Liraglutide Shows Decreased BMI and Waist Circumference

The nonrandomized, uncontrolled study included 19 patients with type 2 diabetes, all with hemoglobin A1c (HbA1c) levels exceeding 7.0%, a body mass index (BMI) greater than 30 kg/m² , and central obesity. They all received metformin and once-daily subcutaneous liraglutide. Initial treatment with liraglutide was 0.6 mg, increasing to 1.2 mg after 2 weeks providing it was tolerated.

Investigators measured BMI, waist circumference, systolic blood pressure, HbA1c level, adiponectin, tumor necrosis factor (TNF)-alpha, C-reactive protein, and other measures at study entry and 10 weeks thereafter.

A total of 17 patients completed the protocol. Investigators found statistically significant decreases on numerous measures, including BMI (4.6%), waist circumference (8.7%), systolic blood pressure (4.2%), HbA1c level (14.4%), TNF-alpha (11.9%), asymmetric dimethylarginine (26.6%), and C-reactive protein (38.1%). They also observed an increase in adiponectin of 23.3%.

Statistical analysis demonstrated that changes in markers of insulin resistance, inflammation, endothelial function, and oxidative stress were significantly linked with a decrease in waist circumference, but not with a reduction in BMI.

Francisco J. Martinez-Martin, MD, PhD, the study's principal investigator and an endocrinologist from the University Hospital in Las Palmas de Gran Canaria, Spain, stated that, "These markers appear to be sensitive to changes in abdominal fat." "There is a significant correlation with a reduction in waist circumference and these changes, but not with these changes and a reduction in BMI."

"We know that liraglutide has an effect that goes beyond lowering blood sugar," said Dr. Martinez-Martin. "There are metabolic changes that seem to be independent of lost body weight."

Dr. Martinez-Martin likened the effect of the glucagon-like peptide 1 (GLP-1) agonist to the effect that bariatric surgery has on patients, as it affects metabolic parameters as well as producing weight loss.

The limitations of the research are that there was no randomization, the number of patients was small, and there was no control group, he noted.

Current literature suggests the effects of liraglutide are not specific to the therapy, but that they represent the effect of this class of agent, he noted. "There appears to be a class effect," he said.

3rd International Congress on Abdominal Obesity (ICAO): Poster 178. Presented July 12, 2012.