scholarly journals Impact of Semaglutide on Body Composition in Adults With Overweight or Obesity: Exploratory Analysis of the STEP 1 Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A16-A17
Author(s):  
John P H Wilding ◽  
Rachel L Batterham ◽  
Salvatore Calanna ◽  
Luc F Van Gaal ◽  
Barbara M McGowan ◽  
...  

Abstract Background: Central obesity is associated with increased risk of cardiometabolic disease. Weight loss reduces lean muscle mass, potentially impacting resting energy expenditure and/or physical functioning. This analysis of the STEP 1 trial evaluated the impact of subcutaneous (s.c.) semaglutide, a glucagon-like peptide-1 analogue, on body composition in adults with overweight/obesity using dual energy X-ray absorptiometry (DEXA). Methods: In STEP 1, 1961 adults aged ≥18 years with body mass index (BMI) ≥27 kg/m2 with ≥1 weight-related comorbidity or BMI ≥30 kg/m2, without diabetes, were randomized to s.c. semaglutide 2.4 mg once-weekly or matched placebo (2:1) for 68 weeks, plus lifestyle intervention. Participants with BMI ≤40 kg/m2 from 9 sites were eligible for the substudy. Total fat mass, total lean body mass and regional visceral fat mass were measured using DEXA at screening and week 68; visceral fat mass was calculated in the L4 region (both males/females), android region (males), or gynoid region (females), depending on site scanner methodology. Proportions of total fat and lean body mass are shown relative to total body mass; proportion of visceral fat mass is expressed relative to region assessed. Results: This analysis included 140 participants (semaglutide n=95; placebo n=45) (mean weight 98.4 kg, BMI 34.8 kg/m2; 76% female). Baseline body composition was similar in those receiving semaglutide and placebo (total fat mass proportion: 43.4% vs 44.6%; regional visceral fat mass proportion: 33.8% vs 36.3%; total lean body mass proportion: 53.9% vs 52.7%; respectively). Percentage change in body weight from baseline to week 68 was -15.0% with semaglutide vs -3.6% with placebo. This resulted in reductions from baseline with semaglutide in total fat mass (-19.3%) and regional visceral fat mass (-27.4%), leading to 3.5%-point and 2.0%-point reductions in the proportions of total fat mass and visceral fat mass, respectively. Total lean body mass decreased from baseline (-9.7%); however, the proportion relative to total body mass increased by 3.0%-points. An increasing improvement in lean body mass:fat mass ratio was seen with semaglutide with increasing weight loss from baseline to week 68 (continuous data). Overall, the ratio increased from baseline (1.34 [95% CI: 1.22, 1.47]) to week 68 by 0.23 [0.14, 0.32], with greater improvement in those with ≥15% weight loss (n=44; 0.41 [0.28, 0.53]) vs <15% weight loss (n=39; 0.03 [-0.05, 0.12]) (observed, dichotomized data; no imputation for missing data). There were no major changes in body composition with placebo from baseline to week 68. Conclusion: In adults with overweight/obesity, semaglutide 2.4 mg was associated with reduced total fat mass and regional visceral fat mass, and an increased proportion of lean body mass. Greater weight loss was associated with greater improvement in body composition (lean body mass:fat mass ratio).

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
TV McIntyre ◽  
JA Elliott ◽  
E Boyle ◽  
NE Donlon ◽  
M Barnes ◽  
...  

