Liraglutide has significant cardiovascular benefit; however, the exact underlying mechanisms remain unclear.

We investigated a novel anti-atherogenic effect of liraglutide in a real-world prospective study on patients with type 2 diabetes mellitus (T2DM).

Our study shows that the vascular benefit of liraglutide in patients with T2DM is associated with reductions in atherogenic small dense low-density lipoproteins.

This vascular effect is independent of glycemic control and body weight reduction and may represent one of the key mechanisms by which liraglutide is able to reduce cardiovascular events.