Dallas, TX—The weight-loss drug liraglutide appears to have a positive effect on heart health in overweight patients without type 2 diabetes.

A report in the Lancet Diabetes & Endocrinology suggests that the incretin mimetic markedly decreased visceral fat and ectopic fat—both of which have been linked to reduced cardiovascular health in adults who are overweight or have obesity. Once-daily liraglutide was administered in combined with lifestyle interventions.

“Our study used the latest imaging technology to evaluate different fat components in the body. The main finding was a significant decrease in visceral fat in patients without diabetes but who were overweight or had obesity. These results show the potential of liraglutide treatment for significantly lowering the risk of chronic disease in this population,” explained senior author Parag Joshi, MD, of UT Southwestern.

Background information in the article explained that visceral fat is stored within the abdominal cavity around critical internal organs, including the liver, pancreas, and intestines, while ectopic fat is stored in tissues that normally contain small amounts of fat, such as the liver, skeletal muscle, heart, and pancreas.

“Visceral and ectopic fat are key drivers of adverse cardiometabolic outcomes in obesity,” the researchers wrote in explaining why they evaluated the effects of injectable liraglutide 3.0 mg daily on body-fat distribution in adults with overweight or obesity. Participants did not have type 2 diabetes but were at high cardiovascular disease risk.

The randomized, double-blind, placebo-controlled, phase IV, single-center trial involved 235 community-dwelling adults recruited from the University of Texas Southwestern Medical Center. The patients, who had a BMI of at least 30 kg/m2 or a BMI of at least 27 kg/m2 with metabolic syndrome but without diabetes, were randomly assigned in a 1:1 ratio to 40 weeks of treatment with once-daily SC liraglutide or placebo. They also had a 500-kcal deficient diet and guideline-recommended physical activity counseling.

Defined as the primary endpoint for the industry-sponsored study was percentage reduction in visceral adipose tissue (VAT) measured with MRI. The study was conducted from July 20, 2017, to February 21, 2020.

Patients included in the final analysis were 92% female, 37% Black and 24% Hispanic participants, with a mean age of 50.2 years and mean BMI of 37.7.

The authors report that mean change in VAT over a median of 36.2 weeks was −12·49% (SD 9.3%) with liraglutide compared with −1·63% (SD 12.3%) with placebo, for an estimated treatment difference of −10·86% (95% CI,−6·97 to −14·75; P <.0001).

Effects appeared consistent across subgroups of age, sex, race, ethnicity, BMI, and baseline prediabetes, according to the authors, who note that the most frequently reported adverse events were gastrointestinal-related (43 [47%] of 92 with liraglutide and 12 [13%] of 93 with placebo) and upper respiratory tract infections (10 [11%] of 92 with liraglutide and 14 [15%] of 93 with placebo).

“In adults with overweight or obesity at high cardiovascular disease risk, once-daily liraglutide 3.0 mg plus lifestyle intervention significantly lowered visceral adipose tissue over 40 weeks of treatment,” the researchers explain. “Visceral fat reduction may be one mechanism to explain the benefits seen on cardiovascular outcomes in previous trials with liraglutide among patients with type 2 diabetes.

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