Effect of liraglutide administration and a calorie-restricted diet on lipoprotein profile in overweight/obese persons with prediabetes

• Published in: Nutrition, metabolism, and cardiovascular diseases Vol. 24; no. 12; pp. 1317 - 1322
• Main Authors: Ariel, D, Kim, S.H, Abbasi, F, Lamendola, C.A, Liu, A, Reaven, G.M
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.12.2014
• Subjects: Aged; Apolipoprotein A-I - blood; Apolipoproteins B - blood; Blood Glucose - metabolism; Body Mass Index; Caloric Restriction; Cardiovascular; Cardiovascular disease; Cholesterol, VLDL - blood; Combined Modality Therapy; Glucagon-Like Peptide 1 - adverse effects; Glucagon-Like Peptide 1 - analogs & derivatives; Glucagon-Like Peptide 1 - therapeutic use; Glucagon-like peptide-1 receptor agonist; Humans; Hypoglycemic Agents - therapeutic use; Incretin treatment; Lipoprotein profile; Lipoprotein(a) - blood; Lipoproteins, HDL - blood; Liraglutide; Male; Middle Aged; Obesity - diet therapy; Obesity - drug therapy; Overweight - diet therapy; Overweight - drug therapy; Prediabetes; Prediabetic State - diet therapy; Prediabetic State - drug therapy; Kcal; triglyceride; C; VAP; kilocalories; Cardiovascular disease; lipoprotein a; IDL; very-low-density lipoprotein; HDL; SD; LDL; VLDL; high-density lipoprotein cholesterol; apoprotein; cholesterol; vertical auto profile; LPa; BMI; GLP-1 RA; apo; intermediate-density lipoprotein; body mass index; Prediabetes; low-density lipoprotein; CVD; Lipoprotein profile; TG; Glucagon-like peptide-1 receptor agonist; Incretin treatment; standard deviation
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2014.06.010

Abstract Background and aims To evaluate the effects of 14 weeks of liraglutide plus modest caloric restriction on lipid/lipoprotein metabolism in overweight/obese persons with prediabetes. Methods and results Volunteers with prediabetes followed a calorie-restricted diet (−500 Kcal/day) plus liraglutide ( n  = 23) or placebo ( n  = 27) for 14 weeks. The groups were similar in age (58 ± 7 vs. 58 ± 8 years) and body mass index (31.9 ± 2.8 vs. 31.9 ± 3.5 kg/m2 ). A comprehensive lipid/lipoprotein profile was obtained before and after intervention using vertical auto profile (VAP). Weight loss was greater in the liraglutide group than in the placebo group (6.9 vs. 3.3 kg, p  < 0.001), as was the fall in fasting plasma glucose concentration (9.9 mg/dL vs. 0.3 mg/dL, p  < 0.001). VAP analysis revealed multiple improvements in lipid/lipoprotein metabolism in liraglutide-treated compared with placebo-treated volunteers, including decreases in concentrations of total cholesterol, low-density lipoprotein cholesterol and several of its subclasses, triglyceride, and non-high-density cholesterol. The liraglutide-treated group also had a significant shift away from small, dense low-density lipoprotein-particles, as well as decreases in apolipoprotein B concentration and ratio of apolipoprotein B/apolipoprotein A-1. There were no significant changes in the lipoprotein profile in the placebo-treated group. Conclusion Treatment with liraglutide plus modest calorie restriction led to enhanced weight loss, a decrease in fasting plasma glucose concentration, and improvement in multiple aspects of lipid/lipoprotein metabolism associated with increased cardiovascular disease (CVD) risk. The significant clinical benefit associated with liraglutide-assisted weight loss in a group at high risk for CVD – obese/overweight individuals with prediabetes – as seen in our pilot study, suggests that this approach deserves further study.