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Cited by 168Cardiovascular Disease and AdiposityDiabetes Treatment and ManagementAdipokines, Inflammation, and Metabolic Diseases

Effects of Semaglutide Versus Dulaglutide on Epicardial Fat Thickness in Subjects with Type 2 Diabetes and Obesity

Open access
Iacobellis, Gianluca, Villasante Fricke, Alexandra C·2020·Journal of the Endocrine Society
DOI 10.1210/jendso/bvz042PMC PMC7069837
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Abstract

Background and Aims: Epicardial adipose tissue (EAT), the visceral fat depot of the heart, is a modifiable cardio-metbolic risk factor and therapeutic target. Semaglutide and dulaglutide, glucagon-like peptide-1 (GLP-1) receptor agonists, are indicated for the treatment of type 2 diabetes mellitus (T2DM). GLP-1 receptor agonists have recently shown to reduce cardiovascular risk. Epicardial adipose tissue expresses GLP-1 receptors (GLP-1Rs). GLP-1 receptor agonist liraglutide is known to significantly decrease EAT thickness. However, the effects of GLP-1 receptor agonists semaglutide and dulaglutide on EAT thickness are unknown. Materials and Methods: We performed a 12-week, controlled, parallel study in 80 subjects with T2DM and obesity. Patients received either semaglutide, up to 1 mg subcutaneous (sc) weekly, or dulaglutide, up to 1.5 mg sc weekly, as the standard of care in addition to their usual medication regimen. Twenty subjects with T2DM and obesity were started on metformin and a diet and served as the control group. Ultrasound-measured EAT thickness was measured at baseline and at the 12-week follow-up. Results: Epicardial adipose tissue thickness significantly decreased in both semaglutide and dulaglutide groups (P < 0.001) after 12 weeks, accounting for a 20% reduction. There was no EAT reduction in the metformin group. Body mass index (BMI) and HbA1c improved in all groups without reaching statistical significance. Epicardial adipose tissue thickness reduction was significantly greater (P < 0.01) with the higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg), respectively. Conclusion: Weekly administration of either GLP-1 receptor agonists semaglutide or dulaglutide causes a rapid, substantial, and dose-dependent reduction in EAT thickness.

AI snapshot

Written from the paper’s full text.

TL;DR

In a 12-week controlled parallel study of 80 subjects with type 2 diabetes and obesity, weekly semaglutide or dulaglutide significantly reduced ultrasound-measured epicardial adipose tissue (EAT) thickness by approximately 20%, while metformin did not. The EAT reduction was dose-dependent, with greater reduction at maximum semaglutide (1 mg) and dulaglutide (1.5 mg) doses.

Key findings

  • EAT thickness decreased significantly in both semaglutide and dulaglutide groups after 12 weeks (reported as P < 0.001 in the abstract and P < 0.01 in the results/table), accounting for an approximate 20% reduction in both groups; there was no significant EAT reduction in the metformin group.
  • EAT reduction was significantly greater with higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg), respectively (P < 0.01 in both groups); 15 patients in each GLP-1 group reached the maximum dose.
  • BMI and HbA1c improved in all groups without reaching statistical significance; BMI reduction was approximately 5%, 6%, and 4% in the semaglutide, dulaglutide, and metformin groups, respectively, and approximately 12% in patients receiving maximum medication dosages.
  • HbA1c reduction was statistically higher in those receiving semaglutide 1 mg compared with dulaglutide 1.5 mg once weekly (P < 0.01). No serious adverse events occurred; 6 patients were lost to follow-up, including 4 who withdrew due to nausea.

Methods

  • Design: 12-week, controlled, parallel group study in 80 subjects with T2DM and obesity (BMI ≥ 27 kg/m²): 30 received semaglutide up to 1 mg subcutaneous weekly, 30 received dulaglutide up to 1.5 mg subcutaneous weekly, and 20 newly diagnosed subjects started metformin plus diet and served as controls.
  • Data/sample: Subjects were screened from a University of Miami outpatient diabetes clinic; data were obtained from electronic medical records. EAT thickness was measured by transthoracic ultrasound at baseline and 12 weeks, with intraclass correlation coefficient 0.90.
  • Analysis: Primary outcome was reduction in EAT thickness on semaglutide or dulaglutide compared with control; secondary outcome was change in HbA1c. Two-sample t-tests, nonparametric tests, and simple linear regression were used; P < 0.05 was considered significant.

