Visual Abstract

Background: Visceral/ectopic fat is a modifiable cardiovascular (CV) risk factor. Liraglutide, a glucagon like peptide 1 receptor agonist, reduces weight and CV events compared with placebo. We investigated its effects on body fat distribution in a high-risk population with overweight/obesity.

Methods: In this double blind, single center trial, we randomly assigned individuals ≥35 years with BMI ≥30 kg/m2 or ≥27 kg/m2 with metabolic syndrome to receive liraglutide or placebo for 40 wks in addition to reduced calorie diet and increased physical activity. Participants underwent a 6-minute neck to knee MRI scan for fat distribution at randomization and end of treatment. The primary outcome was relative percent change in visceral adipose tissue volume. Secondary endpoints included changes in adipose distribution and other biomarkers of CV risk.

Results: Of 185 randomized participants, 128 completed the study and were included in the mITT analysis. The cohort was 92% female, 38% Black, and 24% Hispanic with mean age 50 yrs and BMI 38 kg/m2 with median follow up 36 wks. Liraglutide significantly reduced visceral and ectopic fat and inflammation compared with placebo (Table).

Conclusions: Liraglutide reduced visceral/ectopic fat measured by MRI in adults with overweight/obese at high CV risk, with proportionally greater effects seen in the abdominal viscera and liver.


I. Neeland: Consultant; Self; Merck & Co., Inc. S. P. Marso: Consultant; Self; Novo Nordisk, Other Relationship; Self; Abbott Vascular, ASAHI Intecc, Boston Scientific Corporation. C. Ayers: None. A. Pandey: None. P. H. Joshi: Research Support; Self; Amgen Inc., AstraZeneca, NASA, Novartis AG, Novo Nordisk.


Novo Nordisk

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