title: Reduction of visceral fat by liraglutide is associated with ameliorations of hepatic steatosis, albuminuria, and micro-inflammation in type 2 diabetic patients with insulin treatment: a randomized control trial.
abstract: Liraglutide, an analogue of human glucagon-like peptide 1, reduces cardiovascular events in patients with type 2 diabetes; however, it has still been unknown by which mechanisms liraglutide could reduce cardiovascular events. Type 2 diabetic patients with insulin treatment were enrolled in this randomized, open-label, comparative study. Participants were randomly assigned to liraglutide plus insulin (liraglutide group) and insulin treatment (control group) at 1:1 allocation. Primary endpoint was the change in viscera fat are (VFA, cm2) at 24 weeks. Liver attenuation index (LAI) measured by abdominal computed tomography, urinary albumin-to-creatinine ratio (ACR, mg/g), and C-reactive protein (CRP) levels, skeletal muscle index (SMI), and quality of life (QOL) related to diabetes treatment were also determined. Seventeen patients (8; liraglutide group, 9; control group, mean age 59 ± 13 years; 53% female) completed this study. Liraglutide treatment significantly reduced VFA at 24 weeks; whereas, SFA was unchanged. ACR, LAI, and CRP levels were significantly reduced by liraglutide at 24 weeks and there was no difference in SMI between the two groups. Changes in VFA from baseline to 24 weeks were significantly associated with those in LAI, albuminuria, and HbA1c. Liraglutide treatment significantly improved QOL scores associated with anxiety and dissatisfaction with treatment and satisfaction with treatment. No severe adverse events were observed in both groups. Our data suggest that liraglutide could reduce visceral adiposity in parallel with attenuation of hepatic fat accumulation, albuminuria and micro-inflammation and improve QOL related to diabetes care in insulin-treated patients with type 2 diabetes.
authors.affiliation: Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Bouchi
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Nakano
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fukuda
authors.forename: Takato
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Murakami
authors.forename: Isao
authors.initials: I
authors.lastname: Minami
authors.forename: Hajime
authors.initials: H
authors.lastname: Izumiyama
authors.forename: Koshi
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yoshimoto
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Ogawa
mesh_terms: D050154:Adiposity / Q000187:drug effects; D000419:Albuminuria / Q000209:etiology / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D050152:Intra-Abdominal Fat / Q000187:drug effects* / Q000276:immunology; D007564:Japan / Q000453:epidemiology; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000276:immunology / Q000517:prevention & control*; D017060:Patient Satisfaction; D011788:Quality of Life; D012306:Risk
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin; D000069450:Liraglutide