Limitations

  • Stated: This was not a randomized clinical trial and no cardiovascular outcomes were evaluated; a randomized trial would be desirable. Echocardiographic EAT is a linear measurement at a single location and may not reflect variability of fat thickness or total EAT volume as measured by computed tomography; no other visceral fat depots were measured. Some results may have reached statistical significance with a larger sample size, and confounding variables cannot be ruled out.
  • Evident from the text: Patients were allocated to semaglutide or dulaglutide based on preference or medical insurance coverage, and baseline differences existed between groups, including older age, longer diabetes duration, higher HbA1c, and higher EAT in the GLP-1 groups versus controls.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1210/jendso/bvz042

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 36 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    BMI reduction was higher in patients receiving the maximum medication dosages, approximately 12% in both groups.

    “Body mass index reduction was higher in patients receiving the maximum medication dosages (approximately 12% in both groups).”
    Quote in the paperNot a substantial claim
  • Findingnone given

    Most patients were able to tolerate the maximum dosage of the drugs in each group.

    “Most of the patients were able to tolerate the maximum dosage of the drugs in each group.”
    Quote in the paperNot a substantial claim
  • Findingown data

    EAT thickness reduction was significantly greater with the higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg).

    “Epicardial adipose tissue thickness reduction was significantly greater (P < 0.01) with the higher doses of semaglutide (1 mg) and dulaglutide (1.5 mg), respectively.”
    • Also stated in: § 4. Intervention · plain
      “Epicardial adipose tissue showed a further statistically significant reduction in these patients, P < 0.01 in both groups (Fig. 1).”
    Quote in the paperSubstantial claim
  • Findingown data

    HbA1c reduction was statistically higher in patients receiving semaglutide 1 mg compared to patients using dulaglutide 1.5 mg once weekly.

    “HbA1c reduction was statistically higher in those receiving semaglutide, 1 mg, as compared to patients using dulaglutide, 1.5 mg, once a week (< 0.01).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Baseline EAT thickness was significantly higher in patients on semaglutide and dulaglutide compared to controls.

    “When compared to controls, EAT thickness was significantly higher at baseline in patients on semaglutide and dulaglutide (P < 0.01) despite no statistically significant difference in the BMI between the 3 groups.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 21
  • May combine two claims. 18

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Body mass index decreased in all groups without reaching statistical significance.

    “Body mass index decreased in all groups without reaching statistical significance, reflecting an approximately 5%, 6%, and 4% reduction in the semaglutide, dulaglutide, and metformin groups, respectively.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the dulaglutide group, neither change in EAT thickness nor change in BMI correlated with change in HbA1c over the study.

    “In the dulaglutide group, neither a change in EAT thickness or a change in BMI correlated with change in HbA1c over the course of the study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    HbA1c was reduced in the semaglutide and dulaglutide groups without reaching statistical significance.

    “HbA1c and LDL were also reduced in the semaglutide and dulaglutide groups without reaching enough statistical significance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    No serious adverse events occurred and no patients required hospitalization during the study.

    “No serious adverse events occurred and no patients required hospitalization during the study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Epicardial adipose tissue thickness significantly decreased in both semaglutide and dulaglutide groups after 12 weeks, accounting for approximately a 20% reduction.

    “Epicardial adipose tissue thickness significantly decreased in both semaglutide and dulaglutide groups (P < 0.001) after 12 weeks, accounting for a 20% reduction.”
    • Also stated in: § 4. Intervention · plain
      “Epicardial adipose tissue thickness decreased significantly in both the semaglutide and dulaglutide groups after the 12 weeks (P < 0.01 for both), accounting for an approximate 20% reduction in both groups”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Patients lost weight on either semaglutide or dulaglutide, consistent with the SUSTAIN 7 trial.

