Observational cohorts link remnant cholesterol and inflammation to equivalent coronary risk in BMI 25-26.9 versus current GLP-1 indications
Two large European cohorts indicate that nearly half of adults with BMI 25-26.9 and elevated remnant cholesterol or inflammation face coronary risk equivalent to currently eligible patients. Extending GLP-1 access would require confirmatory randomized outcome trials. Evidence remains observational and hypothesis-generating.
Next steps require dedicated randomized trials measuring hard cardiovascular endpoints in this narrower phenotype, with stratification by remnant cholesterol and inflammation to confirm whether GLP-1 receptor agonists reduce events beyond lifestyle intervention.
EASD investigators: A dedicated randomized cardiovascular outcomes trial in BMI 25-27 with remnant cholesterol above 0.8 mmol/L or CRP above 2 mg/L will launch by 2027 and report primary endpoints before 2031
Sources (3)
- [1]Primary Source(https://medicalxpress.com/news/2026-09-millions-people-overweight-benefit-glp.html)
- [2]Supporting Source(https://www.nejm.org/doi/full/10.1056/NEJMoa2307563)
- [3]Supporting Source(https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00985-4/fulltext)