Abstract Introduction Sarcopenia and obesity in cancer may confer negative outcomes, but their prevalence and impact on modern regimens for retroperitoneal sarcoma (RPS) have not been systematically studied. Sarcopaenia and obesity measurements by computed tomography (CT) measurements at L3 may be confounded by the disease process itself. The aim of this study is to determine feasibility in providing the prevalence of sarcopenia and visceral obesity in the management of RPS to assess their potential impact on operative and oncologic outcomes. Method Consecutive sample patients undergoing treatment for RPS from our database were retrospectively studied. Total, subcutaneous and visceral fat areas (VFA), myosteatosis, skeletal muscle index (SMI) lean body mass and fat mass were determined at diagnosis by CT. Sarcopenia will be defined by CT at L3 as SMI <52.4 cm2/m2 for males and SMI <38.5 cm2/m2 for females, and visceral obesity as VFA >163.8cm2 for men and >80.1cm2 for women. Result 40 consecutive patients, 21 [52.5%] female, 56.7±15.1 years, were studied. The most common histologic types were leiomyosarcoma (8 [20.0%]), dedifferentiated liposarcoma (7 [17.5%]), well differentiated liposarcoma (7 [17.5%]), myxoid liposarcoma (4 [10.0%]). Mean±SD body composition measures were: lean body mass, 50.4±12.0 kg; total fat mass, 27.2±8.6 kg; visceral fat area, 148.5±120.2 cm2; subcutaneous fat area, 222.2±20.4 cm2; myosteatosis, 8.9±7.3 cm2. Conclusion Assessment of body composition among patients with RPS is feasible. Analysis to identify the prevalence and significance of sarcopenia and visceral obesity and its relationship to operative and oncologic outcomes is ongoing. Take-home message Assessment of body composition in RPS is feasible and its effect on outcomes is under investigation


2021 ◽  
pp. 1-27
Author(s):  
Masoome Piri Damaghi ◽  
Atieh Mirzababaei ◽  
Sajjad Moradi ◽  
Elnaz Daneshzad ◽  
Atefeh Tavakoli ◽  
...  

Abstract Background: Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of EAA can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soy and whey protein supplementation on body composition. Thus, we sought to perform a meta-analysis of published Randomized Clinical Trials that examined the effect of whey protein supplementation and soy protein supplementation on body composition (lean body mass, fat mass, body mass and body fat percentage) in adults. Methods: We searched PubMed, Scopus, and Google Scholar, up to August 2020, for all relevant published articles assessing soy protein supplementation and whey protein supplementation on body composition parameters. We included all Randomized Clinical Trials that investigated the effect of whey protein supplementation and soy protein supplementation on body composition in adults. Pooled means and standard deviations (SD) were calculated using random-effects models. Subgroup analysis was applied to discern possible sources of heterogeneity. Results: After excluding non-relevant articles, 10 studies, with 596 participants, remained in this study. We found a significant increase in lean body mass after whey protein supplementation weighted mean difference (WMD: 0.91; 95% CI: 0.15, 1.67. P= 0.019). Subgroup analysis, for whey protein, indicated that there was a significant increase in lean body mass in individuals concomitant to exercise (WMD: 1.24; 95% CI: 0.47, 2.00; P= 0.001). There was a significant increase in lean body mass in individuals who received 12 or less weeks of whey protein (WMD: 1.91; 95% CI: 1.18, 2.63; P<0.0001). We observed no significant change between whey protein supplementation and body mass, fat mass, and body fat percentage. We found no significant change between soy protein supplementation and lean body mass, body mass, fat mass, and body fat percentage. Subgroup analysis for soy protein indicated there was a significant increase in lean body mass in individuals who supplemented for 12 or less weeks with soy protein (WMD: 1.48; 95% CI: 1.07, 1.89; P< 0.0001). Conclusion: Whey protein supplementation significantly improved body composition via increases in lean body mass, without influencing fat mass, body mass, and body fat percentage.


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Mona Abdo ◽  
Ryan P Coyle ◽  
Sharon M Seifert ◽  
Jose R Castillo-Mancilla ◽  
Catherine M Jankowski ◽  
...  

