Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial
RCT (n=235) found liraglutide 3.0mg daily reduced visceral adipose tissue vs placebo at 40 weeks (-12.49% vs -1.63%, p<0.0001). Authors hypothesise visceral fat reduction may be one mechanism to explain benefits seen on CV outcomes in previous trials in type 2 diabetes.
Source:
The Lancet Diabetes & Endocrinology
SPS commentary:
A related editorial notes some limitations of the study. Men, especially those middle-aged and older, have greater accumulation of visceral adipose tissue (VAT) compared with women of the same age, yet men comprised only 8% of the study sample. At baseline, the study participants had normal or almost normal average values of blood pressure, fasting glucose, triglycerides, HDL cholesterol, and N-terminal pro-brain natriuretic peptide, and only 4% had prediabetes. Risk reduction is best demonstrable when patients with significant comorbidities and those at high risk are studied. Also, the overall attrition rate of 31%, although not extremely high, was imbalanced with paired MRI assessment of VAT available for only 59% of the participants in the placebo group.
The editorial notes however endpoints such as changes in VAT and liver fat have far more clinical relevance and pathophysiological implications than changes in bodyweight or BMI, typical primary endpoints in randomised controlled trials of anti-obesity drugs.