    “Consistent with the SUSTAIN 7 trial [19], patients lost weight on either semaglutide or dulaglutide.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Pratley, 2018, Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial, Lancet Diabetes Endocrinol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    No other visceral fat depots were measured in this study.

    “No other visceral fat depots were measured in this study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Echocardiographic EAT is a linear measurement at a single location and may not reflect the variability of fat thickness or total EAT volume as measured by computed tomography.

    “Echocardiographic EAT is a linear measurement at a single location and therefore may not reflect the variability of fat thickness or total EAT volume as measured by computed tomography.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two patients started on metformin discontinued the medication because of diarrhea or bloating.

    “Two patients who were started on metformin discontinued the medication because of diarrhea or bloating.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study was approved by the local institutional review board and conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.

    “The study was approved by local institutional review board (IRB # 20190944) and conducted in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The intraclass correlation coefficient of the EAT measurement was 0.90, indicating good reproducibility and reliability.

    “The intraclass correlation coefficient of the EAT measurement was 0.90, indicating good reproducibility and reliability.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Statistical analysis was performed only on patients who completed the 12-week study.

    “Statistical analysis was performed only on patients who completed the 12-week study.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was registered at clinicaltrials.gov (NCT04200625).

    “The study has been registered in www.clinicaltrials.gov (NCT04200625).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductnone given

    Some results may have reached statistical significance with a larger sample size.

    “Some results may have reached statistical significance with a larger sample size.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    No significant differences in carbohydrate or calorie intake between the groups were detected at baseline.

    “Although the diet varied according to the different ethnicities and habits of the patients, no significant differences in carbohydrates or calorie intake between the groups were detected at baseline.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Patients in the GLP-1 receptor agonist groups were older, had a longer duration of diabetes, and had a higher HbA1c than controls.

    “Patients in the GLP-1 receptor agonists groups were also older, with a longer duration of diabetes and with a higher HbA1c than controls, as expected.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The echocardiographer performing the follow-up measurement was blinded to the baseline EAT thickness value.

    “The echocardiographer performing the follow-up measurement was blinded to the baseline EAT thickness value.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The semaglutide and dulaglutide groups did not differ at baseline in EAT, age, ethnicity, c-peptide, lipids, blood pressure, heart rate, other diabetes drugs, lipid-lowering and blood pressure medications, renal or liver function tests, or diabetes history.

    “There were no differences in EAT, age, ethnicity, c-peptide, lipids, blood pressure, heart rate, other diabetes drugs, lipid lowering and blood pressure medications, renal or liver function tests, and diabetes history between the semaglutide and dulaglutide groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    HbA1c was higher in the dulaglutide group than in the semaglutide group at baseline.

    “However, HbA1c was higher in the dulaglutide group than in the semaglutide group (< 0.01).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Physical activity did not differ between the groups.

    “Physical activity did not differ between the groups, as most of the patients were sedentary to moderately active.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Each group had 2 patients lost to follow-up.

    “Each group had 2 patients lost to follow-up.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    EAT thickness by ultrasound correlates with waist circumference and intra-abdominal, intrahepatic, and intracardiac fat and serves as a good surrogate marker of visceral adiposity.

    “However, EAT thickness by ultrasound has been shown to nicely correlate with waist circumference and intra-abdominal, intrahepatic, and intracardiac fat and serve as a good surrogate marker of visceral adiposity [1].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1] Iacobellis, 2015, Local and systemic effects of the multifaceted epicardial adipose tissue depot, Nat Rev Endocrinol. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    EAT reduction can be mediated by a direct effect and activation of GLP-1R.

    “suggesting that EAT reduction can be mediated by a direct effect and activation of GLP-1R [18].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [18] Iacobellis, 2017, Human epicardial fat expresses glucagon-like peptide 1 and 2 receptors genes, Horm Metab Res. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Exenatide treatment for 12 weeks was associated with a milder reduction of EAT thickness.

