title: Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospective study.
abstract: BACKGROUND
  Liraglutide, a GLP-1 analogue, exerts several beneficial non-glycemic effects in patients with type-2 diabetes (T2DM), such as those on body weight, blood pressure, plasma lipids and inflammation markers. However, the effects of liraglutide on cardiovascular (CV) risk markers in subjects with the metabolic syndrome (MetS) are still largely unknown. We herein explored its effects on various cardio-metabolic risk markers of the MetS in subjects with T2DM.
  
  
  METHODS
  We performed an 18-month prospective, real-world study. All subjects had T2DM and the MetS based on the AHA/NHLBI criteria. Subjects with a history of a major CV event were excluded. One hundred-twenty-one subjects (71 men and 50 women; mean age: 62 ± 9 years) with T2DM and the MetS, who were naïve to incretin-based therapies and treated with metformin only, were included. Liraglutide (1.2 mg/day) was added to metformin (1500-3000 mg/day) for the entire study. Fasting plasma samples for metabolic parameters were collected and carotid-intima media thickness (cIMT) was assessed by B-mode real-time ultrasound at baseline and every 6 months thereafter.
  
  
  RESULTS
  There was a significant reduction in waist circumference, body mass index, fasting glycemia, HbA1c, total- and LDL-cholesterol, triglycerides, and cIMT during the 18-month follow-up. Correlation analysis showed a significant association between changes in cIMT and triglycerides (r = 0.362; p < 0.0001). The MetS prevalence significantly reduced during the study, and the 26% of subjects no longer fulfilled the criteria for the MetS after 18 months.
  
  
  CONCLUSIONS
  Liraglutide improves cardio-metabolic risk factors in subjects with the MetS in a real-world study. Trial Registration ClinicalTrials.gov: NCT01715428.
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.|Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Manfredi
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Rizvi
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors.forename: Angelo Maria
authors.initials: AM
authors.lastname: Patti
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy. draggana.nikolic@gmail.com.
authors.forename: Dragana
authors.identifier: http://orcid.org/0000-0001-9572-9651
authors.initials: D
authors.lastname: Nikolic
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors.forename: Rosaria Vincenza
authors.initials: RV
authors.lastname: Giglio
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Castellino
authors.affiliation: Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Li Volti
authors.affiliation: Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Rome, Italy.|Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Caprio
authors.affiliation: Biomedical Dept of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy.|Institute of Biomedicine and Molecular Immunology "Alberto Monroy", National Research Council (CNR), Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Montalto
authors.affiliation: Department of Internal Medicine, Regional Center for Diabetology, Partinico Hospital, Partinico, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Provenzano
authors.affiliation: IRCCS MultiMedica, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Genovese
authors.affiliation: IRCCS MultiMedica, Milan, Italy.|Diabetes and Endocrinology, Insititut d'Investigacions Biomèdiques August Pi i Sunyer and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Hospital Clínic Barcelona, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D054795:Incretins / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D000069450:Liraglutide / Q000627:therapeutic use*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D054795:Incretins; D000069450:Liraglutide; D008687:Metformin
keywords: Cardiovascular risk; Carotid intima-media thickness; Liraglutide; Metabolic syndrome