Reduced cardiac adipose tissue by GLP-1RA in T2DM
Liraglutide reduces cardiac adipose tissue in type 2 diabetes: results from the LiraFlame randomized controlled trial
Presented at the EASD 2021 by: Tine Willum Hansen, MD – Gentofte, Denmark
Introduction and methods
Cardiac adipose tissue encloses the heart. An increased amount of adipose tissue has been associated with increased risk of CV events.
The mechanisms of CV benefit with some members of the GLP-1RA class are unclear. The GLP-1 receptors are expressed in cardiac adipose tissue, and may mediate the cardioprotective effects observed with GLP-1RAs.
For this study, data of the LIRAFLAME trial were used. The LIRAFLAME trial was a randomized, double-blind, placebo-controlled trial that examined the effect of liraglutide on vascular inflammation compared to placebo in 102 patients with T2DM at week 26. In this trial, liraglutide did not change vascular inflammation.
In this analysis, change in cardiac adipose tissue measured by CT was assessed.
- There was a significant reduction in cardiac adipose tissue in the liraglutide group (P<0.001) and not in the placebo group (P=1.00), with a significant difference of 11.4 mL between the groups after adjustment for baseline values (P=0.006).
- After adjustment for change in BMI, the significance for the difference was lost (P=0.46).
- There was an association between biomarkers of inflammation (expressed as Z-score – the weighted sum of 7 markers) and cardiac adipose tissue at baseline, also after adjustment (P=0.02). There was no association between vascular inflammation (assessed by PET) and cardiac adipose tissue at baseline after adjustment.
- There was no association between baseline levels of cardiac adipose tissue and CACS or CIMT.
Treatment with the GLP-1RA liraglutide for 26 weeks reduced cardiac adipose tissue compared to placebo in patients with T2DM. This reduction was dependent of weight loss, suggesting that this was not a drug-specific effect.
- Our reporting is based on the information provided at the EASD Virtual Meeting–