{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T00:58:36Z","timestamp":1793149116124,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Nat Med"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    In the SELECT trial, once-weekly subcutaneous semaglutide reduced major adverse cardiovascular events (MACE) by 20% versus placebo in patients with atherosclerotic cardiovascular disease and obesity but without diabetes. We examined semaglutide in SELECT patients at high risk for substantial liver fibrosis in a prespecified secondary analysis. Liver biochemical tests and steatosis risk according to fatty liver index were assessed over 104 weeks. Subgroup analyses of the primary MACE (a composite endpoint including cardiovascular death, nonfatal myocardial infarction or nonfatal stroke) outcome used baseline Fibrosis-4 scores\u2009\u2265\u20091.3, age-specific (\u22651.3 (&lt;65 years) or \u22652.0 (\u226565 years)) and any age with Fibrosis-4\u2009&gt;\u20092.67. MACE was reduced by 26% (hazard ratio (HR)\u20090.74; 95% confidence interval (CI)\u20090.63\u20130.88;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.0004), 21% (HR\u20090.79; 95% CI\u20090.63\u20130.98;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.035) and 34% (HR\u20090.66; 95% CI\u20090.39\u20131.10;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.11), respectively. Semaglutide led to a 28% greater decrease in fatty liver index versus placebo (HR\u20090.72; 95% CI\u20090.71\u20130.73;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.0001). In conclusion, semaglutide reduced MACE versus placebo in patients at risk for substantial liver fibrosis, as seen in the overall SELECT population. ClinicalTrials.gov registration no.\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\/study\/NCT03574597\" ext-link-type=\"uri\">NCT03574597<\/jats:ext-link>\n                  <\/jats:p>","DOI":"10.1038\/s41591-026-04281-1","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:02:42Z","timestamp":1775120562000},"page":"1686-1693","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Semaglutide on liver fibrosis and heart outcomes in patients at high risk of liver fibrosis: a prespecified analysis of the SELECT randomized trial"],"prefix":"10.1038","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2034-5922","authenticated-orcid":false,"given":"Sebastian M.","family":"Meyh\u00f6fer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-8040","authenticated-orcid":false,"given":"Bertrand","family":"Cariou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cintia","family":"Cercato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-3288","authenticated-orcid":false,"given":"Helen M.","family":"Colhoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Deanfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6131-3981","authenticated-orcid":false,"given":"Michelle T.","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ole Kleist","family":"Jeppesen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Michael","family":"Lincoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7006-7401","authenticated-orcid":false,"given":"Ildiko","family":"Lingvay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-9876","authenticated-orcid":false,"given":"Jorge","family":"Plutzky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip N.","family":"Newsome","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9668-4368","authenticated-orcid":false,"given":"Stephen J.","family":"Nicholls","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Quiroga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1706-0822","authenticated-orcid":false,"given":"Ferruccio","family":"Santini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8682-5748","authenticated-orcid":false,"given":"Arun J.","family":"Sanyal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Kahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the SELECT Trial Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna