Effect of Liraglutide on Fat Mass Percentage Among Overweight and Obese Adults with Type 2 Diabetes: A Systematic Review

Figures & data

Figure 1 PRISMA 2020 flow diagram of the selection process. *The total number of records identified using the keywords “Glucagon-like peptide-1 receptor agonists or GLP-1 or liraglutide or Saxenda” and “body composition or fat mass or fat-free mass or obesity” and “type 2 diabetes” from all databases (Web of Science, Cochrane, and Pubmed) was 5196. **All excluded records were excluded manually by three independant reviewers.

Table 1 Summary of RCT Studies

Study	Setting	Sample Size	Duration of Intervention	Study Population-Baseline	Intervention Group	Control	Outcome
Harder et al, 2004^Citation16	Denmark	33	8 weeks	Mean age:60.0 ± 9.5 years Sex (M/F): 21/12 Mean body weight: 101 kg Mean BMI: 36.6 ± 4.1 kg/m2 Mean HbA1c: 7.5 ± 1.2%	Liraglutide (0.6 mg)	Placebo	% fat mass: (Liraglutide, −0.98%, and placebo, −0.12%; P = 0.088) Anthropometric measurements:  ● Body weight: (Liraglutide, −0.7 kg, and placebo, −0.9 kg; P = 0.756)  ● Waist circumference: (Liraglutide, −0.5 cm, and placebo, −1.1 cm; P = 0.505) HbA1c: (Liraglutide, −0.33%, and placebo, 0.47%; P = 0.028)
Jendle et al, 2009^Citation17 (LEAD-2)	Mexico & US	160	26 weeks	Mean age: 57 years Sex (M/F): 104/56 Mean body weight: 90.5 kg BMI: ≤40 kg/m2 HbA1c: 8.3 ± 1.0%	Liraglutide (0.6, 1.2, 1.8 mg) + metformin (1.5–2 g)	Placebo + metformin (1.5–2 g)	% fat mass: Reduction (Liraglutide treatment added to metformin; P = 0.9694 for Liraglutide 0.6 mg, P = 0.4889 for Liraglutide 1.2 mg, P = 0.3871 for Liraglutide 1.8 mg). Anthropometric measurements:  ● Body weight: Mean body weight reduction (Liraglutide 0.6 mg, −0.7 kg, Liraglutide 1.2 mg, −2.0, Liraglutide 1.8 mg, −3.2 and placebo, −1.3 kg) HbA1c: in a dose-dependent manner (Liraglutide 0.6 mg, −0.6%, Liraglutide 1.2 mg, −0.9%, Liraglutide 1.8 mg, −1.0%; P < 0.0001 and placebo, +0.4%)
Mensberg et al 2016^Citation18	Denmark	33	16 weeks	Mean age: 56 ± 11 years Sex (M/F): 23/10 Mean body weight: 98.9 ± 15.9 kg Mean BMI: 32.4 ± 4.4 kg/m2 Mean HbA1c: 8.1 ± 1.3%	Liraglutide (1.8 mg) + exercise	Placebo + exercise	% fat mass: (Liraglutide added to exercise, −2.5 ± 1.4%, and placebo added to exercise, −2.2 ± 1.9%; P = 0.77) Anthropometric measurements:  ● Body weight: (Liraglutide added to exercise−3.4 ± 2.9kg, and placebo added to exercise, −1.6 ± 3.2 kg; P = 0.10)  ● BMI: (Liraglutide added to exercise, −1.1 ± 1.1 kg/m^2, and placebo added to exercise, −0.5 ± 1.0; P = 0.11) HbA1c: (Liraglutide added to exercise, −2.0 ± 1.2%, and placebo, −0.3 ± 0.9%; P <0.001)

Table 2 Summary of Observational Studies

Study	Setting	Sample Size	Duration of Intervention	Study Population-Baseline	Intervention	Outcome
Rondanelli et al, 2016^Citation19 Cohort	Italy	28	24 weeks	Mean age:58.75 ± 9.33 years Female sex: 12 Mean body weight: 94.58±18.32 kg Mean BMI: 34.13 ± 5.64 kg/m2 Mean HbA1c: 8.26 ± 1.51%	Liraglutide (3 mg) + diet modification	% fat mass: −1.45% (P= 0.009) Anthropometric measurements:  ● Body weight: From baseline (p = 0.026)  ● BMI (P=0.024)  ● Waist circumference (P < 0.001) HbA1c: −1.40% (P= 0.001)
Perna et al, 2016^Citation13 Case series	Italy	9	24 weeks	Mean age: 68.22+ 3.86 years Female sex: 3 Mean body weight: 86.01 ±15.01 kg BMI: 32.34 ± 4.89 kg/m2 HbA1c: 7.90 ± 1.79%	Liraglutide (3 mg) +diet modification (1800 to 2500 kcal)	% fat mass: (−0.70%). Anthropometric measurements: Median from baseline  ● Body weight: (−2 kg)  ● BMI = −0.78 Kg/m2  ● Waist circumference = −2 cm HbA1c: Median from baseline −0.80%

Figure 2 Risk of bias summary for RCTs. Red (-) high risk of bias; yellow (?) unclear risk of bias green (+) low risk of bias.

Figure 3 Forest plot of mean change in body fat (%) according to liraglutide and placebo.

Figure 4 Forest plot of mean change in weight (%) according to liraglutide and placebo.

Figure 5 Forest plot of mean change in Hba1c (%) according to liraglutide and placebo.

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