{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:38:58Z","timestamp":1792132738163,"version":"4.4.0"},"reference-count":52,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Nature Science Foundation","award":["81601269"],"award-info":[{"award-number":["81601269"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The effects of dulaglutide and a calorie-restricted diet (CRD) on visceral adipose tissue (VAT) and metabolic profiles in polycystic ovary syndrome (PCOS) have not been extensively investigated. In this study, we investigated whether dulaglutide combined with CRD could further reduce VAT and promote clinical benefits as compared with a CRD regimen alone in overweight or obese PCOS-affected women. Between May 2021 and May 2022, this single-center, randomized, controlled, open-label clinical trial was conducted. Overall, 243 participants with PCOS were screened, of which 68 overweight or obese individuals were randomly randomized to undergo dulaglutide combined with CRD treatment (n = 35) or CRD treatment alone (n = 33). The duration of intervention was set as the time taken to achieve a 7% weight loss goal from baseline body weight, which was restricted to 6 months. The primary endpoint was the difference in the change in VAT area reduction between the groups. The secondary endpoints contained changes in menstrual frequency, metabolic profiles, hormonal parameters, liver fat, and body composition. As compared with the CRD group, the dulaglutide + CRD group had a considerably shorter median time to achieve 7% weight loss. There was no significant between-group difference in area change of VAT reduction (\u22120.97 cm2, 95% confidence interval from \u221214.36 to 12.42, p = 0.884). As compared with CRD alone, dulaglutide + CRD had significant advantages in reducing glycated hemoglobin A1c and postprandial plasma glucose levels. The results of the analyses showed different changes in menstruation frequency, additional metabolic profiles, hormonal markers, liver fat, and body composition between the two groups did not differ significantly. Nausea, vomiting, constipation, and loss of appetite were the main adverse events of dulaglutide. These results emphasize the value of dietary intervention as the first line of treatment for PCOS-affected women, while glucagon-like peptide 1 receptor agonist therapy provides an efficient and typically well tolerated adjuvant therapy to aid in reaching weight targets based on dietary therapy in the population of overweight\/obese PCOS-affected women.<\/jats:p>","DOI":"10.3390\/nu15030556","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T03:48:08Z","timestamp":1674445688000},"page":"556","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["Effects of a Dulaglutide plus Calorie-Restricted Diet versus a Calorie-Restricted Diet on Visceral Fat and Metabolic Profiles in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"given":"Yuqin","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihua","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meili","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diliqingna","family":"Dilimulati","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiqing","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8445-1954","authenticated-orcid":false,"given":"Manna","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0811-7070","authenticated-orcid":false,"given":"Shen","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Shanghai Tenth People\u2019s Hospital, School of Medicine, Tongji University, Shanghai 200072, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1038\/nrendo.2018.24","article-title":"Polycystic ovary syndrome: Definition, aetiology, diagnosis and treatment","volume":"14","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1210\/er.2002-0015","article-title":"Insulin-Lowering Agents in the Management of Polycystic Ovary Syndrome","volume":"24","author":"Petraglia","year":"2003","journal-title":"Endocr. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.tem.2007.07.003","article-title":"Abdominal adiposity and the polycystic ovary syndrome","volume":"18","year":"2007","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4178","DOI":"10.1210\/jc.2016-2586","article-title":"Hyperandrogenism Accompanies Increased Intra-Abdominal Fat Storage in Normal Weight Polycystic Ovary Syndrome Women","volume":"101","author":"Dumesic","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1467-789X.2009.00623.x","article-title":"Subcutaneous and visceral adipose tissue: Structural and functional differences","volume":"11","author":"Ibrahim","year":"2010","journal-title":"Obes. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3109\/09513590.2015.1111327","article-title":"Visceral adiposity index as a predictor of clinical severity and therapeutic outcome of PCOS","volume":"32","author":"Zheng","year":"2016","journal-title":"Gynecol. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.beem.2006.03.008","article-title":"Role of lifestyle modification in the management of polycystic ovary syndrome","volume":"20","author":"Hoeger","year":"2006","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Lim, S., Smith, C.A., Costello, M.F., MacMillan, F., Moran, L., and Ee, C. (2019). Barriers and facilitators to weight management in overweight and obese women living in Australia with PCOS: A qualitative study. BMC Endocr. Disord., 19.","DOI":"10.1186\/s12902-019-0434-8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"197216","DOI":"10.1155\/2014\/197216","article-title":"Lifestyle Intervention Involving Calorie Restriction with or without Aerobic Exercise Training Improves Liver Fat in Adults with Visceral Adiposity","volume":"2014","author":"Yoshimura","year":"2014","journal-title":"J. Obes."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Huffman, K.M., Redman, L.M., Landerman, L.R., Pieper, C.F., Stevens, R.D., Muehlbauer, M.J., Wenner, B.R., Bain, J.R., Kraus, V.B., and Newgard, C.B. (2012). Caloric Restriction Alters the Metabolic Response to a Mixed-Meal: Results from a Randomized, Controlled Trial. