Interdisciplinary Department of Medicine, School of Medicine, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy.
National Institute of Gastroenterology, "Saverio de Bellis", Research Hospital, Castellana Grotte, Via Turi 27, 70013 Bari, Italy.
Nutrients. 2022 Nov 4;14(21):4673. doi: 10.3390/nu14214673.
Nonalcoholic fatty liver disease (NAFLD) is commonly observed in patients with type 2 diabetes (T2D). Semaglutide, a glucagon-like peptide 1 receptor agonist, may have a therapeutic role by targeting common mechanisms involved in the pathophysiology of T2D and NAFLD. The study aimed to assess the effectiveness of Semaglutide on NAFLD in patients with T2D.
Forty-eight patients were treated with subcutaneous Semaglutide in add-on to metformin for 52 weeks. After the baseline visit (T0), follow-up was scheduled quarterly (T3, and T6) and then at 12 months of therapy (T12). During each visit, body composition was analyzed by phase-sensitive bio-impedance, and NAFLD was diagnosed and staged by Ultrasound (US) imaging. Surrogate biomarkers of NAFLD were also calculated and followed over time.
A significant decrease in anthropometric and glucometabolic parameters, insulin resistance, liver enzymes, and laboratory indices of hepatic steatosis was observed during treatment. Similarly, fat mass and visceral adipose tissue (VAT) decreased over time more than skeletal muscle and free-fat mass. US-assessed VAT thickness and the 12-point steatosis score also declined at T3 up to T12. Liver steatosis improved in most patients (70%), showing a reduction by at least one class in the semiquantitative US staging.
Besides glucose control and body composition improvements, Semaglutide was effective in ameliorating the clinical appearance and severity of NAFLD in T2D patients.
非酒精性脂肪性肝病（NAFLD）在 2 型糖尿病（T2D）患者中较为常见。胰高血糖素样肽 1 受体激动剂司美格鲁肽可能通过针对 T2D 和 NAFLD 病理生理学中涉及的共同机制发挥治疗作用。本研究旨在评估司美格鲁肽对 T2D 合并 NAFLD 患者的疗效。
48 例患者在接受二甲双胍治疗的基础上联合皮下注射司美格鲁肽，治疗 52 周。在基线访视（T0）后，每 3 个月（T3、T6）和治疗 12 个月（T12）时进行随访。每次访视时，通过相位敏感生物电阻抗分析法分析身体成分，并通过超声（US）成像诊断和分期 NAFLD。还计算并随时间推移跟踪 NAFLD 的替代生物标志物。
在治疗期间，观察到人体测量和糖代谢参数、胰岛素抵抗、肝酶以及肝脂肪变性的实验室指标显著下降。同样，脂肪质量和内脏脂肪组织（VAT）随时间减少，超过了骨骼肌和游离脂肪质量。在 T3 至 T12 时，US 评估的 VAT 厚度和 12 分脂肪变性评分也下降。大多数患者（70%）的肝脏脂肪变性得到改善，在半定量 US 分期中至少降低一个等级。
除了改善血糖控制和身体成分外，司美格鲁肽还能有效改善 T2D 患者的 NAFLD 临床症状和严重程度。