H.","family":"Ryan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott S.","family":"Emerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Kushner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstine","family":"Brown-Frandsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Kees","family":"Hovingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Hardt-Lindberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoffer W.","family":"Torn\u00f8e","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"4281_CR1","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1016\/j.jhep.2024.04.031","volume":"81","author":"F Tacke","year":"2024","unstructured":"Tacke, F. et al. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). J. Hepatol. 81, 492\u2013542 (2024).","journal-title":"J. Hepatol."},{"key":"4281_CR2","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1002\/hep.29367","volume":"67","author":"N Chalasani","year":"2018","unstructured":"Chalasani, N. et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67, 328\u2013357 (2018).","journal-title":"Hepatology"},{"key":"4281_CR3","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/dom.14651","volume":"24","author":"B Cariou","year":"2022","unstructured":"Cariou, B. The metabolic triad of non-alcoholic fatty liver disease, visceral adiposity and type 2 diabetes: implications for treatment. Diabetes Obes. Metab. 24, 15\u201327 (2022).","journal-title":"Diabetes Obes. Metab."},{"key":"4281_CR4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.jhep.2023.03.040","volume":"79","author":"MH Le","year":"2023","unstructured":"Le, M. H. et al. Global incidence of non-alcoholic fatty liver disease: a systematic review and meta-analysis of 63 studies and 1,201,807 persons. J. Hepatol. 79, 287\u2013295 (2023).","journal-title":"J. Hepatol."},{"key":"4281_CR5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/S2468-1253(22)00317-X","volume":"8","author":"J Quek","year":"2023","unstructured":"Quek, J. et al. Global prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in the overweight and obese population: a systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 8, 20\u201330 (2023).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"4281_CR6","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1016\/S2468-1253(21)00308-3","volume":"6","author":"A Mantovani","year":"2021","unstructured":"Mantovani, A. et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events: an updated systematic review and meta-analysis. Lancet Gastroenterol. Hepatol. 6, 903\u2013913 (2021).","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"4281_CR7","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1016\/j.cgh.2020.07.030","volume":"19","author":"NM Meyersohn","year":"2021","unstructured":"Meyersohn, N. M. et al. Association of hepatic steatosis with major adverse cardiovascular events, independent of coronary artery disease. Clin. Gastroenterol. Hepatol. 19, 1480\u20131488 (2021).","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"4281_CR8","doi-asserted-by":"publisher","first-page":"2324","DOI":"10.1016\/j.cgh.2019.12.026","volume":"18","author":"F Baratta","year":"2020","unstructured":"Baratta, F. et al. Nonalcoholic fatty liver disease and fibrosis associated with increased risk of cardiovascular events in a prospective study. Clin. Gastroenterol. Hepatol. 18, 2324\u20132331 (2020).","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"4281_CR9","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","volume":"77","author":"ME Rinella","year":"2023","unstructured":"Rinella, M. E. et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology 77, 1797\u20131835 (2023).","journal-title":"Hepatology"},{"key":"4281_CR10","doi-asserted-by":"publisher","first-page":"1104","DOI":"10.1016\/j.cgh.2009.05.033","volume":"7","author":"AG Shah","year":"2009","unstructured":"Shah, A. G. et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin. Gastroenterol. Hepatol. 