Abstract Background In this study, we evaluate associations between cumulative antiretroviral adherence/exposure, quantified using tenofovir diphosphate (TFV-DP) in dried blood spots (DBS), and human immunodeficiency virus (HIV)-related aging factors. Methods This is a cross-sectional analysis of younger (ages 18–35) and older (ages ≥60) persons with HIV (PWH) taking TFV disoproxil fumarate. Tenofovir diphosphate concentrations were quantified in DBS. Linear and logistic regression models were used to evaluate associations between TFV-DP and bone mineral density (BMD), physical function, frailty, and falls. Results Forty-five PWH were enrolled (23 younger, 22 older). Every 500 fmol/punch (equivalent to an increase in ~2 doses/week) increase in TFV-DP was associated with decreased hip BMD (−0.021 g/cm2; 95% confidence interval [CI], −0.040 to −0.002; P = .03). Adjusting for total fat mass, every 500 fmol/punch increase in TFV-DP was associated with higher odds of Short Physical Performance Battery impairment (score ≤10; adjusted odds ratio [OR], 1.6; 95% CI, 1.0–2.5; P = .04). Every 500 fmol/punch increase in TFV-DP was associated with slower 400-meter walk time (14.8 seconds; 95% CI, 3.8–25.8; P = .01) and remained significant after adjusting for age, lean body mass, body mass index (BMI), and fat mass (all P ≤ .01). Every 500 fmol/punch increase in TFV-DP was associated with higher odds of reporting a fall in the prior 6 months (OR, 1.8; 95% CI, 1.1–2.8; P = .02); this remained significant after adjusting for age, lean body mass, BMI, and total fat mass (all P &lt; .05). Conclusions Higher TFV-DP levels were associated with lower hip BMD, poorer physical function, and greater risk for falls, a concerning combination for increased fracture risk.


1999 ◽  
Vol 82 (11) ◽  
pp. 1490-1496 ◽  
Author(s):  
M. Kockx ◽  
R. Leenen ◽  
J. Seidell ◽  
H. M. G. Princen ◽  
T. Kooistra

SummaryThis study was aimed at evaluating the relationship between visceral fat accumulation and plasma plasminogen activator inhibitor-1 (PAI-1) levels in healthy, obese men and women undergoing weight loss therapy. The subjects, 25 men and 25 premenopausal women, aged between 26 and 49 years, with an initial body mass index between 28 and 38 kg/m2, received a controlled diet for 13 weeks providing a 4.2 MJ/day energy deficit. Magnetic resonance imaging was used to measure visceral and subcutaneous abdominal fat. Our results show that before weight loss visceral fat was significantly correlated with PAI-1 in men (r = 0.45; p <0.05), but not in women (r = -0.15; ns). The association between visceral fat and PAI-1 in men remained significant after adjustment for age and total fat mass, and multiple linear regression analysis showed a significant independent contribution of visceral fat to plasma PAI-1 levels. Both visceral fat areas and PAI-1 levels decreased significantly with weight loss in both men and women. Changes in visceral fat area were related to changes in PAI-1 in women (r = -0.43; p = 0.05) but not in men (r = -0.01; ns); however, this association in women disappeared after adjustment for total fat mass. We conclude that there is a relationship between visceral fat and PAI-1 in obese men but not in obese women, and that PAI-1 levels decrease substantially (52%) by weight loss, but this change is not related to changes in visceral fat mass per se.


Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2349
Author(s):  
Stephen Keenan ◽  
Matthew B. Cooke ◽  
Regina Belski

Diets utilising intermittent fasting (IF) as a strategic method to manipulate body composition have recently grown in popularity, however, dietary practices involving fasting have also been followed for centuries for religious reasons (i.e., Ramadan). Regardless of the reasons for engaging in IF, the impacts on lean body mass (LBM) may be detrimental. Previous research has demonstrated that resistance training promotes LBM accrual, however, whether this still occurs during IF is unclear. Therefore, the objective of this review is to systematically analyse human studies investigating the effects of variations of IF combined with resistance training on changes in LBM in previously sedentary or trained (non-elite) individuals. Changes in body weight and fat mass, and protocol adherence were assessed as a secondary objective. This review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MEDLINE, CINAHL, PubMed and SportDiscus databases were searched for articles investigating IF, combined with resistance training that reported measures of body composition. Eight studies met the eligibility criteria. LBM was generally maintained, while one study reported a significant increase in LBM. Body fat mass or percentage was significantly reduced in five of eight studies. Results suggest that IF paired with resistance training generally maintains LBM, and can also promote fat loss. Future research should examine longer-term effects of various forms of IF combined with resistance training compared to traditional forms of energy restriction. Prospero registration CRD42018103867.


