Skip to main content
Erschienen in: Acta Diabetologica 4/2015

01.08.2015 | Original Article

Short-term effects of glucagon-like peptide 1 (GLP-1) receptor agonists on fat distribution in patients with type 2 diabetes mellitus: an ultrasonography study

verfasst von: Susanna Morano, Elisabetta Romagnoli, Tiziana Filardi, Luciano Nieddu, Elisabetta Mandosi, Mara Fallarino, Irene Turinese, Mariangela Pia Dagostino, Andrea Lenzi, Vincenzo Carnevale

Erschienen in: Acta Diabetologica | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Aims

Glucagon-like peptide 1 receptor agonists (GLP-1 RA) induce weight loss and reduction in adipose tissue, but the effects of GLP-1 RA on the distribution of fat deposits have been poorly investigated.

Methods

In 25 patients with type 2 diabetes (16 females and 9 males, mean age 63.5 ± 8.8 years), treated with GLP-1 RA (exenatide, n. 12; liraglutide, n.13), both before and 3 months after starting treatment, an abdominal ultrasonographic scan, with Doppler of renal arteries, and echocardiography were performed. Subcutaneous fat width (peri-umbilical and sub-xiphoid), deep fat deposits (pre-aortic, peri-renal, and epicardial), and renal resistive index (RI) were evaluated.

Results

GLP-1 RA induced highly significant (p < 0.001) decrease in BMI and in fat thickness at all the assessed sites, without differences between exenatide and liraglutide treatment. A slight decrease in RI (p = 0.055) was also found. The percent changes of fat thickness was different between sites (p < 0.025), and the changes in subcutaneous deposits showed no significant correlation (p = 0.064) with those of deep fat deposits.

