Endocrine Abstracts

Introduction: There is currently high interest in the non-glycemic effects of incretin-based therapies, specifically glucagon-like peptide 1 (GLP-1) analogues, such as those on cardiovascular system. Liraglutide has been approved in Italy since one year to be prescribed in combination with oral hypoglycemic agents; it has several non-glycemic properties, but its effect on carotid intima-media thickness (IMT), a recognized marker of subclinical atherosclerosis, is still unknown.

Methods: We evaluated in our Italian center the effect of liraglutide on carotid IMT as assessed by B-mode real-time ultrasound, in a prospective study of 33 patients with type 2 diabetes (58% males, age: 59±9 years), when added to metformin at a fixed dose of 1500/daily. Patients were newly diagnosed or previously treated subjects with oral hypoglycemic agents. The dose of liraglutide was 0.6mg/daily for the first 2 weeks, followed by a dose of 1.2 mg/daily. Statistical analysis was done using paired t-test and the Spearman correlation method.

Results: At baseline patients weighted 82±9 Kg, with average fasting glucose 9.5±1.4 mmol/L and HbA1c 8.3±0.6%. The following significant changes in these parameters were recorded after 4 months of therapy: weight decreased by 3.1 kg, fasting glucose by 2.3mmol/l, and HbA1c by 1.8% (p<0.0001 for all). In addition, carotid IMT decreased from 1.55±0.45 mm to 1.36±0.31 mm (P=0.0003) after 4 months of treatment. Changes in carotid IMT did not correlate with changes in body weight, fasting glucose, or HbA1c; yet, we cannot exclude that this maybe due to the small sample size.

Conclusions: Liraglutide has desirable actions on carotid IMT, a surrogate marker of subclinical atherosclerosis, in type 2 diabetes after only a few months of therapy. This result may be at least partially independent of the effect of liraglutide on glucose metabolism. Future studies are needed to further explore this topic.

Declaration of interest: I fully declare a conflict of interest. Details below:

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.