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Cited by 35Diabetes Treatment and ManagementBody Composition Measurement TechniquesPharmacology and Obesity Treatment

Intrapatient Changes in CT-Based Body Composition After Initiation of Semaglutide (Glucagon-Like Peptide-1 Receptor Agonist) Therapy

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Nelson, Leslie W., Lee, Matthew H., Garrett, John W., Pickhardt, Silas G., Warner, Joshua D., Summers, Ronald M., Pickhardt, Perry J.·2024·American Journal of Roentgenology
DOI 10.2214/ajr.24.31805
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Abstract

BACKGROUND. The long-acting glucagon-like peptide-1 receptor agonist semaglutide is used to treat type 2 diabetes or obesity in adults. Clinical trials have observed associations of semaglutide with weight loss, improved control of diabetes, and cardiovascular risk reduction.

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  • In a 5-year post-semaglutide study, weight regain was associated with an increased muscle fat infiltration (MFI) and reduced muscle quality.

    “In this context, a 5-year post-semaglutide study reported that weight regain was associated with an increased MFI and reduced muscle quality [104].”

    From GLP-1 Receptor Agonists for Obesity Management in Older Adults: A Scoping Review on the Risk of Sarcopenia and Sarcopenic Obesity (2026) · cites this paper as [104]

  • In a 5-year post-semaglutide study, individuals who gained weight showed no significant changes in muscle area at the lumbar spine (L3) level, but gained visceral, subcutaneous, and intermuscular fat, and experienced decreased muscle attenuation, indicating higher muscle fat infiltration.

    “A study examining body composition changes 5-years post-semaglutide found those who gained weight displayed no significant changes in muscle area (188.9→198.4 cm2) at the lumbar spine (L3)-level, but gained visceral (313→334 cm²), subcutaneous (449→486 cm²), and intermuscular fat (37.6→48.4 cm²), and experienced decreased muscle attenuation (13.1→5.9 HU), indicating higher muscle fat infiltration”

    From Weighing the risk of GLP-1 treatment in older adults: Should we be concerned about sarcopenic obesity? (2025) · cites this paper as [16]

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Cites

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Research works printed but not linked: 43

