Effect of Calorie Restricted Diet Versus Liraglutide on Intrapancreatic Fat Deposition in People With Obesity: A Pilot Study.

Both calorie restricted diet and liraglutide produced significant and comparable reductions in pancreatic fat fraction over 24 weeks.

• Study was a 24-week prospective nonrandomized pilot study with n=23 in each group
• Primary endpoint was change in pancreatic fat fraction (PFF)
• Time effect for PFF reduction: p < 0.001
• Interaction effect between groups for PFF: p = 0.560, indicating no significant difference between interventions

Both interventions produced significant and similar improvements in body weight, liver fat fraction, and visceral fat area.

• Secondary endpoints included changes in body weight, liver fat fraction (LFF), and visceral fat area (VFA)
• All time effects for these measures: p < 0.001
• All interaction effects between groups: p > 0.05, indicating no significant between-group differences
• Findings applied equally to both CRD (n=23) and liraglutide (n=23) groups

Both interventions produced significant and similar improvements in glycemic-related parameters including HbA1c, HOMA2-IR, and ISIM.

• Glycemic endpoints included HbA1c, HOMA2-IR (insulin resistance measure), and ISIM (insulin sensitivity index)
• All time effects: p < 0.001
• All interaction effects between groups: p > 0.05
• Results indicate both CRD and liraglutide were equivalently effective for glycemic improvement

Change in HOMA2-IR was positively associated with change in body weight and change in liver fat fraction, but negatively associated with change in pancreatic fat fraction.

• Regression analysis was used to explore associations between changes in adiposity-related metrics and glycemic parameters
• ΔHOMA2-IR was positively associated with Δweight
• ΔHOMA2-IR was positively associated with ΔLFF (liver fat fraction)
• ΔHOMA2-IR was negatively associated with ΔPFF (pancreatic fat fraction)

Change in ISIM (insulin sensitivity) was negatively associated with change in visceral fat area and positively associated with change in pancreatic fat fraction.

• ΔISIM was negatively associated with ΔVFA (visceral fat area)
• ΔISIM was positively associated with ΔPFF (pancreatic fat fraction)
• These regression findings suggest liver and visceral fat loss primarily drive improved insulin resistance
• Pancreatic fat reduction may relate to subtler insulin dynamics changes, according to the authors

The study was designed as a 24-week prospective nonrandomized pilot study comparing calorie restricted diet versus liraglutide in people with obesity.

• Total sample size was 46 participants (n=23 CRD, n=23 liraglutide)
• Study was nonrandomized with participant allocation to CRD or liraglutide groups
• This study was a sub-study of registered trial ChiCTR1900022948
• Described as a pilot study