Liraglutide improves metabolic parameters and carotid intima-media thickness in diabetic patients with the metabolic syndrome: an 18-month prospective study

Manfredi Rizzo, Ali A Rizvi, Angelo Maria Patti, Dragana Nikolic, Rosaria Vincenza Giglio, Giuseppa Castellino, Giovanni Li Volti, Massimiliano Caprio, Giuseppe Montalto, Vincenzo Provenzano, Stefano Genovese, Antonio Ceriello, Manfredi Rizzo, Ali A Rizvi, Angelo Maria Patti, Dragana Nikolic, Rosaria Vincenza Giglio, Giuseppa Castellino, Giovanni Li Volti, Massimiliano Caprio, Giuseppe Montalto, Vincenzo Provenzano, Stefano Genovese, Antonio Ceriello

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.

Keywords: Cardiovascular risk; Carotid intima-media thickness; Liraglutide; Metabolic syndrome.

Figures

Fig. 1
Fig. 1
Changes in cardio-metabolic parameters during the study. BMI body mass index, HbA1c glycated hemoglobin, TC total cholesterol, TG triglyceride, LDL low-density lipoprotein, HDL high-density lipoprotein, IMT intima media thickness. The data are presented as mean ± SE
Fig. 2
Fig. 2
Prevalence of the MetS among all patients (n = 121) during the study. MetS metabolic syndrome, n number

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