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Effect of GLP-1 receptor agonists on waist circumference among type 2 diabetes patients: a systematic review and network meta-analysis

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Abstract

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used in patients with type 2 diabetes. However, the effect on abdominal obesity has not yet been confirmed. The study aimed to systematically evaluate the effect of GLP-1RAs on waist circumference in patients with type 2 diabetes. MEDLINE, EMBASE, the Cochrane library and www.clinicaltrialgov were searched through October 31, 2013. Randomized controlled trials with available data were selected if they compared GLP-1 RAs with placebo and traditional anti-diabetic drugs with a duration ≥8 weeks. Weighted mean difference was estimated using random-effect model. Network meta-analysis was performed to supplement direct comparisons. Seventeen trials with 12 treatments were included. Overall, significant reductions on waist circumference following treatment of liraglutide—1.8 mg once daily (−5.24 cm, 95 % CI −7.68, −2.93), liraglutide—1.2 mg once daily (−4.73 cm, 95 % CI −6.68, −2.65) and exenatide—10 μg twice daily (−1.34 cm, 95 % CI −2.00, −0.75) were detected versus placebo. The reduction effect was more evident when compared with insulin and thiazolidinediones (range −1.71 to −8.03 cm). Compared with exenatide, liraglutide—0.6 mg once daily, taspoglutide, liraglutide—1.2 mg once daily and liraglutide—1.8 mg once daily significantly decreased waist circumference from −3.32 to −6.01 cm. Besides, liraglutide—1.8 mg once daily significantly decreased waist circumference by −1.73 cm (95 % CI −3.04, −0.55) versus sitagliptin, whereas no significant difference following liraglutide—1.2-mg-once-daily treatment was detected compared with liraglutide—1.8 mg once daily and sitagliptin. Reduction was observed with statistical significance for exenatide—10 μg twice daily compared with exenatide—5 μg twice daily (−1.21 cm, 95 % CI −2.43, −0.06). Ranking probability analysis indicated liraglutide—1.8 mg once daily and liraglutide—1.2 mg once daily decreased waist circumference most among all 12 treatments with probability of 98.36% and 91.82 %, respectively. Some GLP-1RAs, especially liraglutide—1.8 mg once daily and liraglutide—1.2 mg once daily, were associated with a significant reduction in waist circumference.

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Acknowledgments

We are grateful to all cooperating organizations and their staff whose hard work made this study possible. Special thanks to all of the original study authors who promptly and graciously responded to our requests for information.

Funding

This study is funded by National Natural Science Foundation of China (81302508), Research Fund for the Doctoral Program of Higher Education (20120001110015) and the Doctoral Fund of corps (2010JC15) and National Key Technology R&D Program of China (2009BAI82B04).

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing, 100191, China

    Feng Sun, Shanshan Wu, Zhirong Yang, Lishi Li, Yuan Zhang & Siyan Zhan

  2. Department of Preventive Medicine, College of Medicine, Shihezi University, Shihezi, 832002, China

    Feng Sun & Shuxia Guo

  3. Department of orthopedics, Tianjin Fifth Central Hospital, Tianjing, 300450, China

    Kai Yu

  4. Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Guangdong, 515041, China

    Zhirong Yang

  5. Department of statistics, Graduate school of arts and sciences, Columbia University, New York, NY, 10027, USA

    Lishi Li

  6. Department of Endocrinology and Metabolism, People’s Hospital, Peking University, Beijing, 100044, China

    Linong Ji

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  1. Feng Sun
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  7. Yuan Zhang
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Correspondence to Siyan Zhan.

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Feng Sun and Shanshan Wu contributed equally to this work.

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Sun, F., Wu, S., Guo, S. et al. Effect of GLP-1 receptor agonists on waist circumference among type 2 diabetes patients: a systematic review and network meta-analysis. Endocrine 48, 794–803 (2015). https://doi.org/10.1007/s12020-014-0373-0

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