{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T07:43:31Z","timestamp":1772610211691,"version":"3.50.1"},"reference-count":109,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Over the last two decades, glucagon-like peptide-1 (GLP-1) receptor agonists have dramatically improved the management of type 2 diabetes mellitus and obesity. Currently, little is known about the use of semaglutide (a second-generation GLP-1 receptor agonist) in patients with X chromosome abnormalities. Herein, we describe the therapeutic use of semaglutide in a woman with a partial deletion of the X chromosome long arm (partial Xq deletion) and comorbid obesity. We also conducted a narrative mini-review on overweight, obesity and common metabolic derangements in patients with partial Xq deletions and Turner syndrome. Case Presentation: A 65-year-old Italian woman with a partial Xq deletion, class 1 obesity, insulin resistance, prediabetes, hypercholesterolemia and metabolic dysfunction-associated steatotic liver disease (MASLD) was referred to our Institution for persistent difficulty in managing excess body weight despite regular adherence to different structured physical activity programs and hypocaloric diets. Therefore, we prescribed a combination therapy based on low-dose metformin (500 mg\/day) and once-weekly subcutaneous semaglutide (as an adjunct to lifestyle intervention). At 5 months after initiation of the combination therapy, blood tests showed metabolic improvements, including improvement of prediabetes (0.3-percentage-point reduction in glycated hemoglobin [HbA1c] values) and normalization of markers of insulin sensitivity and insulin resistance (QUICKI, HOMA-IR and TyG index). At 8 months, the patient showed substantial weight loss, which amounted to 13.8 kg (percent total body weight loss: 20.95%), and was accompanied by a notable reduction in waist circumference (\u221214.1 cm). Moreover, body mass index (BMI)-based weight status improved from class 1 obesity to overweight: BMI value of 25.1 kg\/m2 at 8 months vs. 31.8 kg\/m2 at baseline (near-normalization of BMI values). Bioelectrical impedance analysis (BIA) revealed that the patient\u2019s overall weight loss consisted of 74.6% fat mass (FM) loss (\u221210.3 kg) and 25.4% fat-free mass (FFM) loss (\u22123.5 kg). Despite the expected FFM reduction in absolute terms, percent FFM increased at 8 months (+9.6%). This increase in percent FFM was accompanied by a reduction in percent FM at 8 months (\u22129.6%), indicating an overall improvement in body composition. Normalization of percent FM and FFM values (28.6% and 71.4%, respectively) was also achieved at 8 months. These body composition changes are in line with those observed in clinical trials investigating the use of semaglutide in patients with overweight or obesity. At 6 months, an abdominal ultrasound also showed the disappearance of the sonographic characteristics suggestive of mild-to-moderate hepatic steatosis. Low-dose metformin (500 mg\/day) and subcutaneous semaglutide (up to a weekly dose of 1.7 mg) were well tolerated by the patient. Conclusions: To the best of our knowledge, this is the first case documenting the effective use of once-weekly subcutaneous semaglutide plus low-dose metformin combination therapy for the treatment of obesity and prediabetes in a woman with a partial Xq deletion. Large prospective cohort studies are warranted to better investigate the safety and efficacy profile of semaglutide (alone or in combination with metformin) in patients with numerical and structural X chromosome abnormalities, comorbid overweight\/obesity and related metabolic disorders.<\/jats:p>","DOI":"10.3390\/reports9010075","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:22:21Z","timestamp":1772551341000},"page":"75","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Semaglutide Plus Low-Dose Metformin Combination Therapy for the Treatment of Obesity and Prediabetes in a Woman with Partial Deletion of the X Chromosome Long Arm"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2943-7631","authenticated-orcid":false,"given":"Vincenzo","family":"Marzolla","sequence":"first","affiliation":[{"name":"Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4182-9942","authenticated-orcid":false,"given":"Stefania","family":"Gorini","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy"},{"name":"Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Open University, Via di Val Cannuta 247, 00166 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0722-7163","authenticated-orcid":false,"given":"Massimiliano","family":"Caprio","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy"},{"name":"Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Open University, Via di Val Cannuta 247, 00166 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2032-8735","authenticated-orcid":false,"given":"Marco","family":"Infante","sequence":"additional","affiliation":[{"name":"Section of Diabetes & Metabolic Disorders, Faculty of Medicine and Surgery, UniCamillus\u2014Saint Camillus International University of Health Sciences, Via di Sant\u2019Alessandro 8, 00131 Rome, Italy"},{"name":"Cell Transplant Center, Diabetes Research Institute (DRI), Division of Cellular Transplantation, Department of Surgery, University of Miami Miller School of Medicine, 1450 NW 10th Ave., Miami, FL 