Effects of semaglutide on abdominal fat distribution and brown adipose tissue activity in overweight/obese patients with type 2 diabetes mellitus
FU Yao
XU Yaping
YIN Xiao
WANG Jian
Abstract：Objective To observe the effects of semaglutide,a glucagon-like peptide-1 receptor agonist(GLP-1RA),on abdominal fat distribution and brown adipose tissue(BAT)activity in the neck region of overweight/obese pa-tients with type 2 diabetes mellitus(T2DM).Methods Thirty-two overweight/obese patients with T2DM were divided into the observation group(n=18)and control group(n=14).The observation group received subcutaneous injections of semaglutide starting at 0.25 mg weekly,gradually titrated to 1.0 mg weekly.The control group was maintained on a hypo-glycemic regimen excluding GLP-1 receptor agonists(GLP-1RAs)and dipeptidyl peptidase-4(DPP-4)inhibitors.Both groups underwent a 3-month intervention period.Anthropometric parameters,including height,weight,waist circumfer-ence,and body mass index(BMI),were measured before and after treatment.We detected the fasting plasma glucose(FPG),fasting insulin(FINS),glycated hemoglobin(HbA1c),triglycerides(TG),and low-density lipoprotein choles-terol(LDL-C).Insulin resistance index(HOMA-IR),insulin sensitivity index(HOMA-IS),and pancreatic β-cell func-tion(HOMA-β)were assessed.Abdominal subcutaneous adipose tissue(SAT)area,visceral adipose tissue(VAT)area,and neck brown adipose tissue(BAT)activity were quantified by magnetic resonance imaging(MRI),with BAT activity represented by T2* values at the C3-4,C4-5,C5-6 vertebral levels.Results Compared with pre-treatment levels,the body weight,waist circumference,BMI,FPG,and both SAT and VAT areas following treatment decreased,while HOMA-β and T2* values at C3-4,C4-5,C5-6 intervertebral spaces increased in the observation group(all P<0.05).After treatment,the observation group exhibited lower body weight,waist circumference,BMI,and HOMA-IR than the control group,while HOMA-IS and HOMA-β were higher than those of the control group(all P<0.05).Conclusions In overweight/obese patients with type 2 diabetes,semaglutide treatment produces significant reductions in body weight and blood glucose along with improved pancreatic β-cell function.It also lowers abdominal visceral and subcutaneous fat content and elevates neck BAT activity.Semaglutide may exert its weight-loss and metabolic-improvement effects by decreasing abdominal fat distribution and enhancing BAT activity.
Keywords：semaglutideobesitytype 2 diabetes mellitussubcutaneous fat tissuesvisceral fat tissuesbrown adipose tissue activitymagnetic resonance imaging
Publication Date：2025-12-25
Online Publishing Date：2026-01-12(First online date of this platform, not the publication date of the document)
Pages：6( 51-56 )