Changes in liraglutide-induced body composition are related to modifications in plasma cardiac natriuretic peptides levels in obese type 2 diabetic patients

Abstract

Background and aims: Liraglutide treatment can improve glycemic control with a concomitant weight loss, but the underlying mechanism on weight loss is not completely understood. Cardiac natriuretic peptides (NPs) can resist body fat accumulation through increasing adipocytes lypolysis. In this study, we tested the hypothesis that liraglutide-induced weight loss was associated with increased plasma NPs concentrations.

Methods: Thirty-one outpatients with type 2 diabetes (T2D) treated with metformin and other oral antidiabetic drugs except for thiazolidinediones (TZDs) were subcutaneously administered with liraglutide for 12 weeks. Body composition, abdominal visceral adipose tissue areas (VAT) and subcutaneous adipose tissue areas (SAT) were assessed at pre- and post-treatment by dual-energy X-ray absorptiometry (DXA) scanning and abdominal computerized tomography (CT). Plasma atrial natriuretic peptides (ANP) and B-type ventricular natriuretic peptides (BNP) concentrations were tested by commercial ELISA Kit quantitatively.

Results: Following 12-week liraglutide treatment, body weight, waist circumference, total fat and lean mass, fat percentage, SAT and VAT areas were significantly reduced from baseline. Concurrently, plasma ANP and BNP levels were significantly increased following 12-week liraglutide treatment. There were significant correlations between the reductions in body compositions and the increases in both plasma ANP and BNP levels.

Conclusions: There were significant correlations between increases in both plasma ANP and BNP levels and changes in liraglutide-induced body composition. Our data implied that increases in plasma NPs may add a novel dimension to explain how liraglutide induces weight loss.

Figure 1

Changes in the plasma ANP and BNP levels following 12-week liraglutide treatment. ANP: A-type natriuretic peptides. BNP: B-type ventricular natriuretic peptides. (A) and (B): Changes in the plasma ANP and BNP levels at pre-treatment and post-treatment respectively. (C) and (D): Comparisons the increases in the ANP and BNP levels within two subgroups stratified by reductions of body weight loss: subjects who lost weight more than 5% and subjects who lost weight less than 5%.

Figure 2

Correlations between changes in ANP and body compositions following 12-week liraglutide treatment. Δ: The change of values following liraglutide treatment. ANP: A-type natriuretic peptides. SAT: subcutaneous adipose tissue. VAT: visceral adipose tissue. (A): Change in plasma ANP levels and change in body weight. (B): Change in plasma ANP levels and change in fat mass. (C): Change in plasma ANP levels and change in relative fat mass. (D): Change in plasma ANP levels and change in lean mass. (E): Change in plasma ANP levels and change in VAT areas. (F): Change in plasma ANP levels and change in SAT areas.

Figure 3

Correlations between changes in BNP levels and body compositions following 12-week liraglutide treatment. Δ: The change of values following liraglutide treatment. BNP: B-type natriuretic peptides. SAT: subcutaneous adipose tissue. VAT: visceral adipose tissue. (A): Change in plasma BNP levels and change in body weight. (B): Change in plasma BNP levels and change in fat mass. (C): Change in plasma BNP levels and change in relative fat mass. (D): Change in plasma BNP levels and change in lean mass. (E): Change in plasma BNP levels and change in VAT areas. (F): Change in plasma BNP levels and change in SAT areas.