INTRODUCTION: We examined the clinical factors associated with a decrease in weight induced by weekly semaglutide in patients with type 2 diabetes mellitus (T2DM).
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.