GLP-1 analogue-induced weight loss does not improve obesity-induced AT dysfunction

Glucagon-like peptide-1 (GLP-1) analogues aid weight loss that improves obesity-associated adipose tissue (AT) dysfunction. GLP-1 treatment may however also directly influence AT that expresses the GLP-1 receptor (GLP-1R). The present study aimed to assess the impact of GLP-1 analogue treatment on subcutaneous AT (SCAT) inflammat-ory and fibrotic responses, compared with weight loss by calorie reduction (control). Among the 39 participants with Type 2 diabetes recruited, 30 age-matched participants were randomized to 4 months treatment with Liraglutide (n= 22) or calorie restriction based on dietetic counselling (n= 8). Assessments included clinical characteristics and repeated sub-cutaneous abdominal AT biopsies. Liraglutide resulted in weight loss in most participants (-3.12+-1.72 kg, P= 0.007) and significant reduction in visceral AT (VAT). It was more e-ffective in lowering fasting glucose, in comparison with weight loss by dieting. However, tumour necrosis factor-a (TNFA) AT-expression (P= 0.0005), macrophage chemoattractant protein-1 (MCP-1) expression (P= 0.027) and its serum levels (P= 0.048) increased with Liraglutide, suggestive of an inflammatory response unlike in the diet arm in which a trend of lower cluster of differentiation 14 (CD14) expression (P= 0.09) was found. Liraglutide treatment also increased expression of factors involved in extracellular matrix (ECM) de-position, transforming growth factor-beta (TGFB) and collagen type 1 alpha 1 chain (COL1A1) (TGFB1: before 0.73 +/- 0.09 arbitrary units (AU), after 1.00 +/- 0.13 AU, P= 0.006; COL1A1: 0.84 +/- 0.09 AU compared with 1.49 +/- 0.26 AU, P= 0.026). Liraglutide thus appears to in-duce an inflammatory response in AT and influences ECM remodelling. Despite its super-ior effect on glycaemia, Liraglutide does not improve obesity-associated AT dysfunction in subcutaneous tissue. It is yet unclear whether this limits AT storage capacity for lipids. This may be of importance in patients being re-exposed to positive energy balance such as post GLP-1 discontinuation.