EASD 2022: Tirzepatide Shows Beneficial Effects on Body Fat Distribution Pattern in People with Type 2 Diabetes

The effect of Tirzepatide (TZP) on the body fat distribution was evaluated in the SURPASS-3 MRI sub-study where the overall fat distribution pattern at baseline and week 52 was observed.   The aim of this study is to describe overall fat distribution pattern and the relation between the actual changes in fat depots to the changes predicted by the difference in two virtual controls groups (VCGs) matching baseline and 52-week data were assessed. 

In the sub-study, people with T2D (metformin ± SGLT-2i, HbA1c 7-10.5%, BMI ≥25kg/m2, fatty liver index value ≥60) were treated with once-weekly TZP 5 mg (N=71), 10 mg (N=79), 15 mg (N=72) or once-daily insulin degludec (IDeg) (N=74).   Results showed that people treated with TZP demonstrated a mean weight loss of -9.6 kg at week 52.

In the present study, for each study participant at baseline and week 52, a VCG of ≥150 participants with the same sex, and similar body size (height, weight, BMI) were identified from the UK Biobank imaging study (N=40,174,). Expected levels of visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT) and liver fat (LF) VAT, deviation from the expected levels (standardized normal z-scores (VATz, aSATz, LFz); units = standard deviation [SD]) were calculated based on individualized matched VCG.   

Baseline fat distribution pattern was similar across pooled TZP and IDeg arms. TZP group had a significant decrease in VATz (-0.18 (0.58), p<0.001) and LFz (-0.54 (0.84), p<0.001) while aSATz increased (0.11 (0.50), p=0.011), which showed a greater loss of VAT and LF, and smaller loss of aSAT than predicted by their observed weight loss. 

As compared to matched VCG, TZP group on average lost 0.31 L more VAT (p<0.001), 5.64 percent more LF (p<0.001) and 0.16 L less aSAT (p=0.018) than would be predicted by observed weight loss. 

The observations from this study showed that treatment with TZP resulted in a greater reduction of VAT and LF than would be predicted by observed weight loss alone, indicating a targeted and potentially beneficial shift in fat distribution pattern.