Key result
During a 52-week weight maintenance phase, exercise alone or in combination with liraglutide significantly reduced carotid intima-media thickness by 7% and 6% respectively, whereas liraglutide alone did not.
Why the study?
Obesity and inactivity are linked to endothelial dysfunction and atherosclerosis, but the vascular effects of exercise and liraglutide during weight loss maintenance remained to be determined.
Does exercise and/or liraglutide improve carotid intima-media thickness and inflammatory/endothelial biomarkers in adults with obesity after diet-induced weight loss?
RCT (n=130)
Double-blind
1:1:1:1 ratio
No
Does exercise and/or liraglutide improve carotid intima-media thickness and inflammatory/endothelial biomarkers in adults with obesity after diet-induced weight loss?
Effect estimate: 7% reduction (Exercise group) (95% CI 2 to 12)
p-value: p=0.01
Regular physical activity, with or without liraglutide, reduces carotid intima-media thickness and systemic inflammation during weight loss maintenance in adults with obesity, whereas liraglutide alone does not.
Exercise should be prioritized in obesity weight-maintenance regimens for vascular benefit; challenges weak prior evidence favoring liraglutide monotherapy.
Obesity and inactivity are linked to endothelial dysfunction and atherosclerosis. In this secondary analysis of the S-LiTE trial (ClinicalTrials.gov identifier: NCT04122716 ; EudraCT identifier: 2015–005585-32 ), 130 adults with obesity completed a diet-induced weight loss plan, followed by randomization to weight maintenance with exercise and/or liraglutide for 52 weeks. We show that exercise, alone or in combination with liraglutide, reduces carotid intima-media thickness and systemic pro-inflammatory cytokine levels (interleukin-6 and interferon-γ). Combination treatment also improves endothelial function biomarkers (sICAM-1, sVCAM-1 and tPA). Liraglutide alone shows no such improvements. Overall, regular physical activity, with or without GLP-1R agonists, is essential for promoting vascular health in adults with obesity.
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Sandsdal et al. (2026) conducted an RCT in Obesity (n=130). Exercise and/or Liraglutide vs. Placebo with usual activity was evaluated on Change in carotid intima-media thickness (cIMT) (7% reduction (Exercise group), 95% CI 2 to 12, p=0.01). During a 52-week weight maintenance phase, exercise alone or in combination with liraglutide significantly reduced carotid intima-media thickness by 7% and 6% respectively, whereas liraglutide alone did not.
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