7, 1104\u20131112 (2009).","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"4281_CR11","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1038\/ajg.2016.453","volume":"112","author":"S McPherson","year":"2017","unstructured":"McPherson, S. et al. Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis. Am. J. Gastroenterol. 112, 740\u2013751 (2017).","journal-title":"Am. J. Gastroenterol."},{"key":"4281_CR12","doi-asserted-by":"publisher","first-page":"2221","DOI":"10.1056\/NEJMoa2307563","volume":"389","author":"AM Lincoff","year":"2023","unstructured":"Lincoff, A. M. et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N. Engl. J. Med. 389, 2221\u20132232 (2023).","journal-title":"N. Engl. J. Med."},{"key":"4281_CR13","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1056\/NEJMoa2413258","volume":"392","author":"AJ Sanyal","year":"2025","unstructured":"Sanyal, A. J. et al. Phase 3 trial of semaglutide in metabolic dysfunction-associated steatohepatitis. N. Engl. J. Med. 392, 2089\u20132099 (2025).","journal-title":"N. Engl. J. Med."},{"key":"4281_CR14","first-page":"504","volume":"11","author":"RJ Henning","year":"2021","unstructured":"Henning, R. J. Obesity and obesity-induced inflammatory disease contribute to atherosclerosis: a review of the pathophysiology and treatment of obesity. Am. J. Cardiovasc. Dis. 11, 504\u2013529 (2021).","journal-title":"Am. J. Cardiovasc. Dis."},{"key":"4281_CR15","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1038\/nrendo.2014.29","volume":"10","author":"M Laakso","year":"2014","unstructured":"Laakso, M. & Kuusisto, J. Insulin resistance and hyperglycaemia in cardiovascular disease development. Nat. Rev. Endocrinol. 10, 293\u2013302 (2014).","journal-title":"Nat. Rev. Endocrinol."},{"key":"4281_CR16","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1001\/jama.279.18.1477","volume":"279","author":"J Danesh","year":"1998","unstructured":"Danesh, J., Collins, R., Appleby, P. & Peto, R. Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies. JAMA 279, 1477\u20131482 (1998).","journal-title":"JAMA"},{"key":"4281_CR17","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1007\/s00535-006-1790-5","volume":"41","author":"Y Eguchi","year":"2006","unstructured":"Eguchi, Y. et al. Visceral fat accumulation and insulin resistance are important factors in nonalcoholic fatty liver disease. J. Gastroenterol. 41, 462\u2013469 (2006).","journal-title":"J. Gastroenterol."},{"key":"4281_CR18","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1053\/j.gastro.2019.12.054","volume":"158","author":"V Azzu","year":"2020","unstructured":"Azzu, V., Vacca, M., Virtue, S., Allison, M. & Vidal-Puig, A. Adipose tissue-liver cross talk in the control of whole-body metabolism: implications in nonalcoholic fatty liver disease. Gastroenterology 158, 1899\u20131912 (2020).","journal-title":"Gastroenterology"},{"key":"4281_CR19","doi-asserted-by":"publisher","first-page":"1069","DOI":"10.1111\/dom.14322","volume":"23","author":"B Cariou","year":"2021","unstructured":"Cariou, B., Byrne, C. D., Loomba, R. & Sanyal, A. J. Nonalcoholic fatty liver disease as a metabolic disease in humans: a literature review. Diabetes Obes. Metab. 23, 1069\u20131083 (2021).","journal-title":"Diabetes Obes. Metab."},{"key":"4281_CR20","doi-asserted-by":"publisher","first-page":"e0289616","DOI":"10.1371\/journal.pone.0289616","volume":"18","author":"C Liao","year":"2023","unstructured":"Liao, C., Liang, X., Zhang, X. & Li, Y. The effects of GLP-1 receptor agonists on visceral fat and liver ectopic fat in an adult population with or without diabetes and nonalcoholic fatty liver disease: a systematic review and meta-analysis. PLoS ONE 18, e0289616 (2023).","journal-title":"PLoS ONE"},{"key":"4281_CR21","doi-asserted-by":"publisher","first-page":"1703","DOI":"10.3390\/ijms24021703","volume":"24","author":"R Nevola","year":"2023","unstructured":"Nevola, R. et al. GLP-1 receptor agonists in non-alcoholic fatty liver disease: current evidence and future perspectives. Int. J. Mol. Sci. 24, 1703 (2023).","journal-title":"Int. J. Mol. Sci."