Effect of GLP-1 receptor agonists on waist circumference among type 2 diabetes patients: a systematic review and network meta-analysis

Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in patients with type 2 diabetes. However, the effect on abdominal obesity has not yet been confirmed. The study aimed to systematically evaluate the effect of GLP-1RAs on waist circumference in patients with type 2 diabetes. MEDLINE, EMBASE, the Cochrane library and www.clinicaltrialgov were searched through October 31, 2013. Randomized controlled trials with available data were selected if they compared GLP-1 RAs with placebo and traditional anti-diabetic drugs with a duration≥8 weeks. Weighted mean difference was estimated using random-effect model. Network meta-analysis was performed to supplement direct comparisons. Seventeen trials with 12 treatments were included. Overall, significant reductions on waist circumference following treatment of liraglutide--1.8 mg once daily (-5.24 cm, 95% CI -7.68, -2.93), liraglutide--1.2 mg once daily (-4.73 cm, 95% CI -6.68, -2.65) and exenatide--10 μg twice daily (-1.34 cm, 95 % CI -2.00, -0.75) were detected versus placebo. The reduction effect was more evident when compared with insulin and thiazolidinediones (range -1.71 to -8.03 cm). Compared with exenatide, liraglutide--0.6 mg once daily, taspoglutide, liraglutide--1.2 mg once daily and liraglutide--1.8 mg once daily significantly decreased waist circumference from -3.32 to -6.01 cm. Besides, liraglutide--1.8 mg once daily significantly decreased waist circumference by -1.73 cm (95 % CI -3.04, -0.55) versus sitagliptin, whereas no significant difference following liraglutide--1.2-mg-once-daily treatment was detected compared with liraglutide--1.8 mg once daily and sitagliptin. Reduction was observed with statistical significance for exenatide--10 μg twice daily compared with exenatide--5 μg twice daily (-1.21 cm, 95% CI -2.43, -0.06). Ranking probability analysis indicated liraglutide--1.8 mg once daily and liraglutide--1.2 mg once daily decreased waist circumference most among all 12 treatments with probability of 98.36% and 91.82%, respectively. Some GLP-1RAs, especially liraglutide--1.8 mg once daily and liraglutide--1.2 mg once daily, were associated with a significant reduction in waist circumference.

Salba-chia (Salvia hispanica L.) in the treatment of overweight and obese patients with type 2 diabetes: A double-blind randomized controlled trial

“…Weight loss in the Salba-chia group was accompanied by reductions of 3.5cm in waist 253 circumference, which is greater than that seen with different types of GLP-1 receptor agonists of 254 -1.85cm in comparison with placebo or insulin treatment(17). Although there was no difference .9%, P=0.047) from baseline in the Salba-chia group, but not in control,257 supporting the assumption that there was an attenuation in visceral fat.…”

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

“…Several studies have shown that liraglutide has a positive effect on anthropometric parameters, in particular on body weight (as seen in the LEAD [Liraglutide Effect and Action in Diabetes] studies (reviewed in [3]) and waist circumference [15]. Liraglutide’s benefit was noted even in non-diabetic subjects [2, 8] and in those at high CV risk [16].…”

Gut Peptides Are Novel Regulators of Intestinal Lipoprotein Secretion: Experimental and Pharmacological Manipulation of Lipoprotein Metabolism

“…Alogliptin decreased fasting TG, apoB-48, and remnant-like particles (28), and anagliptin reduced fasting TG, apoB, and LDL-C (29). These effects may be related to the efficacy of these therapies in improving glycemic control with both GLP-1R agonists and DPP-4 inhibitors (12,30,31) and in reducing weight that is more notable with GLP-1R agonists than DPP-4 inhibitors (12,32,33). Future studies are required to determine the contribution of weight loss and improved glycemic control to fasting and postprandial lipids and to delineate the effects of these compounds on lipids independent of improved glycemic control and weight loss.…”