Once-Weekly Semaglutide Is Associated With Improvement in Vascular Endothelial Function in Patients With Type 2 Diabetes Mellitus: A Retrospective Observational Study.

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) have a high-risk condition of developing cardiovascular disease, and therefore, therapeutic strategies should consider cardiovascular risk reduction. Previously, we demonstrated that circulating glucagon-like peptide-1 (GLP-1) levels are significantly lower in Japanese patients with coronary artery disease (CAD) compared with non-CAD subjects. Once-weekly semaglutide, a GLP-1 receptor agonist, has demonstrated clinical cardiometabolic benefits; however, its effect on vascular endothelial function in Japanese patients with T2DM remains unclear. METHODS: This retrospective observational study included patients with T2DM who were hospitalized at Jinnouchi Hospital and initiated once-weekly subcutaneous semaglutide therapy since 2021. Vascular endothelial function was assessed using reactive hyperemia peripheral arterial tonometry, expressed as the reactive hyperemia index (RHI), before and after semaglutide treatment. Clinical parameters including body weight (BW), glycated hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-cho), and high-sensitivity C-reactive protein (hsCRP) were also evaluated. RESULTS: A total of 24 patients (mean age: 55 years; n=20 (83.3%) male) were included. RHI significantly increased following semaglutide therapy (baseline: 1.62±0.19 versus follow-up: 2.04±0.60; p<0.01). BW, HbA1c, and LDL-cho also showed significant reductions (all p<0.01). HsCRP tended to decrease, though not significantly. None of the changes in BW, HbA1c, LDL-cho, or hsCRP correlated with the changes in RHI. CONCLUSION: Once-weekly semaglutide treatment significantly provided potential improvement in vascular endothelial function in Japanese patients with T2DM, supporting the cardiovascular protective role of semaglutide therapy in the clinical management of T2DM.