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0028190"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1530\/EC-15-0047","article-title":"Fructose content of low calorie diets: Effect on cardiometabolic risk factors in obese women with polycystic ovarian syndrome: A randomized controlled trial","volume":"4","author":"Johnson","year":"2015","journal-title":"Endocr. Connect."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.cmet.2018.03.001","article-title":"Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1","volume":"27","author":"Drucker","year":"2018","journal-title":"Cell Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3346","DOI":"10.2337\/db14-0302","article-title":"GLP-1 Agonism Stimulates Brown Adipose Tissue Thermogenesis and Browning Through Hypothalamic AMPK","volume":"63","author":"Beiroa","year":"2014","journal-title":"Diabetes"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1111\/dom.13053","article-title":"Effect of liraglutide on ectopic fat in polycystic ovary syndrome: A randomized clinical trial","volume":"20","author":"Nylander","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3389\/fendo.2019.00189","article-title":"The Effect of Exenatide on Cardiovascular Risk Markers in Women with Polycystic Ovary Syndrome","volume":"10","author":"Dawson","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/cen.13454","article-title":"Efficacy of exenatide on weight loss, metabolic parameters and pregnancy in overweight\/obese polycystic ovary syndrome","volume":"87","author":"Liu","year":"2017","journal-title":"Clin. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"975","DOI":"10.2147\/PPA.S82866","article-title":"Mode of administration of dulaglutide: Implications for treatment adherence","volume":"10","author":"Amblee","year":"2016","journal-title":"Patient Prefer. Adherence"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1093\/humrep\/deh098","article-title":"Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)","volume":"19","author":"Eleni","year":"2004","journal-title":"Hum. Reprod."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med., 346, 393\u2013403.","DOI":"10.1056\/NEJMoa012512"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1111\/j.1572-0241.2005.41334.x","article-title":"One-Year Intense Nutritional Counseling Results in Histological Improvement in Patients with Nonalcoholic Steatohepatitis: A Pilot Study","volume":"100","author":"Huang","year":"2005","journal-title":"Am. J. Gastroenterol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S76","DOI":"10.1161\/01.cir.0000437740.48606.d1","article-title":"2013 AHA\/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Eckel","year":"2014","journal-title":"Circulation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and \u03b2-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.2337\/dc18-1935","article-title":"Changes in Visceral and Subcutaneous Fat in Youth with Type 2 Diabetes in the Today Study","volume":"42","author":"Dhaliwal","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1007\/s00125-019-05065-8","article-title":"Effects of once-weekly semaglutide vs once-daily canagliflozin on body composition in type 2 diabetes: A substudy of the SUSTAIN 8 randomised controlled clinical trial","volume":"63","author":"McCrimmon","year":"2020","journal-title":"Diabetologia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1002\/oby.20424","article-title":"Assessment of Abdominal Fat Compartments Using DXA in Premenopausal Women from Anorexia Nervosa to Morbid Obesity: DXA for Assessment of Abdominal Fat","volume":"21","author":"Bredella","year":"2013","journal-title":"Obesity"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Panizza, C.E., Lim, U., Yonemori, K.M., Cassel, K.D., Wilkens, L.R., Harvie, M.N., Maskarinec, G., Delp, E.J., Lampe, J.W., and Shepherd, J.A. (2019). Effects of Intermittent Energy Restriction Combined with a Mediterranean Diet on Reducing Visceral Adiposity: A Randomized Active Comparator Pilot Study. Nutrients, 11.","DOI":"10.3390\/nu11061386"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.rbmo.2017.03.023","article-title":"Effects of liraglutide on ovarian dysfunction in polycystic ovary syndrome: A randomized clinical trial","volume":"35","author":"Nylander","year":"2017","journal-title":"Reprod. Biomed. Online"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.2337\/dc17-0589","article-title":"Effects of Liraglutide on Weight Loss, Fat Distribution, and \u03b2-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes","volume":"40","author":"Santilli","year":"2017","journal-title":"Diabetes Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1249\/MSS.0000000000001074","article-title":"Effects of Weight Loss on Lean Mass, Strength, Bone, and Aerobic Capacity","volume":"49","author":"Weiss","year":"2017","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"213","DOI":"10.17306\/J.AFS.2016.2.21","article-title":"The effects of a low-calorie diet or an isocaloric diet combined with metformin on sex hormones in obese women of child-bearing age","volume":"15","author":"Suliburska","year":"2016","journal-title":"Acta Sci. Pol. Technol. Aliment."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jpag.2015.01.002","article-title":"Effect of Dietary Weight Loss on Menstrual Regularity in Obese Young Adult Women with Polycystic Ovary Syndrome","volume":"28","author":"Marzouk","year":"2015","journal-title":"J. Pediatr. Adolesc. