pilot study. Cardiovasc Diabetol. 2014;13:49.