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) inflammatory 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 subcutaneous 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 effective in lowering fasting glucose, in comparison with weight loss by dieting. However, tumour necrosis factor-α ( 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) deposition, transforming growth factor-β ( 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 induce an inflammatory response in AT and influences ECM remodelling. Despite its superior 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.