Effects of Pep19 on adipose tissue distribution and metabolic parameters in adults with obesity: A randomized, double-blind, placebo-controlled trial.

Whether modulation of adipose tissue distribution alone can improve insulin sensitivity independently of weight loss remains unclear. In this randomized, double-blind, placebo-controlled 90-day trial, we investigated whether adults with obesity could achieve metabolic improvement through modulation of adipose tissue distribution independent of weight loss. Fifty-six participants received oral placebo or Pep19 (5 or 10 mg daily). Regional fat distribution and metabolic parameters were assessed longitudinally. Pep19 at 10 mg reduced central adiposity, as demonstrated by a reduced android-to-gynoid fat ratio and decreased abdominal skinfold thickness, without affecting body weight, caloric intake, or physical activity. Glycated hemoglobin (HbA1c) and HOMA-IR were significantly reduced, despite unchanged fasting glucose, indicating improved insulin sensitivity. These findings suggest that Pep19 promotes favorable changes in adipose tissue distribution accompanied by improvements in insulin sensitivity independent of significant weight loss, supporting further evaluation in larger and longer-term clinical studies.