Evaluation of the efficacy of semaglutide in the correction of lipotoxicity in patients with type 2 diabetes mellitus

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Abstract

Objective: Evaluation of the effect of semaglutide on lipotoxicity in patients with type 2 diabetes mellitus (DM2).

Materials and methods: A single-center prospective study included 63 patients aged 40–69 years with DM2 and obesity (body mass index 30.0–39.9 kg/m²) on metformin monotherapy (1000–2500 mg/day) and a glycated hemoglobin level of 7.0 to 9.0%. 59 patients completed the observation. For 6 months, patients received semaglutide 1 times a week with a dose titration of up to 1.0 mg, and the effectiveness of the therapy was evaluated at 3 and 6 months. Lipotoxicity was analyzed within the framework of the lipometabolic continuum using a comprehensive assessment of fat and muscle mass (anthropometry, bioimpedansometry, dual-energy X-ray absorptiometry in the Total Body Composition mode), carbohydrate metabolism, insulin resistance and secretory capacity of pancreatic β cells, lipid profile (total cholesterol, low-density lipoproteins, high-density lipoproteins, triglycerides), free fatty acid (FFA) and adiponectin levels, and biochemical and instrumental markers of liver status, including ultrasound and shear wave elastography with METAVIR fibrosis score.

Results: Semaglutide therapy leads to a decrease in FFA and triglyceride levels, transformation of the body composition with a decrease in fat mass, including visceral fat, an improvement in insulin sensitivity at various levels, including adipose tissue, an increase in β cell function and an improvement in the functional and structural state of the liver. Semaglutide had the greatest anti-lipotoxic effect in patients with initially more pronounced lipotoxicity.

Conclusion: Based on the data obtained, it can be concluded that semaglutide therapy contributes to a multicomponent anti-lipotoxic effectin patients with DM2 and obesity.

About the authors

Daria M. Antsiferova

Endocrinological Dispensary, Moscow Healthcare Department; Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: cifrenda@yandex.ru
ORCID iD: 0000-0002-3920-5914
SPIN-code: 5461-2590

еndocrinologist, Postgraduate Student, Department of Endocrinology

Russian Federation, Moscow; Moscow

A. S. Ametov

Russian Medical Academy of Continuous Professional Education

Email: alexander.ametov@gmail.com
ORCID iD: 0000-0002-7936-7619
SPIN-code: 9511-1413

Dr. Sci. (Med.), Professor, Head of the Department of Endocrinology

Russian Federation, Moscow

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