The Impact of Semaglutide on Liver Fat Assessed by Serial Cardiac CT scans in Patients with Type 2 Diabetes: Results from STOP Trial

Abstract

IntroductionThere is increasing prevalence of hepatic steatosis. Hepatic steatosis is increasingly recognized as the independent risk factor for cardiovascular mortality. However, there are limited options for the treatment of fatty liver. In this study we evaluated the effect of semaglutide on liver fat as measured by non-contrast cardiac CT scans. MethodsSTOP is a randomized controlled trial that evaluated semaglutide treatment effect on coronary atherosclerosis progression (STOP) in type 2 diabetes. We utilized unenhanced cardiac CT scans to quantify liver fat based on CT Hounsfield attenuation method. A total of 114 subjects qualified for this study of the 140 subjects randomized, 59 in semaglutide group and 55 in the placebo group and were followed for 12 months. Multivariate regression models were used to evaluate the change in liver fat content overtime. Results114 subjects were included in the study, 61% male, mean age of 57.8±8.1 years and mean BMI of 32.0±6.7. The average of the three liver measures showed an improvement in the semaglutide group 1.4±9.0 versus worsening in the placebo group of 1.9±9.5 mean HU. The multivariable linear regression models including age, gender, BMI, hypertension, hyperlipidemia, past smoking and baseline liver attenuation, showed that the semaglutide group average liver attenuation measures improved by 4.4 HU versus placebo across the trial, p=0.002 indicating improvement in the liver fat content in treatment group. ConclusionIn type 2 diabetes patients with hepatic steatosis, treatment with semaglutide resulted in a significant improvement in fatty liver resolution compared to placebo.