Fat reduction that harms heart health!

Obese patients usually face a higher risk of cardiovascular disease.

Visceral fat is stored in the abdominal cavity surrounding important internal organs, such as the liver, pancreas, and intestines; ectopic fat is stored in tissues that usually contain only a small amount of fat, such as liver, skeletal muscle, heart, and pancreas

Liraglutide is one of the most widely prescribed drugs for obesity treatment in the world

Liraglutide is a GLP-1 receptor agonist, GLP-1 is a polypeptide incretin hormone, can induce glucose-dependent insulin secretion, reduce plasma glucagon concentration, delay gastric emptying, and inhibit Appetite

Previously, the cardiometabolic benefits of liraglutide have been observed in the LEADER trial

The study recruited adults ≥ 35 years of age who were obese (body mass index [BMI] ≥ 30 kg/m2) or overweight (BMI ≥ 27 kg/m2) with metabolic syndrome

Metabolic syndrome is defined as meeting at least the following 3 items:

Men's waist circumference ≥102 cm, women's waist circumference ≥88 cm; fasting triglycerides ≥150 mg/dL; blood pressure ≥130/85 mmHg; male high-density lipoprotein cholesterol (HDL-C) <40 mg/dL, female HDL-C ＜50 mg/dL; Fasting blood glucose ≥100 mg/dL

After screening, the subjects need to first undergo a 2-week adaptation period, the dietary calorie intake is reduced by 500 kcal, and moderate and high-intensity physical activity is at least 150 minutes per week; subsequently, a total of 185 subjects are randomly assigned to receive daily 1:1 A subcutaneous injection of 3.

A total of 128 persons (73 persons in the liraglutide group and 55 persons in the placebo group) were included in the final analysis of effectiveness

▲ Visceral adipose tissue changes in the liraglutide group (red) and placebo group (blue)

At the same time, liraglutide also significantly reduced overall fat (8.

The improvement in body fat distribution is also reflected in a more intuitive measure of obesity

The paper pointed out that compared to intuitive weight loss, liraglutide has twice the effect of reducing visceral fat and six times the effect of reducing liver fat

In addition, compared with placebo, liraglutide also significantly reduced fasting blood glucose levels and improved inflammation

In terms of safety, all adverse events were grade 1-2, and there were no serious adverse events

The research team said that the reduction of visceral fat and liver fat helps explain why liraglutide is beneficial to the cardiovascular system and also shows the benefits of this drug for non-diabetics

In a review article published in the same journal, two experts from the Pennington Biomedical Research Center in the United States pointed out that compared with changes in body weight or BMI, end points such as visceral fat tissue and liver fat changes have more clinical and pathophysiological significance.
With the advancement of detection methods, we can evaluate these indicators in research
.

On the other hand, although in patients with complications such as type 2 diabetes and chronic kidney disease, GLP-1 receptor agonists including liraglutide have been proven to have cardiovascular benefits, there is still a lack of evidence to show that through Life>
.
The smegaglutide SELECT study is expected to be completed by the end of 2023, and will further answer whether anti-obesity drug treatment can reduce major adverse cardiovascular events in non-diabetic patients
.

Note: The original text has been deleted

Reference

[1] Ian J Neeland, et al.
, (2021).
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.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00179-0

[2] Kishore M Gadde, Steven B Heymsfield.
(2021).
Targeting visceral adiposity with pharmacotherapy.
The Lancet Diabetes & Endocrinology, DOI: https://doi.
org/10.
1016/S2213-8587(21)00204-7

[3] Common weight-loss drug successfully targets fat that can endanger heart health.
Retrieved August 5, 2021, from https://medicalxpress.
com/news/2021-08-common-weight-loss-drug-successfully-fat.
html