    “A milder reduction of EAT thickness was also reported after 12 weeks of treatment with exenatide, a once weekly GLP-1 receptor agonist [17].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] Morano, 2015, Short-term effects of glucagon-like peptide 1 (GLP-1) receptor agonists on fat distribution in patients with type 2 diabetes mellitus: an ultrasonography study, Acta Diabetol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    EAT has been associated with fatal and nonfatal coronary events regardless of traditional cardiovascular risk factors.

    “Epicardial adipose tissue has been associated with fatal and nonfatal coronary events regardless of the traditional cardiovascular risk factors [21].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Mahabadi, 2013, Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf Recall Study, J Am Coll Cardiol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    EAT can be easily measured with standard ultrasound and independently reflects intra-abdominal visceral fat and myocardial triglyceride content.

    “Epicardial adipose tissue can be easily measured with standard ultrasound and independently reflects intra-abdominal visceral fat and myocardial triglyceride content [7–10].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [7] Iacobellis, 2003, Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk, J Clin Endocrinol Metab. source

      Not checked in the free run.

    • cites [8] Pierdomenico, 2013, Metaanalysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome, Am J Cardiol. source

      Not checked in the free run.

    • cites [9] Iacobellis, 2005, Epicardial adipose tissue and insulin resistance in obese subjects, J Clin Endocrinol Metab. source

      Not checked in the free run.

    • cites [10] Malavazos, 2010, Relation of echocardiographic epicardial fat thickness and myocardial fat, Am J Cardiol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Long-acting GLP-1 receptor analogs, such as semaglutide and dulaglutide, are convenient and effective therapeutic options given weekly administration and weight loss benefit.

    “Long-acting GLP-1 receptor analogs, such as semaglutide and dulaglutide, are convenient and effective therapeutic options given the ease of weekly administration and the benefit of weight loss [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Pratley, 2018, Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial, Lancet Diabetes Endocrinol. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    GLP-1 receptor agonists provide weight loss and cardiovascular protective effects.

    “In addition to providing control of diabetes mellitus, GLP-1 receptor agonists have shown to provide weight loss and cardiovascular protective effects [12–15].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [12] Kristensen, 2019, Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials, Lancet Diabetes Endocrinol.

      Not checked in the free run.

    • cites [13] Marso, 2016, Liraglutide and cardiovascular outcomes in type 2 diabetes, N Engl J Med. source

      Not checked in the free run.

    • cites [14] Gerstein, 2019, Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial, Lancet. source

      Not checked in the free run.

    • cites [15] Marso, 2016, Semaglutide and cardiovascular outcomes in patients with type 2 diabetes, N Engl J Med. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    EAT plays a key role in the development and progression of atherosclerosis and coronary artery disease.

    “Due to its peculiar anatomical location and proinflammatory transcriptome, EAT plays a key role in the development and progression of atherosclerosis and coronary artery disease [20].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] Mazurek, 2003, Human epicardial adipose tissue is a source of inflammatory mediators, Circulation. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A correlation between epicardial fat GLP-1R and genes encoding for brown fat activity and fatty acid oxidation has been reported.

    “Interestingly, a correlation between epicardial fat GLP-1R and genes encoding for brown fat activity and fatty acid oxidation has been recently reported [26].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [26] Dozio, 2019, Epicardial adipose tissue GLP-1 receptor is associated with genes involved in fatty acid oxidation and white-to-brown fat differentiation: a target to modulate cardiovascular risk?, Int J Cardiol. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Diabetic EAT has a peculiar proatherogenic transcriptome.

    “Remarkably, diabetic EAT has a peculiar proatherogenic transcriptome, as recently reported [22].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Camarena, 2017, Novel atherogenic pathways from the differential transcriptome analysis of diabetic epicardial adipose tissue, Nutr Metab Cardiovasc Dis. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    GLP-1 receptor is expressed in adipose tissue and mRNA and protein expressions are increased in epicardial and other visceral fat.