Conclusions

A short course of treatment with GLP-1 RA, besides weight loss, induces a redistribution of adipose tissue deposits, possibly contributing to a better cardiovascular risk profile in patients with type 2 diabetes mellitus.
Literatur
1.
Zurück zum Zitat Jendle J, Nauck MA, Matthews DR, Frid A, Hermansen K, Düring M, Zdravkovic M, Strauss BJ, Garber AJ, on the behalf of the LEAD-2 and LEAD-3 Study Groups (2009) Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue. Diabetes Obes Metab 11:1163–1172PubMedCrossRef Jendle J, Nauck MA, Matthews DR, Frid A, Hermansen K, Düring M, Zdravkovic M, Strauss BJ, Garber AJ, on the behalf of the LEAD-2 and LEAD-3 Study Groups (2009) Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue. Diabetes Obes Metab 11:1163–1172PubMedCrossRef
2.
Zurück zum Zitat De Fronzo RA, Ratner RE, Han J, Kim DD, Fineman MS, Baron AD (2005) Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes. Diabetes Care 28:1092–1100CrossRef De Fronzo RA, Ratner RE, Han J, Kim DD, Fineman MS, Baron AD (2005) Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes. Diabetes Care 28:1092–1100CrossRef
3.
Zurück zum Zitat Kim D, MacConell L, Zhuang D, Kothare PA, Trautman M, Fineman M, Taylor K (2007) Effects of once-weekly dosing of a long-acting release formulation of exenatide on glucose control and body weight in subjects with type 2 diabetes. Diabetes Care 30:1487–1493PubMedCrossRef Kim D, MacConell L, Zhuang D, Kothare PA, Trautman M, Fineman M, Taylor K (2007) Effects of once-weekly dosing of a long-acting release formulation of exenatide on glucose control and body weight in subjects with type 2 diabetes. Diabetes Care 30:1487–1493PubMedCrossRef
4.
Zurück zum Zitat Vilsbøll T, Zdravkovic M, Le-Thi T, Krarup T, Schmitz O, Courreges JP, Verhoeven R, Buganova I, Madsbad S (2007) Liraglutide, a long-acting human glucagon-like peptide-1 analog, given as monotherapy significantly improves glycemic control and lowers body weight without risk of hypoglycemia in patients with type 2 diabetes. Diabetes Care 30:1608–1610PubMedCrossRef Vilsbøll T, Zdravkovic M, Le-Thi T, Krarup T, Schmitz O, Courreges JP, Verhoeven R, Buganova I, Madsbad S (2007) Liraglutide, a long-acting human glucagon-like peptide-1 analog, given as monotherapy significantly improves glycemic control and lowers body weight without risk of hypoglycemia in patients with type 2 diabetes. Diabetes Care 30:1608–1610PubMedCrossRef
5.
6.
Zurück zum Zitat Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C (1995) Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. Am J Epidemiol 141:1128–1141PubMed Williamson DF, Pamuk E, Thun M, Flanders D, Byers T, Heath C (1995) Prospective study of intentional weight loss and mortality in never-smoking overweight US white women aged 40–64 years. Am J Epidemiol 141:1128–1141PubMed
7.
Zurück zum Zitat Chaston TB, Dixon JB (2008) Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systemic review. Int J Obes 32:619–628CrossRef Chaston TB, Dixon JB (2008) Factors associated with percent change in visceral versus subcutaneous abdominal fat during weight loss: findings from a systemic review. Int J Obes 32:619–628CrossRef
8.
Zurück zum Zitat Després JP (2011) Excess visceral adipose tissue/ectopic fat. J Am Coll Cardiol 57:1887–1889PubMedCrossRef Després JP (2011) Excess visceral adipose tissue/ectopic fat. J Am Coll Cardiol 57:1887–1889PubMedCrossRef
9.
Zurück zum Zitat Bazzocchi A, Diano D, Ponti F, Salizzoni E, Albisinni U, Marchesini G, Battista G (2014) A 360-degree overview of body composition in healthy people: relationships among anthropometry, ultrasonography, and dual-energy x-ray absorptiometry. Nutrition 30:696–701PubMedCrossRef Bazzocchi A, Diano D, Ponti F, Salizzoni E, Albisinni U, Marchesini G, Battista G (2014) A 360-degree overview of body composition in healthy people: relationships among anthropometry, ultrasonography, and dual-energy x-ray absorptiometry. Nutrition 30:696–701PubMedCrossRef
10.
Zurück zum Zitat Kawai T, Kamide K, Onishi M, Yamamoto-Hanasaki H, Baba Y, Hongyo K, Shimaoka I, Tatara Y, Takeya Y, Ohishi M, Rakugi H (2011) Usefulness of the resistive index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atheroscerosis. Nephrol Dial Transplant 26:3256–3262PubMedCrossRef Kawai T, Kamide K, Onishi M, Yamamoto-Hanasaki H, Baba Y, Hongyo K, Shimaoka I, Tatara Y, Takeya Y, Ohishi M, Rakugi H (2011) Usefulness of the resistive index in renal Doppler ultrasonography as an indicator of vascular damage in patients with risks of atheroscerosis. Nephrol Dial Transplant 26:3256–3262PubMedCrossRef
12.
