The Effect of Liraglutide on Epicardial Adipose Tissue in Type 2 Diabetes

Abstract

Objective. To study the effect of liraglutide on the thickness of epicardial adipose tissue (EAT) in type 2 diabetes mellitus (T2DM) patients with abdominal obesity. Methods. Abdominal obesity T2DM patients with poor glycemic control were collected and treated with liraglutide. The changes of blood glucose, blood lipid, waist circumference, body mass index (BMI), and EAT thickness were compared after 3 months of treatment with liraglutide. Cardiac magnetic resonance imaging (MRI) was used to measure EAT thickness. Results. After 3 months of treatment with liraglutide, glycosylated hemoglobin (HbA1c) decreased from 9.81 ± 1.46 % to 6.94 ± 1.29 % ( 95 % CI = 2.14 – 3.59 , p < 0.001 ). The weight decreased from 91.67 ± 16.29 kg to 87.29 ± 16.43 kg ( 95 % CI = 2.97 – 5.79 , p < 0.001 ). Waist circumference before treatment was 103.69 ± 9.14 cm, and after treatment was 96.42 ± 8.42 cm ( 95 % CI = 5.04 – 9.50 , p < 0.001 ). Total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were significantly lower than those before treatment. TC decreased from 5.34 ± 1.05 mmol/L to 4.86 ± 0.97 mmol/L ( 95 % CI = 0.15 – 0.82 , p < 0.001 ). TG was 1.89 (1.48-3.17) and then to 1.92 ± 0.69 ( p = 0.03 ). LDL-C decreased from 3.39 ± 0.84 mmol/L to 3.01 ± 0.74 mmol/L ( 95 % CI = 0.17 – 0.59 , p = 0.001 ). HDL-C increased by 1.7% after treatment, with no significant difference ( p = 0.062 ). More importantly, the thickness of EAT decreased from 5.0 (5.0-7.0) mm to 3.95 ± 1.43 mm ( p < 0.001 ) after liraglutide administered for 3 months. Conclusion. Liraglutide significantly reduces EAT thickness in T2DM with abdominal obesity, which provides theoretical support for the cardiovascular benefits of liraglutide.

Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue: a systematic review and meta-analysis

“…The revision of full-length articles allowed the exclusion of four studies due to irrelevant information in their content. Overall, eighteen studies [21][22][23][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] enrolling 1064 patients were included in the qualitative and quantitative analyses of the effect of the cardiometabolic drug on EAT.…”

“…The parasternal long-axis view allowed for the most accurate measurement of EAT on the right ventricle, with optimal cursor beam orientation in each view. The meta-analysis was thus performed on eight studies [21,23,28,29,34,[36][37][38] (Fig. 3).…”

Role of epicardial adipose tissue in diabetic cardiomyopathy through the lens of cardiovascular magnetic resonance imaging – a narrative review

“… 72 However, contradicting these findings, Zhao et al . 73 showed a statistically significant reduction in EAT thickness after 3 months of treatment with liraglutide.…”

Epicardial Adipose Tissue and Diabetic Cardiomyopathy

“…The thickness and volume of EAT in DM patients were significantly thicker than in non-DM patients under the same conditions. 14,15 Moreover, a recent metaanalysis further confirmed the relationship between type 2 diabetes mellitus and EAT, clearly pointing out that the thickness of EAT in diabetic patients is thicker than that in nondiabetic patients. 7 Several studies have shown that taking GLP-1 agonists, 14,16,17 SGLT2-i, 16,18 metformin, 19 and other hypoglycemic drugs and insulin under the skin 20 can reduce the thickness of EAT in patients with type 2 diabetes, which further indicates that EAT is closely related to type 2 diabetes.…”