    “GLP-1 receptor is expressed in the adipose tissue and mRNA, and protein expressions are increased in epicardial and other visceral fat [18, 24, 28, 29].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [18] Iacobellis, 2017, Human epicardial fat expresses glucagon-like peptide 1 and 2 receptors genes, Horm Metab Res. source

      Not checked in the free run.

    • cites [24] Yang, 2013, Glucagon-like peptide 1 regulates adipogenesis in 3T3-L1 preadipocytes, Int J Mol Med. source

      Not checked in the free run.

    • cites [28] Vendrell, 2011, Study of the potential association of adipose tissue GLP-1 receptor with obesity and insulin resistance, Endocrinol. source

      Not checked in the free run.

    • cites [29] Jendle, 2009, Weight loss with liraglutide, a once-daily human glucagon-like peptide-1 analogue for type 2 diabetes treatment as monotherapy or added to metformin, is primarily as a result of a reduction in fat tissue, Diabetes Obes Metab. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    EAT is a modifiable and measurable cardiovascular risk factor that is thicker in subjects with diabetes, owing to its strong correlation with visceral adiposity and insulin resistance.

    “EAT has shown to be a modifiable and measurable cardiovascular risk factor that is thicker in subjects with diabetes, owing to its strong correlation with visceral adiposity and insulin resistance [7–9].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [7] Iacobellis, 2003, Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk, J Clin Endocrinol Metab. source

      Not checked in the free run.

    • cites [8] Pierdomenico, 2013, Metaanalysis of the relation of echocardiographic epicardial adipose tissue thickness and the metabolic syndrome, Am J Cardiol. source

      Not checked in the free run.

    • cites [9] Iacobellis, 2005, Epicardial adipose tissue and insulin resistance in obese subjects, J Clin Endocrinol Metab. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    EAT activity can be downregulated in advanced chronic diseases, as observed in severe coronary artery disease.

    “Epicardial adipose tissue activity can be downregulated in advanced chronic diseases, as we observed in severe coronary artery disease [3].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [3] McAninch, 2015, Epicardial adipose tissue has a unique transcriptome modified in severe coronary artery disease, Obesity (Silver Spring). source

      Not checked in the free run.

34 of 34

  • The paper relies on this without support.

    There are no data on the effects of either semaglutide or dulaglutide on visceral fat, and their roles on EAT are unknown.

    “However, to date, there are no data on the effects of either semaglutide or dulaglutide on visceral fat. The roles of semaglutide and dulaglutide, respectively, on EAT are also unknown.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Dulaglutide baseline EAT differs between tables

    Minor

    Table 1 reports baseline dulaglutide-group EAT as 9.2 mm, while Table 2 reports 9.3 mm for the same group's baseline.

  • Metformin-group HbA1c rose rather than improved

    Minor

    The abstract says HbA1c improved in all groups, but Table 2 shows it increasing from 5.8% to 5.9% in the metformin group.

2 of 2

The citation lists haven’t been fetched yet

References 30 · Cited by 168

Authors
Iacobellis, G., & Villasante Fricke, A. C.
Affiliations
  • University of Miami (US)
  • Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida
Corresponding author
Iacobellis, Gianluca
ORCID
Iacobellis, Gianluca
Venue
Journal of the Endocrine Society
Publisher
The Endocrine Society
Published
2020-03-13
Volume
4
Issue
4
Pages
bvz042-bvz042
ISSN
2472-1972 (ISSN-L)
DOI
10.1210/jendso/bvz042
PMC
PMC7069837
OpenAlex
W3012225375
Semantic Scholar
c73066394f11fd13c3de9bc9a86287039a68989f
Cited by
168
References
30
Citations by year
2026: 28 · 2025: 42 · 2024: 34 · 2023: 27 · 2022: 18 · 2021: 15 · 2020: 4
FWCI
10.03
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the Endocrine Society (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
Keywords
semaglutide, dulaglutide, epicardial adipose tissue, epicardial fat thickness, GLP-1 receptor agonists, type 2 diabetes, obesity, cardiovascular risk, dose-dependent effects, metformin, body mass index, HbA1c

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