  1. Singh G, Krauthamer M, Bjalme-Evans M. Wegovy (semaglutide): a new weight loss drug for chronic weight management. J Investig Med 2022; 70:5-13
  2. Latini R, Staszewsky L. Semaglutide and effective weight control. Lancet 2021; 397:942-943
  3. Knop FK, Aroda VR, do Vale RD, et al.; OASIS 1 Investigators. Oral semaglu- tide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2023; 402:705-719
  4. Davies M, Færch L, Jeppesen OK, et al.; STEP 2 Study Group. Semaglutide 2•4 mg once a week in adults with overweight or obesity, and type 2 diabe- tes (STEP 2): a randomised, double-blind, double-dummy, placebo-con- trolled, phase 3 trial. Lancet 2021; 397:971-984
  5. Wilding JPH, Batterham RL, Calanna S, et al.; STEP 1 Study Group. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med 2021; 384:989-1002
  6. Davies M, Pieber TR, Hartoft-Nielsen ML, Hansen OKH, Jabbour S, Rosen- stock J. Effect of oral semaglutide compared with placebo and subcutane- ous semaglutide on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JAMA 2017; 318:1460-1470
  7. Sorli C, Harashima SI, Tsoukas GM, et al. Efficacy and safety of once-weekly semaglutide monotherapy versus placebo in patients with type 2 diabetes (SUSTAIN 1): a double-blind, randomised, placebo-controlled, paral- lel-group, multinational, multicentre phase 3a trial. Lancet Diabetes Endo- crinol 2017; 5:251-260
  8. Després JP, Lemieux I. Abdominal obesity and metabolic syndrome. Na- ture 2006; 444:881-887
  9. Lee SJ, Liu J, Yao J, Kanarek A, Summers RM, Pickhardt PJ. Fully automated segmentation and quantification of visceral and subcutaneous fat at ab- dominal CT: application to a longitudinal adult screening cohort. Br J Radi- ol 2018; 91:20170968
  10. Yki-Järvinen H. Non-alcoholic fatty liver disease as a cause and a conse- quence of metabolic syndrome. Lancet Diabetes Endocrinol 2014; 2:901-910
  11. Graffy PM, Liu J, Pickhardt PJ, Burns JE, Yao J, Summers RM. Deep learn- ing-based muscle segmentation and quantification at abdominal CT: ap- plication to a longitudinal adult screening cohort for sarcopenia assess- ment. Br J Radiol 2019; 92:20190327
  12. Cruz-Jentoft AJ, Sayer AA. Sarcopenia. Lancet 2019; 393:2636-2646
  13. Bates DDB, Pickhardt PJ. CT-derived body composition assessment as a prognostic tool in oncologic patients: from opportunistic research to arti- ficial intelligence-based clinical implementation. AJR 2022; 219:671-680
  14. Pickhardt PJ. Value-added opportunistic CT screening: state of the art. Ra- diology 2022; 303:241-254
  15. Pickhardt PJ, Summers RM, Garrett JW, et al. Opportunistic screening: Ra- diology Scientific Expert Panel. Radiology 2023; 307:e222044
  16. Summers RM, Elton DC, Lee S, et al. Atherosclerotic plaque burden on ab- dominal CT: automated assessment with deep learning on noncontrast and contrast-enhanced scans. Acad Radiol 2021; 28:1491-1499
  17. Moeller AR, Garrett JW, Summers RM, Pickhardt PJ. Adjusting for the effect of IV contrast on automated CT body composition measures during the portal venous phase. Abdom Radiol (NY) 2024; 49:2543-2551
  18. Perez AA, Pickhardt PJ, Elton DC, Sandfort V, Summers RM. Fully automat- ed CT imaging biomarkers of bone, muscle, and fat: correcting for the ef- fect of intravenous contrast. Abdom Radiol (NY) 2021; 46:1229-1235
  19. Ghusn W, De la Rosa A, Sacoto D, et al. Weight loss outcomes associated with semaglutide treatment for patients with overweight or obesity. JAMA Netw Open 2022; 5:e2231982-e2231982
  20. Rubino D, Abrahamsson N, Davies M, et al.; STEP 4 Investigators. Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: the STEP 4 randomized clinical trial. JAMA 2021; 325:1414-1425
  21. Rubino DM, Greenway FL, Khalid U, et al.; STEP 8 Investigators. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: the STEP 8 random- ized clinical trial. JAMA 2022; 327:138-150
  22. Chen LY, Xia MF, Wu L, et al. Skeletal muscle loss is associated with diabetes in middle-aged and older Chinese men without non-alcoholic fatty liver disease. World J Diabetes 2021; 12:2119-2129
  23. Haines MS, Leong A, Porneala BC, Meigs JB, Miller KK. Association between muscle mass and diabetes prevalence independent of body fat distribu- tion in adults under 50 years old. Nutr Diabetes 2022; 12:29
  24. Srikanthan P, Hevener AL, Karlamangla AS. Sarcopenia exacerbates obesi- ty-associated insulin resistance and dysglycemia: findings from the Na- tional Health and Nutrition Examination Survey III. PLoS One 2010; 5:e10805
  25. Nachit M, Horsmans Y, Summers RM, Leclercq IA, Pickhardt PJ. AI-based CT body composition identifies myosteatosis as key mortality predictor in asymptomatic adults. Radiology 2023; 307:e222008
  26. Iwai S, Kaji K, Nishimura N, et al. Glucagon-like peptide-1 receptor agonist, semaglutide attenuates chronic liver disease-induced skeletal muscle at- rophy in diabetic mice. Biochim Biophys Acta Mol Basis Dis 2023; 1869:166770
  27. Xiang J, Ding XY, Zhang W, et al. Clinical effectiveness of semaglutide on weight loss, body composition, and muscle strength in Chinese adults. Eur Rev Med Pharmacol Sci 2023; 27:9908-9915
  28. Volpe S, Lisco G, Fanelli M, et al. Once-weekly subcutaneous semaglutide improves fatty liver disease in patients with type 2 diabetes: a 52-week prospective real-life study. Nutrients 2022; 14:4673
  29. Han AL. Validation of fatty liver index as a marker for metabolic dysfunc- tion-associated fatty liver disease. Diabetol Metab Syndr 2022; 14:44
  30. Bandyopadhyay S, Das S, Samajdar SS, Joshi SR. Role of semaglutide in the treatment of nonalcoholic fatty liver disease or non-alcoholic steatohepatitis: a systematic review and meta-analysis. Diabetes Metab Syndr 2023; 17:102849
  31. Radlinger B, Ress C, Folie S, et al. Empagliflozin protects mice against di- et-induced obesity, insulin resistance and hepatic steatosis. Diabetologia 2023; 66:754-767
  32. Cai TT, Li HQ, Jiang LL, et al. Effects of GLP-1 receptor agonists on bone mineral density in patients with type 2 diabetes mellitus: a 52-week clinical study. BioMed Res Int 2021; 2021:3361309
  33. Herrou J, Mabilleau G, Lecerf JM, Thomas T, Biver E, Paccou J. Narrative re- view of effects of glucagon-like peptide-1 receptor agonists on bone health in people living with obesity. Calcif Tissue Int 2024; 114:86-97
  34. Yoshimura Y, Hashimoto Y, Okada H, et al. Changes in glycemic control and skeletal muscle mass indices after dapagliflozin treatment in individuals with type 1 diabetes mellitus. J Diabetes Investig 2023; 14:1175-1182
  35. Pathak A, Agrawal A. Evolution of C-reactive protein. Front Immunol 2019; 10:943
  36. Borlaug BA, Kitzman DW, Davies MJ, et al. Semaglutide in HFpEF across obesity class and by body weight reduction: a prespecified analysis of the STEP-HFpEF trial. Nat Med 2023; 29:2358-2365
  37. Conte C, Hall KD, Klein S. Is weight loss-induced muscle mass loss clinically relevant? JAMA 2024; 332:9-10 (Editorial Comment starts on next page) References
  38. Nelson LW, Lee MH, Garrett JW, et al. Intrapatient changes in CT-based body composition after initiation of semaglutide (glucagon-like peptide-1 receptor agonist) therapy. AJR 2024; 223:2431805
  39. Lee H, Chung HS, Kim YJ, et al. Association between body composition and the risk of mortality in the obese population in the United States. Front Endocrinol 2023;14:1257902
  40. Arsenault BJ, Carpentier AC, Poirier P, Després JP. Adiposity, type 2 diabe- tes and atherosclerotic cardiovascular disease risk: use and abuse of the body mass index. Atherosclerosis 2024; 394:117546 (Editorial Comment starts on next page) References
  41. Volpe S, Lisco G, Fanelli M, et al. Oral semaglutide improves body composi- tion and preserves lean mass in patients with type 2 diabetes: a 26-week prospective real-life study. Front Endocrinol (Lausanne) 2023; 14:1240263
  42. Pickhardt PJ, Summers RM, Garrett JW, et al. Opportunistic screening: Ra- diology Scientific Expert Panel. Radiology 2023; 307:e222044
  43. Nelson LW, Lee MH, Garrett JW, et al. Intrapatient changes in CT-based body composition after initiation of semaglutide (glucagon-like peptide-1 receptor agonist) therapy. AJR 2024; 223:e2431805