},{"key":"4281_CR22","doi-asserted-by":"publisher","first-page":"1379189","DOI":"10.3389\/fcvm.2024.1379189","volume":"11","author":"W Masson","year":"2024","unstructured":"Masson, W. et al. Anti-inflammatory effect of semaglutide: updated systematic review and meta-analysis. Front. Cardiovasc. Med. 11, 1379189 (2024).","journal-title":"Front. Cardiovasc. Med."},{"key":"4281_CR23","first-page":"26","volume":"110","author":"Q Hu","year":"2025","unstructured":"Hu, Q. et al. Semaglutide ameliorates hepatocyte steatosis in a cell co-culture system by downregulating the IRE1\u03b1-XBP1-C\/EBP\u03b1 signaling pathway in macrophages. Pharmacology 110, 26\u201335 (2025).","journal-title":"Pharmacology"},{"key":"4281_CR24","doi-asserted-by":"publisher","first-page":"1133","DOI":"10.1007\/s11010-023-04784-2","volume":"479","author":"X Pan","year":"2024","unstructured":"Pan, X. et al. Semaglutide ameliorates obesity-induced cardiac inflammation and oxidative stress mediated via reduction of neutrophil Cxcl2, S100a8, and S100a9 expression. Mol. Cell. Biochem. 479, 1133\u20131147 (2024).","journal-title":"Mol. Cell. Biochem."},{"key":"4281_CR25","doi-asserted-by":"publisher","first-page":"bvz042","DOI":"10.1210\/jendso\/bvz042","volume":"4","author":"G Iacobellis","year":"2020","unstructured":"Iacobellis, G. & Villasante Fricke, A. C. Effects of semaglutide versus dulaglutide on epicardial fat thickness in subjects with type 2 diabetes and obesity. J. Endocr. Soc. 4, bvz042 (2020).","journal-title":"J. Endocr. Soc."},{"key":"4281_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12933-023-02096-9","volume":"23","author":"D Garc\u00eda-Vega","year":"2024","unstructured":"Garc\u00eda-Vega, D. et al. Semaglutide modulates prothrombotic and atherosclerotic mechanisms, associated with epicardial fat, neutrophils and endothelial cells network. Cardiovasc. Diabetol. 23, 1 (2024).","journal-title":"Cardiovasc. Diabetol."},{"key":"4281_CR27","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1007\/s12020-024-04085-8","volume":"87","author":"A Al Refaie","year":"2025","unstructured":"Al Refaie, A. et al. Adiponectin may play a crucial role in the metabolic effects of GLP-1RAs treatment in patients with type 2 diabetes mellitus: a preliminary longitudinal study. Endocrine 87, 951\u2013958 (2025).","journal-title":"Endocrine"},{"key":"4281_CR28","doi-asserted-by":"publisher","first-page":"154455","DOI":"10.1016\/j.metabol.2020.154455","volume":"115","author":"DA Koutoukidis","year":"2021","unstructured":"Koutoukidis, D. A. et al. The effect of the magnitude of weight loss on non-alcoholic fatty liver disease: a systematic review and meta-analysis. Metabolism 115, 154455 (2021).","journal-title":"Metabolism"},{"key":"4281_CR29","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1111\/apt.16608","volume":"54","author":"A Flint","year":"2021","unstructured":"Flint, A. et al. Randomised clinical trial: semaglutide versus placebo reduced liver steatosis but not liver stiffness in subjects with non-alcoholic fatty liver disease assessed by magnetic resonance imaging. Aliment. Pharmacol. Ther. 54, 1150\u20131161 (2021).","journal-title":"Aliment. Pharmacol. Ther."},{"key":"4281_CR30","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","volume":"149","author":"E Vilar-Gomez","year":"2015","unstructured":"Vilar-Gomez, E. et al. Weight loss through lifestyle modification significantly reduces features of nonalcoholic steatohepatitis. Gastroenterology 149, 367\u2013378 (2015).","journal-title":"Gastroenterology"},{"key":"4281_CR31","doi-asserted-by":"publisher","first-page":"1113","DOI":"10.1056\/NEJMoa2028395","volume":"384","author":"PN Newsome","year":"2021","unstructured":"Newsome, P. N. et al. A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis. N. Engl. J. Med. 384, 1113\u20131124 (2021).","journal-title":"N. Engl. J. Med."