title: Liraglutide causes large and rapid epicardial fat reduction.
abstract: Epicardial adipose tissue (EAT), the visceral fat depot of the heart, is a modifiable cardiovascular risk factor and emerging therapeutic target. Liraglutide, an analog of glucagon-like peptide-1, is indicated for the treatment of type 2 diabetes mellitus. Liraglutide has recently been shown to reduce cardiovascular risk. Nevertheless, whether liraglutide could reduce EAT is unknown.
  
  
  
  To test the hypothesis, a 6-month randomized, open-label, controlled study was performed in 95 type 2 diabetic subjects with body mass index (BMI) ≥27 kg/m2and hemoglobinA1c ≤8% on metformin monotherapy. Individuals were randomized in two groups to receive additional liraglutide up to 1.8 mg s.c. once daily (n = 54) or to remain on metformin up to 1,000 mg twice daily (n = 41). Ultrasound-measured EAT thickness was measured at baseline and at 3- and 6-month follow-ups.
  
  
  
  In the liraglutide group, EAT decreased from 9.6 ± 2 to 6.8 ± 1.5 and 6.2 ± 1.5 mm (P < 0.001), accounting for a -29% and -36% of reduction at 3 and 6 months, respectively, whereas there was no EAT reduction in the metformin group; BMI and hemoglobinA1c improved only in the liraglutide group after 6 months.
  
  
  
  Liraglutide causes a substantial and rapid EAT reduction. Liraglutide cardiometabolic effects may be EAT-mediated.
authors.affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Miami, Miller School of Medicine, Miami, Florida, USA.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
authors.affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Miami, Miller School of Medicine, Miami, Florida, USA.
authors.forename: Mahshid
authors.initials: M
authors.lastname: Mohseni
authors.affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Miami, Miller School of Medicine, Miami, Florida, USA.
authors.forename: Suzy D
authors.initials: SD
authors.lastname: Bianco
authors.affiliation: Department of Medicine, Division of Diabetes, Endocrinology and Metabolism, University of Miami, Miller School of Medicine, Miami, Florida, USA.
authors.forename: Pritisheel K
authors.initials: PK
authors.lastname: Banga
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects*; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D050152:Intra-Abdominal Fat / Q000187:drug effects; D000069450:Liraglutide / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D010496:Pericardium; D012307:Risk Factors
chemical_list: D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069450:Liraglutide; D008687:Metformin