Impact of Semaglutide on fat mass, lean mass and muscle function in patients with obesity: The SEMALEAN study.

IF 5.7 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2025-10-09 DOI:10.1111/dom.70141

Mathieu Alissou, Thomas Demangeat, Vanessa Folope, Hélène Van Elslande, Hélène Lelandais, Julia Blanchemaison, Pierre-Emmanuel Cailleaux, Suzan Guney, Alexandra Aupetit, Agnès Aubourg, Clément Rapp, André Petit, Morgane Godin, Luc Vignal, Sébastien Grigioni, Pierre Déchelotte, Guillaume Colange, Moïse Coëffier, Najate Achamrah

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Abstract

Aims: Semaglutide, a GLP-1 receptor agonist, has shown efficacy in promoting weight loss. However, limited data exist on its impact on lean mass, muscle function, and metabolic adaptations. The SEMALEAN study aims to evaluate these parameters in patients with obesity treated with Semaglutide (2.4 mg).

Materials and methods: This prospective study enrolled 115 patients with obesity between February 2022 and November 2024. Body weight, body composition (measured by DXA), muscle function (handgrip strength), and resting energy expenditure (REE) were assessed at baseline (M0), 7 months (M7), and 12 months (M12). Subgroup analyses examined the impact of sex, type 2 diabetes, previous GLP-1 use, and history of bariatric surgery.

Results: A total of 106 patients (68.9% female; mean BMI 46.3 kg/m²) completed the study. Weight loss was significant, with mean reductions of 10% at M7 and 13% at M12; 59% of patients achieved ≥10% weight loss. Total fat mass decreased by 14% at M7 and 18% at M12, while lean mass initially declined (-3 kg at M7) but stabilised thereafter. Handgrip strength improved significantly (+4.5 kg at M12), and the prevalence of sarcopenic obesity decreased from 49% at baseline to 33% at M12. REE normalised to lean mass increased significantly from M7 to M12. Subgroup analyses revealed greater weight and fat mass loss in women, while patients with type 2 diabetes or prior GLP-1 analogue use showed attenuated responses. Patients with a history of bariatric surgery exhibited the most pronounced reductions in body composition parameters.

Conclusions: The SEMALEAN study highlights the significant impact of Semaglutide 2.4 mg on weight loss, fat mass reduction, and muscle function improvement, with preserved lean mass and metabolic efficiency. These findings underscore the importance of a comprehensive approach to obesity management, addressing not only weight loss but also functional and metabolic adaptation.

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塞马鲁肽对肥胖患者脂肪质量、瘦质量和肌肉功能的影响：塞马鲁肽研究

目的：Semaglutide是一种GLP-1受体激动剂，已显示出促进体重减轻的功效。然而，关于它对瘦质量、肌肉功能和代谢适应的影响的数据有限。SEMALEAN研究旨在评估接受Semaglutide （2.4 mg）治疗的肥胖患者的这些参数。材料和方法：这项前瞻性研究在2022年2月至2024年11月期间招募了115名肥胖患者。在基线（M0）、7个月（M7）和12个月（M12）时评估体重、身体组成（通过DXA测量）、肌肉功能（握力）和静息能量消耗（REE）。亚组分析检查了性别、2型糖尿病、既往GLP-1使用和减肥手术史的影响。结果：106例患者（女性68.9%，平均BMI 46.3 kg/m2）完成研究。体重减轻显著，在M7和M12时平均减少10%和13%；59%的患者体重减轻≥10%。总脂肪质量在M7和M12时分别下降14%和18%，而瘦肉质量在M7时开始下降（-3 kg），但此后趋于稳定。握力显著提高（M12时增加4.5 kg），肌肉减少型肥胖的患病率从基线时的49%下降到M12时的33%。从M7到M12， REE归一化到瘦质量显著增加。亚组分析显示，女性的体重和脂肪减少更大，而2型糖尿病患者或既往使用GLP-1类似物的患者则表现出减弱的反应。有减肥手术史的患者表现出最明显的身体成分参数下降。结论：SEMALEAN研究强调了2.4 mg Semaglutide对体重减轻、脂肪减少和肌肉功能改善的显著影响，并保留了瘦质量和代谢效率。这些发现强调了肥胖管理综合方法的重要性，不仅要解决减肥问题，还要解决功能和代谢适应问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.