Department of Gastroenterology and Hepatology, Tokyo Medical University, Shinjuku-ku, Japan.
Department of Radiology, Tokyo Medical University, Shinjuku-ku, Japan.
Medicine (Baltimore). 2024 Jun 7;103(23):e38444. doi: 10.1097/MD.0000000000038444.
To investigate changes in skeletal muscle mass and fat fraction in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) undergoing treatment with Semaglutide for 6months. This single-arm pilot study included 21 patients with MASLD who received semaglutide for T2DM. Body weight, metabolic parameters, liver enzymes, fibrosis markers, skeletal muscle index (cm2/m2), and fat fraction (%) at the L3 level using the two-point Dixon method on magnetic resonance imaging (MRI), as well as liver steatosis and liver stiffness assessed using MRI-based proton density fat fraction (MRI-PDFF) and MR elastography, respectively, were prospectively examined before and 6 months after semaglutide administration. The mean age of the patients was 53 years and 47.6% were females. The median liver steatosis-fraction (%) and skeletal muscle steatosis-fraction values (%) significantly decreased (22.0 vs 12.0; P = .0014) and (12.8 vs 9.9; P = .0416) at baseline and 6 months, respectively, while maintaining muscle mass during treatment. Semaglutide also dramatically reduced hemoglobin A1c (%) (6.8 vs 5.8, P = .0003), AST (IU/L) (54 vs 26, P < .0001), ALT (IU/L) (80 vs 34, P = .0004), and γ-GTP (IU/L) levels (64 vs 34, P = .0007). Although not statistically significant, Body weight (kg) (79.9 vs 77.4), body mass index (BMI) (kg/m2) (28.9 vs 27.6), and liver stiffness (kPa) (28.9 vs 27.6) showed a decreasing trend. Fibrosis markers such as M2BPGi, type IV collagen, and skeletal muscle area did not differ. Semaglutide demonstrated favorable effects on liver and skeletal muscle steatosis, promoting improved liver function and diabetic status.
探讨接受司美格鲁肽治疗 6 个月的代谢功能相关脂肪性肝病（MASLD）合并 2 型糖尿病（T2DM）患者骨骼肌质量和脂肪分数的变化。
这项单臂试点研究纳入了 21 名接受司美格鲁肽治疗 T2DM 的 MASLD 患者。前瞻性检测治疗前及治疗 6 个月时体重、代谢参数、肝酶、纤维化标志物、磁共振成像（MRI）上 L3 水平的骨骼肌指数（cm2/m2）和脂肪分数（%），以及分别采用 MRI 质子密度脂肪分数（MRI-PDFF）和磁共振弹性成像评估肝脂肪变性和肝硬度。
患者平均年龄为 53 岁，47.6%为女性。肝脂肪变性分数（22.0%比 12.0%；P=0.0014）和骨骼肌脂肪变性分数（12.8%比 9.9%；P=0.0416）中位数在基线和治疗 6 个月时均显著降低，同时治疗期间肌肉质量保持不变。司美格鲁肽还显著降低了糖化血红蛋白（%）（6.8%比 5.8%，P=0.0003）、AST（IU/L）（54 比 26，P<0.0001）、ALT（IU/L）（80 比 34，P=0.0004）和γ-GTP（IU/L）水平（64 比 34，P=0.0007）。尽管没有统计学意义，但体重（kg）（79.9 比 77.4）、体重指数（kg/m2）（28.9 比 27.6）和肝硬度（kPa）（28.9 比 27.6）呈下降趋势。M2BPGi、IV 型胶原和骨骼肌面积等纤维化标志物无差异。司美格鲁肽对肝和骨骼肌脂肪变性有良好的疗效，促进肝功能和糖尿病状态改善。