33136, USA"},{"name":"Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Endocrinology, Diabetes and Obesity Outpatient Clinic, Via Cola di Rienzo 28, 00192 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1007\/s00125-023-05906-7","article-title":"The expanding incretin universe: From basic biology to clinical translation","volume":"66","author":"Drucker","year":"2023","journal-title":"Diabetologia"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1124\/pr.108.000604","article-title":"The role of incretins in glucose homeostasis and diabetes treatment","volume":"60","author":"Kim","year":"2008","journal-title":"Pharmacol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/cei.12781","article-title":"Cut to the chase: A review of CD26\/dipeptidyl peptidase-4\u2019s (DPP4) entanglement in the immune system","volume":"185","author":"Klemann","year":"2016","journal-title":"Clin. Exp. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1093\/ndt\/gfaf177","article-title":"IDF diabetes atlas 11th edition 2025: Global prevalence and projections for 2050","volume":"41","author":"Duncan","year":"2026","journal-title":"Nephrol. Dial. Transplant"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/S2213-8587(25)00299-2","article-title":"11th edition of the IDF Diabetes Atlas: Global, regional, and national diabetes prevalence estimates for 2024 and projections for 2050","volume":"14","author":"Genitsaridi","year":"2026","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"GBD 2021 Adult BMI Collaborators (2025). Global, regional, and national prevalence of adult overweight and obesity, 1990-2021, with forecasts to 2050: A forecasting study for the Global Burden of Disease Study 2021. Lancet, 405, 813\u2013838. Erratum in Lancet 2025, 406, 810. https:\/\/doi.org\/10.1016\/S0140-6736(25)01722-2.","DOI":"10.1016\/S0140-6736(25)01722-2"},{"key":"ref_7","unstructured":"Kommu, S., and Whitfield, P. (2026, February 21). Semaglutide, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK603723\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"14514","DOI":"10.3390\/cimb46120872","article-title":"Spotlight on the Mechanism of Action of Semaglutide","volume":"46","author":"Papakonstantinou","year":"2024","journal-title":"Curr. Issues Mol. Biol."},{"key":"ref_9","unstructured":"European Medicines Agency (EMA) (2026, February 21). Summary of Product Characteristics (SmPC)\u2014Wegovy (Semaglutide). Available online: https:\/\/www.ema.europa.eu\/en\/documents\/product-information\/wegovy-epar-product-information_en.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"q642","DOI":"10.1136\/bmj.q642","article-title":"Wegovy: FDA approves weight loss drug to cut cardiovascular risk","volume":"384","author":"Tanne","year":"2024","journal-title":"BMJ"},{"key":"ref_11","first-page":"1971","article-title":"FDA Approves GLP-1 Pill for Cardiovascular Risk in Type 2 Diabetes","volume":"334","author":"Pant","year":"2025","journal-title":"JAMA"},{"key":"ref_12","first-page":"1109","article-title":"FDA Approves Semaglutide to Reduce Risk of Kidney Disease Progression","volume":"333","author":"Anderer","year":"2025","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"(2025). Wegovy approved for MASH. Nat. Biotechnol., 43, 1404.","DOI":"10.1038\/s41587-025-02828-0"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11892-024-01539-1","article-title":"Metformin: Past, Present, and Future","volume":"24","author":"Chaudhary","year":"2024","journal-title":"Curr. Diabetes Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1007\/s00125-017-4342-z","article-title":"The mechanisms of action of metformin","volume":"60","author":"Rena","year":"2017","journal-title":"Diabetologia"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/dom.12812","article-title":"Metformin reduces the rate of small intestinal glucose absorption in type 2 diabetes","volume":"19","author":"Wu","year":"2017","journal-title":"Diabetes Obes. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 3. Prevention or Delay of Diabetes and Associated Comorbidities: Standards of Care in Diabetes-2026. Diabetes Care, 49, S50\u2013S60.","DOI":"10.2337\/dc26-S003"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"190","DOI":"10.2174\/138920211795677930","article-title":"Structural Chromosome Abnormalities Associated with Obesity: Report of Four New subjects and Review of Literature","volume":"12","author":"Dasouki","year":"2011","journal-title":"Curr. Genom."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1542\/peds.45.4.656","article-title":"Genetic and clinical considerations of long-arm deletion of the X chromosome","volume":"45","author":"Hsu","year":"1970","journal-title":"Pediatrics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/(SICI)1096-8628(19980226)76:1<45::AID-AJMG8>3.0.CO;2-O","article-title":"Characterization of a supernumerary small marker X chromosome in two females with similar phenotypes","volume":"76","author":"Wolff","year":"1998","journal-title":"Am. J. Med. Genet."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1002\/(SICI)1096-8628(19981116)80:3<227::AID-AJMG10>3.0.CO;2-Q","article-title":"Prader-Willi-like syndrome in a patient with an Xq23q25 duplication","volume":"80","author":"Monaghan","year":"1998","journal-title":"Am. J. Med. Genet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1002\/ajmg.a.32070","article-title":"Characterization of interstitial Xp duplications in two families by tiling path array CGH","volume":"146","author":"Tzschach","year":"2008","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/j.1399-0004.2007.00960.x","article-title":"Prader-Willi syndrome phenocopy due to duplication of Xq21.1-q21.31, with array CGH of the critical region","volume":"73","author":"Gabbett","year":"2008","journal-title":"Clin. Genet."