Evaluation of the efficacy of semaglutide in the correction of lipotoxicity in patients with type 2 diabetes mellitus

Antsiferova D.M., Ametov A.S.

1) Endocrinological Dispensary, Moscow Healthcare Department, Moscow, Russia; 2) Russian Medical Academy of Continuous Professional Education, Moscow, Russia

Objective: Evaluation of the effect of semaglutide on lipotoxicity in patients with type 2 diabetes mellitus (DM2).
Materials and methods: A single-center prospective study included 63 patients aged 40–69 years with DM2 and obesity (body mass index 30.0–39.9 kg/m²) on metformin monotherapy (1000–2500 mg/day) and a glycated hemoglobin level of 7.0 to 9.0%. 59 patients completed the observation. For 6 months, patients received semaglutide 1 times a week with a dose titration of up to 1.0 mg, and the effectiveness of the therapy was evaluated at 3 and 6 months. Lipotoxicity was analyzed within the framework of the lipometabolic continuum using a comprehensive assessment of fat and muscle mass (anthropometry, bioimpedansometry, dual-energy X-ray absorptiometry in the Total Body Composition mode), carbohydrate metabolism, insulin resistance and secretory capacity of pancreatic β cells, lipid profile (total cholesterol, low-density lipoproteins, high-density lipoproteins, triglycerides), free fatty acid (FFA) and adiponectin levels, and biochemical and instrumental markers of liver status, including ultrasound and shear wave elastography with METAVIR fibrosis score.
Results: Semaglutide therapy leads to a decrease in FFA and triglyceride levels, transformation of the body composition with a decrease in fat mass, including visceral fat, an improvement in insulin sensitivity at various levels, including adipose tissue, an increase in β cell function and an improvement in the functional and structural state of the liver. Semaglutide had the greatest anti-lipotoxic effect in patients with initially more pronounced lipotoxicity.
Conclusion: Based on the data obtained, it can be concluded that semaglutide therapy contributes to a multicomponent anti-lipotoxic effectin patients with DM2 and obesity.

For citations: Antsiferova D.M., Ametov A.S. Evaluation of the efficacy of semaglutide in the correction of lipotoxicity in patients with type 2 diabetes mellitus. Pharmateca. 2026;33(4):237-248. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2026.4.237-248

Authors’ contribution: D.M. Antsiferova – selection, examination and treatment of patients, review of publications on the topic of the article, collection of clinical material, processing, analysis and interpretation of data, statistical analysis, writing of the manuscript text. A.S. Ametov – study design, critical content review, manuscript approval for publication.
Conflict of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.
Ethical Approval: The study was conducted with the voluntary informed consent of the legal representatives of the patients and the patients themselves. The clinical study was approved by the local ethics committee of the Russian Medical Academy of Continuous Professional Education (protocol No. 12 dated 10.10.2023).
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors’ Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.

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About the Authors

Daria M. Antsiferova, еndocrinologist Healthcare Department, Moscow; Postgraduate Student, Department of Endocrinology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; e-mail: cifrenda@yandex.ru, ORCID: https://orcid.org/0000-0002-3920-5914, eLibrary SPIN: 5461-2590 (corresponding author)
A.S. Ametov, Dr. Sci. (Med.), Professor, Head of the Department of Endocrinology, Russian Medical Academy of Continuous Professional Education, Moscow, Russia; e-mail: alexander.ametov@gmail.com, ORCID: https://orcid.org/0000-0002-7936-7619, eLibrary SPIN: 9511-1413

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