Golub Lana S, Manubolu Venkat S, Aldana-Bitar Jairo, Dahal Suraj, Verghese Dhiran, Alalawi Luay, Krishnan Srikanth, Kianoush Sina, Benzing Travis, Ichikawa Keishi, Kinninger April, Fazlalizadeh Hooman, Pourafkari Leili, Ahmad Khadije, Susarla Shriraj, Mangaoang Czarina, Ghanem Ahmed K, Javier Denise Alison, Hamal Sajad, Roy Sion K, Budoff Matthew J
Harbor-UCLA Medical Center Lundquist Institute, Torrance, CA, USA.
Harbor-UCLA Medical Center Lundquist Institute, Torrance, CA, USA.
Nutr Metab Cardiovasc Dis. 2025 Apr 5:104036. doi: 10.1016/j.numecd.2025.104036.
The prevalence of hepatic steatosis continues to increase worldwide. Hepatic steatosis is increasingly recognized as an independent risk factor for cardiovascular mortality. However, there are limited options for the treatment of fatty liver. In this study, we evaluated the effect of semaglutide on liver fat as measured by non-contrast cardiac CT scans.
STOP is a randomized controlled trial that evaluated the semaglutide treatment effect on coronary atherosclerosis progression (STOP) in type 2 diabetes. We utilized unenhanced cardiac CT scans to quantify liver fat based on the CT Hounsfield attenuation method. Of the 140 subjects who were originally randomized, a total of 114 individuals qualified for this study. 59 participants were in the semaglutide group and 55 were in the placebo group, and these subjects were followed for 12 months. The secondary outcome (liver fat attenuation) was quantified using non-contrast cardiac computed tomography (CT) images at both the baseline and 12-month follow-up time points. Multivariate regression models were then used to evaluate the change in liver fat content overtime. One hundred and fourteen subjects were included in the study: 61 % male, mean age of 57.8 ± 8.1 years, and mean BMI of 32.0 ± 6.7. The average of three liver measures over 12 months showed an improvement in the semaglutide group of 1.4 ± 9.0 mean HU, versus a worsening in the placebo group of 1.9 ± 9.5 mean HU. The multivariable linear regression models (after adjusting for age, gender, BMI, hypertension, hyperlipidemia, past smoking and baseline liver attenuation) showed that average liver attenuation measures improved by 4.4 HU in the semaglutide group when compared to the placebo group (p = 0.002). This result demonstrated improvement in the liver fat content within the treatment group.
In type 2 diabetes patients with hepatic steatosis, treatment with semaglutide resulted in a significant improvement in fatty liver reduction when compared to placebo.
全球范围内，肝脂肪变性的患病率持续上升。肝脂肪变性日益被视为心血管疾病死亡率的独立危险因素。然而，脂肪肝的治疗选择有限。在本研究中，我们通过非增强心脏CT扫描评估了司美格鲁肽对肝脏脂肪的影响。
STOP是一项随机对照试验，评估了司美格鲁肽对2型糖尿病患者冠状动脉粥样硬化进展（STOP）的治疗效果。我们利用非增强心脏CT扫描，基于CT亨氏衰减法对肝脏脂肪进行量化。在最初随机分组的140名受试者中，共有114人符合本研究条件。59名参与者在司美格鲁肽组，55名在安慰剂组，这些受试者接受了12个月的随访。在基线和12个月随访时间点，使用非增强心脏计算机断层扫描（CT）图像对次要结局（肝脏脂肪衰减）进行量化。然后使用多变量回归模型评估肝脏脂肪含量随时间的变化。114名受试者纳入研究：男性占61%，平均年龄57.8±8.1岁，平均BMI为32.0±6.7。12个月内三次肝脏测量的平均值显示，司美格鲁肽组改善了1.4±9.0平均HU，而安慰剂组恶化了1.9±9.5平均HU。多变量线性回归模型（在调整年龄、性别、BMI、高血压、高脂血症、既往吸烟和基线肝脏衰减后）显示，与安慰剂组相比，司美格鲁肽组的平均肝脏衰减测量值改善了4.4 HU（p = 0.002）。这一结果表明治疗组肝脏脂肪含量有所改善。
在伴有肝脂肪变性的2型糖尿病患者中，与安慰剂相比，司美格鲁肽治疗可显著改善脂肪肝。
