Once-Weekly Semaglutide Induces an Early Improvement in Body Composition in Patients with Type 2 Diabetes: A 26-Week Prospective Real-Life Study

Abstract

Background: Body weight (BW) loss is an essential therapeutic goal in type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists are effective in reducing BW, but their effect on body composition has not yet been fully explored. The study aim was to assess the impact of Semaglutide on body composition in patients with T2D. Methods: Forty patients with T2D were treated with subcutaneous Semaglutide and evaluated at the baseline (T0) and after three (T3) and six (T6) months. Body composition was assessed by a phase-sensitive bioimpedance analyzer. Visceral adipose tissue (VAT) thickness was also measured with an ultrasonographic method (US-VAT). Anthropometric variables, muscular strength, and laboratory tests were analyzed and compared. Results: A significant decrease in VAT, the fat mass index (FMI), and BW loss was observed at all observation times. US-VAT, the skeletal mass index (SMI), the fat-free mass index (FFMI), waist circumferences, and glycated hemoglobin had lessened after three months and remained stable at T6. No variations in muscle strength, the muscle quality index, and body water were found. Discussion: In a real-life setting, Semaglutide provided significant weight loss mainly due to a reduction in the FMI and VAT, with non-clinically relevant changes in the SMI, the FFMI, and muscle strength. Most importantly, the results were obtained after three months of treatment and persisted thereafter.

Once-Weekly Subcutaneous Semaglutide Improves Fatty Liver Disease in Patients with Type 2 Diabetes: A 52-Week Prospective Real-Life Study

“…An improvement in body composition with Semaglutide was demonstrated in our previous study [ 28 ], and was herein confirmed after 52 weeks. In particular, fat mass and, more importantly, VAT, which is the leading contributor to insulin resistance and CV risk, significantly and progressively improved through the follow-up and had further decreased by T12 compared to T6.…”

“…Body composition was non-invasively measured by phase-sensitive, octopolar Segmental Multifrequency Bioelectrical Impedance Analysis (SMF-BIA; Seca mBCA 525; Seca GmbH & Co., KG, Hamburg, Germany), as described elsewhere [ 28 ]. Briefly, the measurements were obtained with patients in a supine position with each leg lying at an angle of 45° and each arm at an angle of 30° from the trunk.…”

“…Semaglutide is one of the most potent GLP-1 RAs, as demonstrated by its beneficial effects on glucose control [ 24 , 25 ], CV and renal protection [ 26 , 27 ], weight loss, and improving body composition [ 28 ]. The pathophysiological background of CV and renal diseases, T2D, obesity, and NAFLD is close, and the beneficial effect of a single treatment on composite endpoints is therefore desirable.…”

Comparison between obese and non-obese nonalcoholic fatty liver disease

“…Although the total lean body mass decreased from baseline (–9.7%), the proportion relative to total body mass increased by 3.0% with improvement in lean body mass to fat mass ratio [ 53 ]. Another study found that semaglutide resulted in significant declines in fat mass index and visceral adipose tissue, but not skeletal mass index, fat free mass index, and muscle strength [ 54 ]. However, further studies are needed on the use of these emerging novel therapies in lean or non-obese NAFLD patients [ 55 ].…”

Phenotyping obesity: A focus on metabolically healthy obesity and metabolically unhealthy normal weight

“…[265][266][267] Furthermore, they have a positive impact on body composition through significant improvements in VAT, fat mass index (FMI), epicardial fat and hepatic steatosis, thus making them an appealing drug in the management of different obesity phenotypes. [268][269][270] FGF21 is also being proposed as a potential novel therapeutic modality, especially with regard to improving hepatic steatosis. 271,272 Bariatric surgery to date is still the most effective strategy for weight loss and weight loss maintenance.…”