Effect of Semaglutide Add-on to Metformin on Visceral Adiposity Index and Markers of Visceral Adipose Tissue Activity in Type 2 Diabetic Patients

The objective of the study was to find out the effect of semaglutide add-on to metformin on the visceral adiposity index and markers of visceral adipose tissue activity in type 2 diabetic patients based on body mass. A total of 90 patients with type 2 diabetes (both genders aged 30-60 years) were included in the study. The participants were divided into three groups based on their Body Mass Index (BMI), which includes the subjects with normal body weight (BMI between 18.5 - 24.9 kg/m2), overweight (BMI between 25 - 29.9 kg/m2) and obesity (BMI ≥30 kg/m2). Enzyme-linked immunosorbent assay was used to analyze serum leptin and adiponectin. Visceral Adiposity Index (VAI) was determined by the formula: Waist Circumference/(39.68 + [1.88 × BMI]) × Triglycerides/1.03 × 1.31/High-Density Lipoproteins. VAI showed minimal changes with metformin alone but decreased significantly with semaglutide add-on (p < 0.05), with the greatest reduction in the obesity group (-0.70). Leptin levels remained unchanged after metformin but significantly declined following semaglutide treatment (p < 0.05). The reduction was most pronounced in the obesity group (-5.10 ng/mL), followed by overweight (-3.40 ng/mL) and normal-weight individuals (-2.60 ng/mL). Adiponectin levels increased significantly post-semaglutide add-on therapy (p < 0.05). The greatest increase was observed in the obesity group (+3.70 μg/mL), followed by overweight (+3.30 μg/mL) and normal-weight participants (+3.30 μg/mL). Semaglutide presents a promising long-term solution for reducing the visceral adiposity index and enhancing metabolic health by modulating markers of visceral fat activity in patients with poorly controlled type 2 diabetes. This study highlights the importance of personalized treatment approaches, suggesting that semaglutide can be strategically utilized to prevent excess fat accumulation in the abdominal cavity.