Favorable liver and skeletal muscle changes in patients with MASLD and T2DM receiving glucagon-like peptide-1 receptor agonist: A prospective cohort study
Open accessAbstract
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 (cm 2 /m 2 ), 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/m 2 ) (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.
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Few studies of anti-obesity drug treatment directly evaluate intramyocellular lipids in humans or animals, and none were conducted in aged humans or animals; all involved models of obesity and/or Type 2 diabetes.
“There are few studies of anti-obesity drug treatment that directly evaluate IMCLs in either humans or animals [153–156], which report either decreases or no change in IMCL. However, none of these studies were conducted in aged humans or animals, and all involved models of obesity and/or Type 2 diabetes.”
From Targeting Intramyocellular Lipids to Improve Aging Muscle Function (2025) · cites this paper as [155]
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- Authors
- Kakegawa, T., Sugimoto, K., Saito, K., Yunaiyama, D., Araki, Y., Wada, T., Takahashi, H., Yoshimasu, Y., Takeuchi, H., & Itoi, T.
- Affiliations
- Tokyo Medical University (JP)
- Corresponding author
- Sugimoto, Katsutoshi
- ORCID
- Venue
- Medicine
- Published
- 2024-06-07
- Volume
- 103
- Issue
- 23
- Pages
- e38444
- ISSN
- 0025-7974 (ISSN-L)
- 1536-5964
- PMC
- PMC11155541
- OpenAlex
- W4399431363
- Cited by
- 32
- References
- 23
- Citations by year
- 2026: 11 · 2025: 20 · 2024: 1
- FWCI
- 9.71
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- non-alcoholic fatty liver disease, type 2 diabetes, semaglutide, GLP-1 receptor agonists, hepatic steatosis, skeletal muscle mass, proton density fat fraction, magnetic resonance elastography, liver stiffness, liver fibrosis, glycemic control, liver enzymes
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Semaglutide, Adult, Aged, Diabetes Mellitus, Type 2, Glucagon-Like Peptides, Fatty Liver, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Liver, Magnetic Resonance Imaging, Male, Middle Aged, Pilot Projects, Prospective Studies, Muscle, Skeletal, Elasticity Imaging Techniques
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