2018 ◽  
Vol 62 (1) ◽  
pp. 177-184 ◽  
Author(s):  
Adam Lee Owen ◽  
Carlos Lago-Peñas ◽  
Gordon Dunlop ◽  
Rouissi Mehdi ◽  
Moktar Chtara ◽  
...  

AbstractThe primary aim of the investigation was to study the seasonal changes in body composition in elite European soccer players and identify key playing positional differences. Twenty-two players (age = 24 ± 3.7 years, body height = 180.45 ± 5.12 cm, body mass = 76.66 ± 5.34 kg) were tested. Players’ mass (kg), lean body mass (LBM), fat free mass (FFM), fat mass (FM), muscle girths (MG) and sum of 8 skinfolds (mm) were measured across 5 time points (T0 = Start of pre-season training; T1 = End of pre-season training; T2 = Mid-season; T3 = End of mid-season break; T4 = End of season). Players were divided into their tactical positional roles for analysis. The specific positions they were divided into included defenders (n = 8), midfielders (n = 8) and forwards (n = 6). Assessment of training and matchplay exposure were also recorded. Sites-4, Sites-7, Sites-8 and Fat Mass decreased dramatically from T0 to T1 and T2 in all playing positions (p < 0.01), while no remarkable differences were found between T2, T3 and T4. Except for defenders, calf girth and lean mass were higher in T2, T3 and T4 compared to T0 and T1 (p < 0.01). Midfielders were found to be leaner than forwards and defenders in all data collection time point sessions. Defenders showed higher values in calf girth and lean body mass than midfielders and forwards. It can be concluded from this investigation that there are large variances n positional body composition profiles amongst professional European soccer players. Furthermore, significant changes are prevalent and occur across the season from LBM, FFM, MG and skinfold assessment amongst European elite level soccer players.


2000 ◽  
Vol 85 (1) ◽  
pp. 35-41
Author(s):  
Colleen Hadigan ◽  
Colleen Corcoran ◽  
Takara Stanley ◽  
Sarah Piecuch ◽  
Anne Klibanski ◽  
...  