},{"key":"4281_CR32","doi-asserted-by":"publisher","first-page":"1786","DOI":"10.1016\/S0140-6736(23)00634-7","volume":"401","author":"O Verrastro","year":"2023","unstructured":"Verrastro, O. et al. Bariatric-metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomised trial. Lancet 401, 1786\u20131797 (2023).","journal-title":"Lancet"},{"key":"4281_CR33","doi-asserted-by":"publisher","first-page":"561","DOI":"10.3350\/cmh.2023.0384","volume":"30","author":"J Hwang","year":"2024","unstructured":"Hwang, J. et al. Bariatric intervention improves metabolic dysfunction-associated steatohepatitis in patients with obesity: a systematic review and meta-analysis. Clin. Mol. Hepatol. 30, 561\u2013576 (2024).","journal-title":"Clin. Mol. Hepatol."},{"key":"4281_CR34","doi-asserted-by":"publisher","first-page":"1350","DOI":"10.2337\/dc24-0491","volume":"47","author":"SE Kahn","year":"2024","unstructured":"Kahn, S. E. et al. Effect of semaglutide on regression and progression of glycemia in people with overweight or obesity but without diabetes in the SELECT trial. Diabetes Care 47, 1350\u20131359 (2024).","journal-title":"Diabetes Care"},{"key":"4281_CR35","doi-asserted-by":"publisher","first-page":"444","DOI":"10.2337\/dc24-1903","volume":"48","author":"R Pradhan","year":"2025","unstructured":"Pradhan, R. et al. Glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors and the prevention of cirrhosis among patients with type 2 diabetes. Diabetes Care 48, 444\u2013454 (2025).","journal-title":"Diabetes Care"},{"key":"4281_CR36","doi-asserted-by":"publisher","first-page":"100067","DOI":"10.1016\/j.jhepr.2020.100067","volume":"2","author":"K Patel","year":"2020","unstructured":"Patel, K. & Sebastiani, G. Limitations of non-invasive tests for assessment of liver fibrosis. JHEP Rep. 2, 100067 (2020).","journal-title":"JHEP Rep."},{"key":"4281_CR37","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.ahj.2020.07.008","volume":"229","author":"DH Ryan","year":"2020","unstructured":"Ryan, D. H. et al. Semaglutide effects on cardiovascular outcomes in people with overweight or obesity (SELECT) rationale and design. Am. Heart J. 229, 61\u201369 (2020).","journal-title":"Am. Heart J."},{"key":"4281_CR38","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1002\/oby.23621","volume":"31","author":"I Lingvay","year":"2023","unstructured":"Lingvay, I. et al. Semaglutide for cardiovascular event reduction in people with overweight or obesity: SELECT study baseline characteristics. Obesity 31, 111\u2013122 (2023).","journal-title":"Obesity"},{"key":"4281_CR39","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/1471-230X-6-33","volume":"6","author":"G Bedogni","year":"2006","unstructured":"Bedogni, G. et al. The fatty liver index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol. 6, 33 (2006).","journal-title":"BMC Gastroenterol."}],"container-title":["Nature Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04281-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04281-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04281-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T14:03:32Z","timestamp":1779285812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41591-026-04281-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":39,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["4281"],"URL":"https:\/\/doi.org\/10.1038\/s41591-026-04281-1","relation":{},"ISSN":["1078-8956","1546-170X"],"issn-type":[{"value":"1078-8956","type":"print"},{"value":"1546-170X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]},"assertion":[{"value":"19 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"S.M.M. has received consulting honoraria from Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daichii-Sankyo, Eli Lilly, esanum, Gilead, Ipsen, Novartis, Novo Nordisk, Sandoz and Sanofi, and has received research grants from AstraZeneca, Eli Lilly and Novo Nordisk. B.C. has received consulting honoraria from Abbott, Amgen, AstraZeneca, Bristol Myers Squibb, Eli Lilly, Novartis, Novo Nordisk, Sanofi and Ultragenyx, and research funding to his institution from Air Liquide, Sanofi and