Zurück zum Zitat Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMedCentralPubMedCrossRef Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, Coresh J, CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Suzuki R, Watanabe S, Hirai Y, Akiyama K, Nishide T, Matsushima Y, Murayama H, Ohshima H, Shinomiya M, Shirai K, Saito Y, Yoshida S, Saisho H, Ohto M (1993) Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen. Am J Med 95:309–314PubMedCrossRef Suzuki R, Watanabe S, Hirai Y, Akiyama K, Nishide T, Matsushima Y, Murayama H, Ohshima H, Shinomiya M, Shirai K, Saito Y, Yoshida S, Saisho H, Ohto M (1993) Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen. Am J Med 95:309–314PubMedCrossRef
14.
Zurück zum Zitat Kawasaki S, Aoki K, Hasegawa O, Numata K, Tanaka K, Shibata N, Shimada S, Okamura A, Terauchi Y (2008) Sonographic evaluation of visceral fat by measuring para- and perirenal fat. J Clin Ultrasound 36:129–133PubMedCrossRef Kawasaki S, Aoki K, Hasegawa O, Numata K, Tanaka K, Shibata N, Shimada S, Okamura A, Terauchi Y (2008) Sonographic evaluation of visceral fat by measuring para- and perirenal fat. J Clin Ultrasound 36:129–133PubMedCrossRef
15.
Zurück zum Zitat Sabir N, Sermez Y, Kazil S, Zencir M (2001) Correlation of abdominal fat accumulation and liver steatosis: importance of ultrasonographic and anthropometric measurements. Eur J Ultrasound 14:121–128PubMedCrossRef Sabir N, Sermez Y, Kazil S, Zencir M (2001) Correlation of abdominal fat accumulation and liver steatosis: importance of ultrasonographic and anthropometric measurements. Eur J Ultrasound 14:121–128PubMedCrossRef
16.
Zurück zum Zitat Sperandeo M, Varriale A, D’Amico G, Sperandeo G, Piattelli ML, De Cata A, Greco A, Prigigallo F, Annese MA, Cedrone L, Vendemiale G (2007) Intrarenal resistive index in patients with type 2 diabetes mellitus with and without microalbuminuria. Eur J Inflamm 5:103–110 Sperandeo M, Varriale A, D’Amico G, Sperandeo G, Piattelli ML, De Cata A, Greco A, Prigigallo F, Annese MA, Cedrone L, Vendemiale G (2007) Intrarenal resistive index in patients with type 2 diabetes mellitus with and without microalbuminuria. Eur J Inflamm 5:103–110
17.
Zurück zum Zitat Iacobellis G, Ribaudo MC, Assael F, Vecci E, Tiberti C, Zappaterreno A, Di Mario U, Leonetti F (2003) Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 88:5163–5168PubMedCrossRef Iacobellis G, Ribaudo MC, Assael F, Vecci E, Tiberti C, Zappaterreno A, Di Mario U, Leonetti F (2003) Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 88:5163–5168PubMedCrossRef
18.
Zurück zum Zitat Sperandeo M, Carnevale V, Muscarella S, Sperandeo G, Varriale A, Filabozzi P, Piattelli ML, D’Alessandro V, Copetti M, Pellegrini F, Dimitri L, Vendemiale G (2011) Clinical application of transthoracic ultrasonography in patients with pneumonia. Eur J Clin Invest 41:1–7PubMedCrossRef Sperandeo M, Carnevale V, Muscarella S, Sperandeo G, Varriale A, Filabozzi P, Piattelli ML, D’Alessandro V, Copetti M, Pellegrini F, Dimitri L, Vendemiale G (2011) Clinical application of transthoracic ultrasonography in patients with pneumonia. Eur J Clin Invest 41:1–7PubMedCrossRef
19.
20.
Zurück zum Zitat Holst JJ, Deacon CF (2013) Is there a place for incretin therapies in obesity and prediabetes? Trends Endocrinol Metab 24:145–152PubMedCrossRef Holst JJ, Deacon CF (2013) Is there a place for incretin therapies in obesity and prediabetes? Trends Endocrinol Metab 24:145–152PubMedCrossRef
21.
Zurück zum Zitat Sever MJ, Kocjan T, Pfeifer M, Kravos NA, Janez A (2014) Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin. Eur J Endocrinol 170:451–459CrossRef Sever MJ, Kocjan T, Pfeifer M, Kravos NA, Janez A (2014) Short-term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syndrome and previous poor response to metformin. Eur J Endocrinol 170:451–459CrossRef
22.
Zurück zum Zitat Tchernof A, Despres JP (2013) Pathophysiology of human visceral obesity: an update. Physiol Rev 93:359–404PubMedCrossRef Tchernof A, Despres JP (2013) Pathophysiology of human visceral obesity: an update. Physiol Rev 93:359–404PubMedCrossRef
23.
Zurück zum Zitat Bartelt A, Heeren J (2014) Adipose tissue browning and metabolic health. Nat Rev Endocrinol 10:24–36PubMedCrossRef Bartelt A, Heeren J (2014) Adipose tissue browning and metabolic health. Nat Rev Endocrinol 10:24–36PubMedCrossRef
24.
Zurück zum Zitat Liu KH, Chan JL, Chan WB, Chan JCN, Chu CWW (2006) Mesenteric fat thickness is an independent determinant of metabolic syndrome and identifies subjects with increased carotid intima-media thickness. Diabetes Care 29:379–384PubMedCrossRef Liu KH, Chan JL, Chan WB, Chan JCN, Chu CWW (2006) Mesenteric fat thickness is an independent determinant of metabolic syndrome and identifies subjects with increased carotid intima-media thickness. Diabetes Care 29:379–384PubMedCrossRef
25.
