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Brown Adipose Tissue as a Mechanistic Determinant of Semaglutide Treatment Response in Obesity (BAT-Sema Study) (BAT-Sema)

20 de julio de 2026 actualizado por: Hun Jee Choe, Hallym University

Brown Adipose Tissue as a Mechanistic Determinant of GLP-1 Receptor Agonist Treatment Response in Adults With Obesity: A Multicenter Prospective Cohort Study Using ¹⁸FDG-PET/CT and Cold Stimulation Protocol

This study investigates whether the activity of brown adipose tissue (BAT) - a special type of fat that burns energy as heat - can predict how well individuals with obesity respond to semaglutide (Wegovy), a once-weekly injectable weight loss medication. Participants who are starting semaglutide treatment will undergo ¹⁸FDG-PET/CT imaging before and after 24 weeks of treatment. Prior to each PET/CT scan, participants will wear a water-circulating cooling vest to activate BAT. By measuring BAT activity at baseline and comparing it with the degree of weight loss and metabolic improvement at 24 weeks, the investigators aim to identify BAT as a predictive biomarker for personalized obesity treatment.

Descripción general del estudio

Estado

Aún no reclutando

Condiciones

Intervención / Tratamiento

Descripción detallada

Despite the remarkable efficacy of semaglutide (GLP-1 receptor agonist) in treating obesity, considerable individual variation in treatment response remains unexplained. Brown adipose tissue (BAT) is a metabolically active thermogenic organ that has been implicated in energy expenditure, insulin sensitivity, and cardiometabolic health. We hypothesize that baseline BAT activity, as measured by ¹⁸FDG-PET/CT following individualized cold stimulation, is a mechanistic determinant of semaglutide treatment response in adults with obesity without diabetes.

This multicenter prospective cohort study will enroll 80 adults (40 per site: Hallym University Dongtan Sacred Heart Hospital and Seoul National University Bundang Hospital) with BMI ≥27 kg/m² plus obesity-related comorbidity, or BMI ≥30 kg/m², who are initiating semaglutide therapy. ¹⁸FDG-PET/CT with standardized cold stimulation (water-circulating cooling vest, starting at 16°C, individualized to prevent shivering) will be performed at baseline (V1) and 24 weeks (V7). BAT activity (SUVmax, SUVmean, BAT volume, total metabolic activity) will be quantified per BARCIST 1.0 criteria. Liver fat fraction (MRI-PDFF) and liver stiffness (MR elastography) will be assessed as secondary endpoints. Correlations between baseline BAT parameters and treatment outcomes (% body weight loss, metabolic biomarker changes) will be analyzed.

Tipo de estudio

Intervencionista

Inscripción (Estimado)

80

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Estudio Contacto

  • Nombre: Hun Jee Choe Hallym University Dongtan Sacred Heart Hospital, MD, PhD
  • Número de teléfono: +82-31-8086-2869
  • Correo electrónico: hunjeechoe@gmail.com

Copia de seguridad de contactos de estudio

  • Nombre: Hye Jeong Lee Hallym University Dongtan Sacred Heart Hospital, CRC
  • Número de teléfono: +82-10-4694-3886
  • Correo electrónico: geumzzogi@naver.com

Ubicaciones de estudio

  • Corea del Sur
    • Gyeonggi-do
      • Hwaseong-si, Gyeonggi-do, Corea del Sur, 18450
        • Hallym University Dongtan Sacred Heart Hospital
        • Contacto:
          • Hun Jee Choe Hallym University Dongtan Sacred Heart Hospital, MD, PhD
          • Número de teléfono: +82-10-9493-5703
          • Correo electrónico: hunjeechoe@gmail.com
      • Seongnam-si, Gyeonggi-do, Corea del Sur, 13620
        • Seoul National University Bundang Hospital
        • Contacto:
          • Soo Lim Seoul National University Bundang Hospital, MD, PhD
          • Número de teléfono: +82-10-9766-2706
          • Correo electrónico: limsoo@snu.ac.kr
        • Contacto:
          • Soo Lim Seoul National University Bundang Hospital, MD, PhD
          • Número de teléfono: +82-010-9766-2706
          • Correo electrónico: limsoo@snu.ac.kr

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

  • Adulto
  • Adulto Mayor

Acepta Voluntarios Saludables

No

Descripción

Inclusion Criteria:

  1. Age 20-70 years at the time of enrollment
  2. Initiating semaglutide (Wegovy) treatment for obesity (newly starting treatment)

  3. BMI ≥ 27 kg/m² with at least one weight-related comorbidity:

    • Hypertension (SBP ≥130 or DBP ≥80 mmHg, or on antihypertensive medication)
    • Dyslipidemia (LDL-C ≥130, TG ≥150, or low HDL-C, or on lipid-lowering medication)
    • Non-alcoholic fatty liver disease (NAFLD/MASLD, confirmed by imaging or ALT/AST ≥1.5× ULN)
    • Obstructive sleep apnea (AHI ≥5/hr or clinically diagnosed)
    • Established cardiovascular disease (CAD, stroke, PAD)
    • Obesity-related osteoarthritis of knee or hip with functional impairment OR BMI ≥ 30 kg/m² (regardless of comorbidity)
  4. Ability and willingness to provide written informed consent

Exclusion Criteria:

  1. Diagnosis of type 1 or type 2 diabetes mellitus
  2. History of neck surgery or radiation therapy to the neck
  3. Use of anti-obesity medications within 1 month prior to enrollment, or current use of beta-adrenergic blocking agents
  4. Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN2)
  5. Active malignancy, severe renal disease (eGFR <30 mL/min/1.73m²), severe hepatic disease, or other severe endocrine disorders
  6. Pregnancy or breastfeeding
  7. Severe psychiatric illness or cognitive impairment precluding informed consent
  8. Contraindication to MRI (pacemaker, cochlear implant, non-MRI-compatible implants)
  9. Severe claustrophobia

