Kurinami Noboru, Takada Masafumi, Ashida Kenji, Sugiyama Seigo, Yoshida Akira, Hieshima Kunio, Suzuki Tomoko, Miyamoto Fumio, Kajiwara Keizo, Jinnouchi Katsunori, Nomura Masatoshi, Jinnouchi Hideaki
Diabetes Care Center, Jinnouchi Hospital, Kumamoto, Japan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
JMA J. 2025 Apr 28;8(2):526-532. doi: 10.31662/jmaj.2024-0366. Epub 2025 Mar 28.
We examined the clinical factors associated with a decrease in weight induced by weekly semaglutide in patients with type 2 diabetes mellitus (T2DM).
Patients with T2DM who visited the Diabetes Care Center of Jinnouchi Hospital between June 2020 and October 2023 and were treated with semaglutide, 1.0 mg weekly, in addition to their ongoing medications were retrospectively registered. We measured body weight both before weekly administration of 1.0 mg semaglutide and 180 days after treatment and calculated the change in weight.
A total of 96 patients with T2DM were enrolled, with a mean body weight of 87.2 ± 17.1 kg and mean HbA1c of 7.3 ± 1.7% at baseline. The greater response group, defined as having 1.0 mg weekly semaglutide treatment-related weight reduction of more than 7.0%, comprised 23 patients (24.0%). Weekly 1.0 mg semaglutide treatment for 180 days significantly reduced body weight (-3.1 ± 4.8 kg, p < 0.001) and glycated hemoglobin (-0.39% ± 1.23%, p = 0.003). Multivariable logistic regression analysis found that pretreatment high-density lipoprotein (HDL)-cholesterol levels per 1.0 mg/dL (odds ratio [OR] 1.05; 95% confidence interval [CI] 1.01-1.09, p = 0.02) were independently and significantly associated with greater weight reduction after weekly 1.0 mg semaglutide treatment, while a switch from other glucagon-like peptide-1 receptor agonists (OR 0.31; 95% CI 0.11-0.87; p = 0.03) was independently and significantly associated with lesser weight reduction after weekly 1.0 mg semaglutide treatment. In receiver-operator characteristic analysis, the cutoff value of pretreatment HDL-cholesterol levels for the presence of greater response in weight reduction was 46 mg/dL (sensitivity 61%, specificity 62%; p = 0.03).
Pretreatment HDL-cholesterol levels serve as important information for weekly treatment with 1.0 mg semaglutide in patients with T2DM and expectation of weight reduction.
我们研究了2型糖尿病（T2DM）患者中与每周注射司美格鲁肽导致体重下降相关的临床因素。
回顾性登记了2020年6月至2023年10月期间就诊于神内医院糖尿病护理中心、在继续服用现有药物的基础上接受每周1.0毫克司美格鲁肽治疗的T2DM患者。我们测量了每周注射1.0毫克司美格鲁肽前及治疗180天后的体重，并计算体重变化。
共纳入96例T2DM患者，基线时平均体重为87.2±17.1千克，平均糖化血红蛋白为7.3±1.7%。反应较大组定义为每周1.0毫克司美格鲁肽治疗相关体重减轻超过7.0%，包括23例患者（24.0%）。每周1.0毫克司美格鲁肽治疗180天可显著降低体重（-3.1±4.8千克，p<0.001）和糖化血红蛋白（-0.39%±1.23%，p=0.003）。多变量逻辑回归分析发现，每1.0毫克/分升的治疗前高密度脂蛋白（HDL）胆固醇水平（优势比[OR]1.05；95%置信区间[CI]1.01-1.09，p=0.02）与每周1.0毫克司美格鲁肽治疗后更大的体重减轻独立且显著相关，而从其他胰高血糖素样肽-1受体激动剂转换（OR 0.31；95%CI 0.11-0.87；p=0.03）与每周1.0毫克司美格鲁肽治疗后较小的体重减轻独立且显著相关。在受试者工作特征分析中，治疗前HDL胆固醇水平对体重减轻有较大反应的截断值为46毫克/分升（敏感性61%，特异性62%；p=0.03）。
治疗前HDL胆固醇水平是T2DM患者每周使用1.0毫克司美格鲁肽并期望减轻体重的重要参考信息。