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1093\/ajcn\/nqy196","article-title":"Effects of intermittent and continuous calorie restriction on body weight and metabolism over 50 wk: A randomized controlled trial","volume":"108","author":"Sookthai","year":"2018","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1056\/NEJMoa2114833","article-title":"Calorie Restriction with or without Time-Restricted Eating in Weight Loss","volume":"386","author":"Liu","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1210\/jc.2006-2184","article-title":"Effect of Calorie Restriction with or without Exercise on Body Composition and Fat Distribution","volume":"92","author":"Redman","year":"2007","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1016\/j.numecd.2009.04.007","article-title":"Short term effects of energy restriction and dietary fat sub-type on weight loss and disease risk factors","volume":"20","author":"Tapsell","year":"2010","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Jensterle, M., Kravos, N.A., Gori\u010dar, K., and Janez, A. (2017). Short-term effectiveness of low dose liraglutide in combination with metformin versus high dose liraglutide alone in treatment of obese PCOS: Randomized trial. BMC Endocr. Disord., 17.","DOI":"10.1186\/s12902-017-0155-9"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1186\/s12933-020-01148-8","article-title":"Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: A multi-institutional cohort study and meta-analysis","volume":"19","author":"Chang","year":"2020","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1161\/HYPERTENSIONAHA.114.03062","article-title":"Effects of the Once-Weekly Glucagon-Like Peptide-1 Receptor Agonist Dulaglutide on Ambulatory Blood Pressure and Heart Rate in Patients with Type 2 Diabetes Mellitus","volume":"64","author":"Ferdinand","year":"2014","journal-title":"Hypertension"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/S2213-8587(19)30151-2","article-title":"2 years of calorie restriction and cardiometabolic risk (CALERIE): Exploratory outcomes of a multicentre, phase 2, randomised controlled trial","volume":"7","author":"Kraus","year":"2019","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1080\/00015458.2018.1479022","article-title":"Lipid profile change after bariatric surgeries: Laparoscopic gastric plication versus mini gastric bypass","volume":"119","author":"Bagheri","year":"2018","journal-title":"Acta Chir. Belg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"778","DOI":"10.7326\/0003-4819-140-10-200405180-00007","article-title":"The Effects of Low-Carbohydrate versus Conventional Weight Loss Diets in Severely Obese Adults: One-Year Follow-up of a Randomized Trial","volume":"140","author":"Stern","year":"2004","journal-title":"Ann. Intern. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1111\/hepr.12837","article-title":"Effect of 12-week dulaglutide therapy in Japanese patients with biopsy-proven non-alcoholic fatty liver disease and type 2 diabetes mellitus","volume":"47","author":"Seko","year":"2017","journal-title":"Hepatol. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1007\/s00125-020-05265-7","article-title":"Effect of dulaglutide on liver fat in patients with type 2 diabetes and NAFLD: Randomised controlled trial (D-LIFT trial)","volume":"63","author":"Kuchay","year":"2020","journal-title":"Diabetologia"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"607","DOI":"10.3389\/fendo.2020.00607","article-title":"Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients with Obesity","volume":"11","author":"Cunha","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s40618-017-0785-9","article-title":"The effect of vitamin D supplementation in combination with low-calorie diet on anthropometric indices and androgen hormones in women with polycystic ovary syndrome: A double-blind, randomized, placebo-controlled trial","volume":"41","author":"Ahangari","year":"2018","journal-title":"J. Endocrinol. Investig."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/S0140-6736(14)60976-4","article-title":"Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): A randomised, open-label, phase 3, non-inferiority trial","volume":"384","author":"Dungan","year":"2014","journal-title":"Lancet"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1007\/s13300-020-00869-z","article-title":"Evaluation of Characteristics of Gastrointestinal Adverse Events with Once-Weekly Dulaglutide Treatment in Chinese Patients with Type 2 Diabetes: A Post Hoc Pooled Analysis of Two Randomized Trials","volume":"11","author":"Guo","year":"2020","journal-title":"Diabetes Ther."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2210","DOI":"10.1111\/dom.13353","article-title":"Semaglutide induces weight loss in subjects with type 2 diabetes regardless of baseline BMI or gastrointestinal adverse events in the SUSTAIN 1 to 5 trials","volume":"20","author":"Atkin","year":"2018","journal-title":"Diabetes Obes. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.numecd.2018.03.009","article-title":"Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial","volume":"28","author":"Svendsen","year":"2018","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Keenan, S., Cooke, M.B., Chen, W.S., Wu, S., and Belski, R. (2022). The Effects of Intermittent Fasting and Continuous Energy Restriction with Exercise on Cardiometabolic Biomarkers, Dietary Compliance, and Perceived Hunger and Mood: Secondary Outcomes of a Randomised, Controlled Trial. Nutrients, 14.","DOI":"10.3390\/nu14153071"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1038\/oby.2011.367","article-title":"Dual-Energy X-Ray Performs as Well as Clinical Computed Tomography for the Measurement of Visceral Fat","volume":"20","author":"Micklesfield","year":"2012","journal-title":"Obesity"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/0284185117711475","article-title":"Quantification of visceral adipose tissue in polycystic ovary syndrome: Dual-energy X-ray absorptiometry versus magnetic resonance imaging","volume":"59","author":"Nylander","year":"2018","journal-title":"Acta Radiol."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/3\/556\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:12:25Z","timestamp":1760119945000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/3\/556"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,20]]},"references-count":52,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["nu15030556"],"URL":"https:\/\/doi.org\/10.3390\/nu15030556","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,20]]}}}