Ypsomed. C.C. has received consulting honoraria from Brace Pharma, Eli Lilly, Eurofarma, Merck and Novo Nordisk. H.M.C. has served on advisory panels for Bayer and Novo Nordisk, has received research funding from IQVIA, Roche and Sanofi, has received grants from the Chief Scientist Office, Diabetes UK, the European Commission, the Juvenile Diabetes Research Foundation and the Medical Research Council, has served on a speaker\u2019s bureau for Novo Nordisk and holds stock in Bayer and Roche Pharmaceuticals. J.D. has received consulting honoraria from Aegerion, Amgen, Bayer, Boehringer Ingelheim, Merck, Novartis, Novo Nordisk, Pfizer, Sanofi and Takeda, and research grants from Aegerion, the British Heart Foundation, Colgate, the Medical Research Council (UK), Merck Sharp & Dohme, the National Institute for Health and Care Research, Pfizer, Public Health England and Roche. M.T.L., O.K.J. and M.Q. are employees of Novo Nordisk. A.M.L. has received research grants from AbbVie, AstraZeneca, CSL Behring, Eli Lilly, Esperion Therapeutics and Novartis, paid to his institution, and has served as a consultant for Akebia Therapeutics, Alnylam Pharmaceuticals, Ardelyx, Canary Cure, Eli Lilly, FibroGen, GlaxoSmithKline, Intarcia, Medtronic Vascular, the Novartis Pharmaceuticals Corporation, Novo Nordisk, Provention Bio, and ReCor Medical. I.L. has received research grants from Boehringer Ingelheim, Merck, Mylan Pharmaceuticals, Novo Nordisk, Pfizer and Sanofi US Services, has served as a consultant for AstraZeneca, Bayer Healthcare Pharmaceuticals, Biomea, Boehringer Ingelheim, Carmot, Eli Lilly, Intarcia, Intercept Pharmaceuticals, Janssen Global Services, Johnson & Johnson Medical Devices & Diagnostics Group-Latin America, MannKind Corporation, Merck, Novo Nordisk, Pfizer, Sanofi US Services, Shionogi, StructureTherapeutics, Target Pharma, Valeritas and Zealand Pharma, and has received travel expenses from Boehringer Ingelheim, Eli Lilly, Johnson & Johnson Medical Devices & Diagnostics Group-Latin America, Novo Nordisk, Sanofi US Services and Zealand Pharma. J.P. has received consulting honoraria from Altimmune, Amgen, Esperion Therapeutics, Merck, MJH Life Sciences, Novartis and Novo Nordisk, has received a grant, paid to his institution, from Boehringer Ingelheim and holds the position of Director, Preventive Cardiology at Brigham and Women\u2019s Hospital. P.N.N. has received consulting fees from Aligos, Boehringer Ingelheim, Madrigal, Novo Nordisk, Sagimet, Shionogi and 89bio. S.J.N. has received research support from Amgen, Anthera, AstraZeneca, Cerenis, CSL Behring, Cyclarity, Eli Lilly, Esperion, Infraredx, New Amsterdam Pharma, Novartis, Resverlogix and Sanofi-Regeneron, and is a consultant for Akcea, Amgen, AstraZeneca, Boehringer Ingelheim, CSL Behring, CSL Sequiris, Eli Lilly, Esperion, Kowa, Merck, Novo Nordisk, Pfizer, Sanofi-Regeneron, Takeda and Vaxxinity. F.S. has worked as a consultant for, participated in studies for or received travel funds from the following companies that are involved with obesity, lipodystrophy or diabetes: Aegerion\/Amryt, BioItalia, Boehringer Ingelheim, Bruno Pharma, Lilly, Novo Nordisk and Pfizer. A.J.S. consults for and advises AstraZeneca and Avant Sant\u00e9, consults for and has received grants from Akero, Bristol Myers Squibb, Eli Lilly, Intercept, Madrigal and Novo Nordisk, consults for and owns stock in Rivus, consults for 89bio, AGED Diagnostics, Albireo, Alnylam, Altimmune, Boehringer Ingelheim, Echosens, Genentech, Gilead, GlaxoSmithKline, HistoIndex, Mallinckrodt, Merck, NGM Bio, Novartis, PathAI, Pfizer, Poxel, Regeneron, Salix, Siemens, Surrozen, Takeda, Terns and Zydus, owns stock in Durect, Exalenz, Genfit, Indalo, Inversago and Tiziana, and has received royalties from Elsevier and Wolters Kluwer. S.E.K. has received consulting honoraria from Anii Pharmaceuticals, Boehringer Ingelheim, Eli Lilly, Merck, Novo Nordisk and Oramed, and stock options from Altpep.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}