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According to the different distribution locations, human adipose tissue is mainly divided into subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT), which is related to the pathology of a variety of diseases, including insulin resistance, glucose lipid metabolism disorders, which can increase the risk of prostate cancer, breast cancer, colon cancer, arterial hypertension and ischemic heart disease.
Diabetes is one of the most common diseases worldwide, with 90% of type 2 diabetes. Type 2 diabetes mellitus is caused by a combination of decreased insulin secretion by pancreatic β cells and peripheral insulin resistance. Insulin resistance is not only a major feature of type 2 diabetes, but also a range of atherosclerotic diseases and obesity. However, body fat distribution is a key factor influencing insulin sensitivity. Body fat distribution may be more important than obesity in inducing insulin resistance, type 2 diabetes, and cardiovascular disease risk.
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in the treatment of type 2 diabetes. Not only does it lower glucose, but it also has a positive effect on weight loss, but few studies have reported on the effects of GLP-1RAs on fat distribution.
Recently, Professor Song Guangyao of the Department of Endocrinology of Hebei Provincial People's Hospital conducted the Evolution of Glucagon-like Peptide-1 Receptor Agonists on Fat Distribution in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis in the Journal of Diabetes The journal investigation publishes research reports entitled Research Reports. Studies have shown that GLP-1RAs can lead to a significant reduction in subcutaneous adipose tissue and visceral adipose tissue, which plays an active role in fat distribution in patients with type 2 diabetes.
Randomized controlled trials of GLP-1RAs and type 2 diabetes were screened in PubMed, Cochrane, Embase, and ClinicalTrials.gov databases until June 2021. The primary study endpoints were a reduction in VAT and SAT.
GLP-RAs significantly reduce visceral fat and subcutaneous fat
The study included 10 studies enrolling 541 patients.
Vat (SMD=-0.54, P=0.005) and SAT (SMD=-0.44, P<0.00001) were significantly reduced in the GLP-1RAs group compared with the control group.
In addition, there were significant reductions in body weight (WMD=-3.59, P<0.00001), waist circumference (WMD=-3.09, P=0.0001) and body mass index (BMI) (WMD=-1.11, P<0.00001).
Figure 1 Visceral fat in the GLP-RAs group was significantly reduced
Fig. 2 Significant reduction in subcutaneous fat in the GLP-RAs group
Summary of this article
This study suggests that GLP-1RAs, particularly liraglutide and exenatide, may play an active role in fat distribution in people with type 2 diabetes. After receiving GLP-1RAs, both VAT and SAT decreased significantly, but VAT decreased numerically more than SAT.
医脉通编译整理自：Duan K, Yan X, Gao Z, Hou Y, Lv X, Song G.Effect of Glucagon-like Peptide-1 Receptor Agonists on Fat Distribution in Patients with Type 2 Diabetes: A Systematic Review and Meta-analysis.J DIABETES INVEST. 2022 Feb 21.DOI: 10.1111/jdi.13775, PMID:35191185