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Ciencia básica
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Semaglutide + BAT Evaluation
Adults with obesity initiating semaglutide (0.25 mg → 2.4 mg over 20 weeks, maintained for 4 weeks; total 24 weeks). At baseline and 24 weeks, ¹⁸FDG-PET/CT with individualized cold stimulation (water-circulating cooling vest at 16°C, 60 minutes) and liver MRI (PDFF + MRE) are performed.
Droga: Semaglutide (Wegovy®)
Once-weekly subcutaneous injection, titrated from 0.25 mg to 2.4 mg over 20 weeks per standard protocol. Standard of care treatment for obesity.
Procedimiento: ¹⁸FDG-PET/CT with cold stimulation
Whole-body ¹⁸FDG-PET/CT (5.18 MBq/kg, max 370 MBq) after 60-minute individualized cold stimulation using a water-circulating cooling vest (Polar Products Arctic Chiller, starting 16°C). Performed at baseline (V1) and 24 weeks (V7). BAT activity quantified per BARCIST 1.0.
Procedimiento: Liver MRI (PDFF + MRE)
Hepatic proton density fat fraction (MRI-PDFF) and liver stiffness by MR elastography (MRE) using Siemens MAGNETOM Vida 3T. Performed at baseline (V1) and 24 weeks (V7).

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Correlation between baseline BAT metabolic activity (SUVmean and BAT volume on ¹⁸FDG-PET/CT) and percentage body weight loss at 24 weeks of semaglutide treatment
Periodo de tiempo: Baseline to 24 weeks
: Pearson (or Spearman) correlation coefficient between baseline BAT parameters (SUVmean, BAT volume, total metabolic activity per BARCIST 1.0) and % body weight loss after 24 weeks of semaglutide therapy (0.25 mg escalated to 2.4 mg).
Baseline to 24 weeks

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Change in waist circumference
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in body weight (kg)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in Body Mass Index (BMI)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in HbA1c (%)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in fasting glucose (mg/dL)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in HOMA-IR
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in fasting lipids (LDL-C, HDL-C, TG, TC)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in body composition by BIA (fat mass, lean mass, skeletal muscle mass)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in liver fat fraction (MRI-PDFF, %)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in liver stiffness by MRE (kPa)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in adipokines (adiponectin, leptin, NEFA)
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
Change in hsCRP
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
BAT-positive rate based on SUVmax at baseline
Periodo de tiempo: Baseline
The percentage of participants determined as brown adipose tissue (BAT)-positive, defined by a maximum standardized uptake value (SUVmax) of 1.5 or higher ($\ge 1.5$) at baseline.
Baseline
Change in Quality of life using the Impact of Weight on Quality of Life-Lite Clinical Trials (IWQOL-Lite-CT) total score
Periodo de tiempo: Baseline to 24 weeks
The Impact of Weight on Quality of Life-Lite Clinical Trials (IWQOL-Lite-CT) is a self-report questionnaire used to assess the quality of life in individuals with obesity. The total score ranges from a minimum of 0 to a maximum of 100, where higher scores indicate a better outcome (better quality of life).
Baseline to 24 weeks
Change in Quality of Life using the Short Form-36 Health Survey Version 2 (SF-36v2) domain scores
Periodo de tiempo: Baseline to 24 weeks
The Short Form-36 Health Survey Version 2 (SF-36v2) is a 36-item questionnaire measuring health-related quality of life across 8 domains: Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional, and Mental Health. Each domain score ranges from a minimum of 0 to a maximum of 100, where higher scores indicate a better outcome (better health status or higher quality of life).
Baseline to 24 weeks
Change in BAT activity (SUVmax, SUVmean, BAT volume, TMA) from baseline to 24 weeks
Periodo de tiempo: Baseline to 24 weeks
Baseline to 24 weeks
BAT-positive rate based on CT Hounsfield Units (HU) at baseline
Periodo de tiempo: Baseline
The percentage of participants determined as brown adipose tissue (BAT)-positive, defined by Computed Tomography Hounsfield Units (CT HU) within the range of $-250$ to $-50$ at baseline.
Baseline

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Hallym University

Colaboradores

Hallym University Dongtan Sacred Heart Hospital

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Estimado)

1 de junio de 2026

Finalización primaria (Estimado)

1 de febrero de 2028

Finalización del estudio (Estimado)

1 de febrero de 2031

Fechas de registro del estudio

Enviado por primera vez

20 de mayo de 2026

Primero enviado que cumplió con los criterios de control de calidad

27 de mayo de 2026

Publicado por primera vez (Actual)

2 de junio de 2026

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

22 de julio de 2026

Última actualización enviada que cumplió con los criterios de control de calidad

20 de julio de 2026

Última verificación

1 de julio de 2026

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • 2026-04-009
  • RS-2026-25483260 (Otro número de subvención/financiamiento: National Research Foundation of Korea)

Plan de datos de participantes individuales (IPD)

¿Planea compartir datos de participantes individuales (IPD)?

NO

Descripción del plan IPD

Individual participant data will not be shared publicly. De-identified aggregate results will be published in peer-reviewed journals

Información sobre medicamentos y dispositivos, documentos del estudio

Estudia un producto farmacéutico regulado por la FDA de EE. UU.

No

Estudia un producto de dispositivo regulado por la FDA de EE. UU.

No

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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