Zurück zum Zitat Liu J, Fox CS, Hickson DA, May WD, Hairston KG, Carr JJ, Taylor HA (2010) Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab 95:5419–5426PubMedCentralPubMedCrossRef Liu J, Fox CS, Hickson DA, May WD, Hairston KG, Carr JJ, Taylor HA (2010) Impact of abdominal visceral and subcutaneous adipose tissue on cardiometabolic risk factors: the Jackson Heart Study. J Clin Endocrinol Metab 95:5419–5426PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Cetin DC, Nasr G (2014) Obesity in the elderly: more complicated than you think. Clev Clin J Med 81:51–61CrossRef Cetin DC, Nasr G (2014) Obesity in the elderly: more complicated than you think. Clev Clin J Med 81:51–61CrossRef
27.
Zurück zum Zitat Christensen DL, Faurholt-Jepsen D, Faerch K, Mwaniki DL, Boit MK, Kilonzo B, Tetens I, Friis H, Borch-Johnsen K (2014) Insulin resistance and beta-cell function in different ethnic groups in Kenya: the role of abdominal fat distribution. Acta Diabetol 51:53–60PubMedCrossRef Christensen DL, Faurholt-Jepsen D, Faerch K, Mwaniki DL, Boit MK, Kilonzo B, Tetens I, Friis H, Borch-Johnsen K (2014) Insulin resistance and beta-cell function in different ethnic groups in Kenya: the role of abdominal fat distribution. Acta Diabetol 51:53–60PubMedCrossRef
28.
Zurück zum Zitat The Emerging Risk Factors Collaboration (2011) Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 377:1085–1095PubMedCentralCrossRef The Emerging Risk Factors Collaboration (2011) Separate and combined associations of body-mass index and abdominal adiposity with cardiovascular disease: collaborative analysis of 58 prospective studies. Lancet 377:1085–1095PubMedCentralCrossRef
29.
Zurück zum Zitat Ross R, Bradshaw AJ (2009) The future of obesity reduction: beyond weight loss. Nat Rev Endocrinol 5:319–326PubMedCrossRef Ross R, Bradshaw AJ (2009) The future of obesity reduction: beyond weight loss. Nat Rev Endocrinol 5:319–326PubMedCrossRef
30.
Zurück zum Zitat Iacobellis G, Singh N, Wharton S, Sharma AM (2008) Substantial changes in epicardial fat thickness after weight loss in severely obese subjects. Obesity 16:1693–1697PubMedCrossRef Iacobellis G, Singh N, Wharton S, Sharma AM (2008) Substantial changes in epicardial fat thickness after weight loss in severely obese subjects. Obesity 16:1693–1697PubMedCrossRef
31.
Zurück zum Zitat Kim MK, Tomita T, Kim MJ, Sasai H, Maeda S, Tanaka K (2009) Aerobic exercise training reduces epicardial fat in obese men. J Appl Physiol 106:5–11PubMedCrossRef Kim MK, Tomita T, Kim MJ, Sasai H, Maeda S, Tanaka K (2009) Aerobic exercise training reduces epicardial fat in obese men. J Appl Physiol 106:5–11PubMedCrossRef
32.
Zurück zum Zitat Bazzocchi A, Filonzi G, Ponti F, Amadori M, Sassi C, Salizzoni E, Albisinni U, Battista G (2013) The role of ultrasonography in the evaluation of abdominal fat: analysis of technical and methodological issues. Acad Radiol 20:1278–1285PubMedCrossRef Bazzocchi A, Filonzi G, Ponti F, Amadori M, Sassi C, Salizzoni E, Albisinni U, Battista G (2013) The role of ultrasonography in the evaluation of abdominal fat: analysis of technical and methodological issues. Acad Radiol 20:1278–1285PubMedCrossRef
33.
Zurück zum Zitat Iacobellis G, Corradi D, Sharma AM (2005) Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2:536–543PubMedCrossRef Iacobellis G, Corradi D, Sharma AM (2005) Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2:536–543PubMedCrossRef
34.
Zurück zum Zitat Lorber D (2013) GLP-1 receptor agonists: effects on cardiovascular risk reduction. Cardiovasc Ther 31:238–249PubMedCrossRef Lorber D (2013) GLP-1 receptor agonists: effects on cardiovascular risk reduction. Cardiovasc Ther 31:238–249PubMedCrossRef
35.
Zurück zum Zitat Bacchi E, Negri C, Tarperi C, Baraldo A, Faccioli N, Milanese C, Zanolin ME, Lanza M, Cevese A, Bonora E, Schena F, Moghetti P (2014) Relationships between cardiorespiratory fitness, metabolic control, and fat distribution in type 2 diabetes subjects. Acta Diabetol 51:369–375PubMedCrossRef Bacchi E, Negri C, Tarperi C, Baraldo A, Faccioli N, Milanese C, Zanolin ME, Lanza M, Cevese A, Bonora E, Schena F, Moghetti P (2014) Relationships between cardiorespiratory fitness, metabolic control, and fat distribution in type 2 diabetes subjects. Acta Diabetol 51:369–375PubMedCrossRef
Metadaten
Titel
Short-term effects of glucagon-like peptide 1 (GLP-1) receptor agonists on fat distribution in patients with type 2 diabetes mellitus: an ultrasonography study
verfasst von
Susanna Morano
Elisabetta Romagnoli
Tiziana Filardi
Luciano Nieddu
Elisabetta Mandosi
Mara Fallarino
Irene Turinese
Mariangela Pia Dagostino
Andrea Lenzi
Vincenzo Carnevale
Publikationsdatum
01.08.2015
Verlag
Springer Milan
Erschienen in
Acta Diabetologica / Ausgabe 4/2015
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-014-0710-z

Weitere Artikel der Ausgabe 4/2015

Acta Diabetologica 4/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.