Copenhagen study: half of mildly overweight adults have heart risk like GLP-1 drug candidates

A team from Copenhagen University Hospital in Herlev, led by Karen Hvid, reports that about half of adults with a body mass index of 25 to 26.9 have a coronary disease risk comparable to that of patients now eligible for GLP-1 analogues, according to Futura Sciences. The work was presented at the annual congress of the European Association for the Study of Diabetes in Milan at the end of September. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗ It is a conference communication, not a peer-reviewed publication.

The current marketing authorization for weight loss covers adults with a body mass index of 30 or more. It also covers those with an index of 27 or more who have at least one weight-related condition: lipid abnormalities, high blood pressure, type 2 diabetes or a cardiovascular history. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗ People with an index of 25 to 26.9 are therefore not covered, although they are in the overweight range.

Cohorts and markers

The researchers used two large prospective studies: the UK Biobank cohort and the Copenhagen General Population Study. They included 313,145 people with a body mass index of 25 or more. The median age was 58 years, the sexes were evenly balanced, and all participants were free of coronary disease and diabetes at entry. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗

Follow-up exceeded ten years. During that time 23,134 participants developed coronary disease, defined as a diagnosis, a heart attack, bypass surgery, coronary dilation or cardiovascular death. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗

The analysis added two markers to body weight: remnant cholesterol, meaning cholesterol that belongs to neither the HDL nor the LDL fraction, and low-grade chronic inflammation measured by blood markers.

Comparison of risk

About two thirds of participants, 204,850 people, met the current indication. More than 90% of those who did not had an index of 25 to 26.9. Among them, 44% in the Danish cohort and 48% in the British cohort had elevated remnant cholesterol, low-grade inflammation, or both. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗

People without an indication who had both abnormalities had a risk 41% higher in the Danish cohort and 47% higher in the British cohort than people without an indication and with normal cholesterol and inflammation. For people who met the indication, the increase was 41% in the Danish cohort and 35% in the British cohort. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗

Hvid noted that GLP-1 analogues can reduce cholesterol and inflammation and lower the risk of heart attack and stroke. She argues for widening the indication, with the explicit caveat that clinical trials are now needed. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗

The study is purely observational. It shows a comparable risk in this group but does not show that a GLP-1 analogue would reduce that risk. Methodological details of the results remain unavailable, and they may change before publication. futura-sciences.comFutura Sciencesfutura-sciences.comOpen source ↗