Fat redistribution in the setting of protease inhibitor use is increasingly common and is associated with insulin resistance in human immunodeficiency virus (HIV)-infected patients. However, little is known regarding the factors that may contribute to abnormal insulin regulation in this population. We assessed fasting insulin levels in HIV-infected men and determined the relationship among insulin, body composition, endogenous gonadal steroid concentrations, and antiviral therapy in this population. We also determined the effects of exogenous testosterone administration using the homeostatic model for insulin resistance (HOMA IR) in hypogonadal HIV-infected men with the acquired immunodeficiency syndrome wasting syndrome. Fifty HIV-infected men with acquired immunodeficiency syndrome wasting were compared with 20 age- and body mass index (BMI)-matched healthy control subjects. Insulin concentrations were significantly increased in HIV-infected patients compared to those in control patients (16.6 ± 1.8 vs. 10.4 ± 0.8 μU/mL; P &lt; 0.05) and were increased in nucleoside reverse transcriptase (NRTI)-treated patients who did not receive a protease inhibitor (PI; 21.7 ± 4.3 vs. 10.4 ± 0.8μ U/mL; P &lt; 0.05). Insulin concentrations and HOMA IR were inversely correlated with the serum free testosterone concentration (r = −0.36; P = 0.01 for insulin level; r = −0.30; P = 0.03 for HOMA), but not to body composition parameters, age, or BMI. In a multivariate regression analysis, free testosterone (P = 0.05), BMI (P &lt; 0.01), and lean body mass (P = 0.04) were significant. Lower lean body mass and higher BMI predicted increased insulin resistance. The HIV-infected patients demonstrated an increased trunk fat to total fat ratio (0.49 ± 0.02 vs. 0.45 ± 0.02; P &lt; 0.05) and an increased trunk fat to extremity fat ratio (1.27 ± 0.09 vs. 0.95 ± 0.06, P = 0.01), but a reduced extremity fat to total fat ratio (0.44 ± 0.01 vs. 0.49 ± 0.01; P = 0.02) and reduced overall total body fat (13.8 ± 0.7 vs. 17.2 ± 0.9 kg; P &lt; 0.01) compared to the control subjects. Increased truncal fat and reduced extremity fat were seen among NRTI-treated patients, but this pattern was most severe among patients receiving combined NRTI and PI therapy [trunk fat to extremity ratio, 1.47 ± 0.15 vs. 0.95 ± 0.06 (P &lt; 0.01); extremity fat to total fat ratio, 0.40 ± 0.02 vs. 0.49 ± 0.01 (P &lt; 0.05)]. Insulin responses to testosterone administration were investigated among 52 HIV-infected men with hypogonadism and wasting (weight &lt;90% ideal body weight and/or weight loss &gt;10%) randomized to either testosterone (300 mg, im, every 3 weeks) or placebo for 6 months. Testosterone administration reduced HOMA IR in the HIV-infected men (−0.6 ± 0.7 vs. +1.41 ± 0.8, testosterone vs. placebo, P = 0.05) in association with increased lean body mass (P = 0.02). These data demonstrate significant hyperinsulinemia in HIV-infected patients, which can occur in the absence of PI use. In NRTI-treated patients not receiving PI, a precursor phenotype is apparent, with increased truncal fat, reduced extremity fat, and increased insulin concentrations. This phenotype is exaggerated in patients receiving PI therapy, with further increased truncal fat and reduced extremity fat, although hyperinsulinemia per se is not worse. Endogenous gonadal steroid levels are inversely related to hyperinsulinemia in HIV-infected men, but reduced lean body mass and increased weight are the primary independent predictors of hyperinsulinemia. Indexes of insulin sensitivity improve in response to physiological androgen administration among hypogonadal HIV-infected patients, and this change is again related primarily to increased lean body mass in response to testosterone administration.


2008 ◽  
Vol 18 ◽  
pp. S54
Author(s):  
E. Søndergaard ◽  
L.C. Gormsen ◽  
E.T. Vestergaard ◽  
J.S. Christiansen ◽  
S. Nielsen

2003 ◽  
Vol 94 (6) ◽  
pp. 2368-2374 ◽  
Author(s):  
Marjolein Visser ◽  
Marco Pahor ◽  
Frances Tylavsky ◽  
Stephen B. Kritchevsky ◽  
Jane A. Cauley ◽  
...  

Changing body composition has been suggested as a pathway to explain age-related functional decline. No data are available on the expected changes in body composition as measured by dual-energy X-ray absorptiometry (DXA) in a population-based cohort of older persons. Body composition data at baseline, 1-yr follow-up, and 2-yr follow-up was measured by DXA in 2,040 well-functioning black and white men and women aged 70–79 yr, participants of the Health, Aging, and Body Composition Study. After 2 yr, a small decline in total body mass was observed (men: −0.3%, women: −0.4%). Among men, fat-free mass and appendicular lean soft tissue mass (ALST) decreased by −1.1 and −0.8%, respectively, which was masked by a simultaneous increase in total fat mass (+2.0%). Among women, a decline in fat-free mass was observed after 2 yr only (−0.6%) with no change in ALST and body fat mass. After 2 yr, the decline in ALST was greater in blacks than whites. Change in total body mass was associated with change in ALST ( r = +0.58 to +0.70; P < 0.0001). Among participants who lost total body mass, men lost relatively more ALST than women, and blacks lost relatively more ALST than whites. In conclusion, the mean change in body composition after a 1- to 2-yr follow-up was 1–2% with a high interindividual variability. Loss of ALST was greater in men compared with women, and greater in blacks compared with whites, suggesting that men and blacks may be more prone to muscle loss.


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