Cited by

Sorted by citations

Authors
Nelson, L. W., Lee, M. H., Garrett, J. W., Pickhardt, S. G., Warner, J. D., Summers, R. M., & Pickhardt, P. J.
Affiliations
  • University of Wisconsin–Madison (US)
  • National Institutes of Health (US)
ORCID
Venue
American Journal of Roentgenology
Publisher
American Roentgen Ray Society
Published
2024-12
Volume
223
Issue
6
Pages
e2431805-e2431805
ISSN
  • 0002-9580 (ISSN-L)
  • 0361-803X
  • 1546-3141
DOI
10.2214/ajr.24.31805
OpenAlex
W4402222908
Cited by
35
References
10
Citations by year
2026: 17 · 2025: 14 · 2024: 4
FWCI
11.54
Type
journal article
Language
en
Open access
Locations
  • American Journal of Roentgenology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Javna Agencija za Raziskovalno Dejavnost RS
  • National Institutes of Health
  • NIH Clinical Center
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
  • Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
Keywords
semaglutide, GLP-1 receptor agonists, body composition, computed tomography, type 2 diabetes, obesity, weight loss
MeSH terms
Glucagon-Like Peptide-1 Receptor, Semaglutide, Adult, Aged, Body Composition, Diabetes Mellitus, Type 2, Glucagon-Like Peptides, Female, Humans, Hypoglycemic Agents, Male, Middle Aged, Obesity, Retrospective Studies, Tomography, X-Ray Computed

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