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1002\/ajmg.a.20129","article-title":"De novo paracentric inversion (X)(q26q28) with features mimicking Prader-Willi syndrome","volume":"121","author":"Florez","year":"2003","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1159\/000084206","article-title":"Inherited pericentric inversion (X)(p11.4q11.2) associated with delayed puberty and obesity in two brothers","volume":"109","author":"Talaban","year":"2005","journal-title":"Cytogenet. Genome Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/j.1469-8749.2007.00219.x","article-title":"Bilateral periventricular nodular heterotopia, severe learning disability, and epilepsy in a male patient with 46,XY,der(19)t(X;19) (q11.1-11.2;p13.3)","volume":"49","author":"Balci","year":"2007","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.37765\/ajmc.2025.89778","article-title":"Trends in glucagon-like peptide 1 receptor agonist prescribing patterns","volume":"31","author":"Ukhanova","year":"2025","journal-title":"Am. J. Manag. Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e2540890","DOI":"10.1001\/jamanetworkopen.2025.40890","article-title":"Prescribing Trends of Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes or Obesity","volume":"8","author":"Li","year":"2025","journal-title":"JAMA Netw. Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1007\/s00228-025-03823-9","article-title":"Prescribing patterns of glucagon-like peptide-1 receptor agonists in the Swedish capital region-a register-based cross-sectional study","volume":"81","author":"Fors","year":"2025","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1038\/ejcn.2016.109","article-title":"Clinical anthropometrics and body composition from 3D whole-body surface scans","volume":"70","author":"Ng","year":"2016","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1002\/osp4.467","article-title":"Digital anthropometry for body circumference measurements: Toward the development of universal three-dimensional optical system analysis software","volume":"7","author":"Sobhiyeh","year":"2021","journal-title":"Obes. Sci. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1152\/jappl.2000.89.2.465","article-title":"Estimation of skeletal muscle mass by bioelectrical impedance analysis","volume":"89","author":"Janssen","year":"2000","journal-title":"J. Appl. Physiol. (1985)"},{"key":"ref_33","unstructured":"Zierle-Ghosh, A., and Jan, A. (2026, February 21). Physiology, Body Mass Index, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK535456\/."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.eprac.2025.07.017","article-title":"American Association of Clinical Endocrinology Consensus Statement: Algorithm for the Evaluation and Treatment of Adults with Obesity\/Adiposity-Based Chronic Disease\u20142025 Update","volume":"31","author":"Nadolsky","year":"2025","journal-title":"Endocr. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1016\/j.jacc.2025.05.008","article-title":"2025 ACC Scientific Statement on the Management of Obesity in Adults with Heart Failure: A Report of the American College of Cardiology","volume":"86","author":"Kittleson","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee for Diabetes (2026). 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes-2026. Diabetes Care, 49, S27\u2013S49.","DOI":"10.2337\/dc26-S002"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"210","DOI":"10.2337\/dc10-0665","article-title":"Prevalence, metabolic features, and prognosis of metabolically healthy obese Italian individuals: The Cremona Study","volume":"34","author":"Calori","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3320","DOI":"10.2337\/diacare.26.12.3320","article-title":"Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism","volume":"26","author":"Ascaso","year":"2003","journal-title":"Diabetes Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.12688\/f1000research.12170.1","article-title":"Optimal cutoff for the evaluation of insulin resistance through triglyceride-glucose index: A cross-sectional study in a Venezuelan population","volume":"6","author":"Salazar","year":"2017","journal-title":"F1000Res"},{"key":"ref_40","unstructured":"Kaur, J., Khare, S., Sizar, O., and Givler, A. (2026, February 21). Vitamin D Deficiency, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK532266\/."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin. Chem."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1093\/jalm\/jfad047","article-title":"The CKD-EPI 2021 Equation and Other Creatinine-Based Race-Independent eGFR Equations in Chronic Kidney Disease Diagnosis and Staging","volume":"8","author":"Lu","year":"2023","journal-title":"J. Appl. Lab. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.ahj.2022.10.025","article-title":"Side Effect Synergism Between Metformin and GLP-1 Receptor Agonists","volume":"254","author":"Cristiano","year":"2022","journal-title":"Am. Heart J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/dom.12854","article-title":"Understanding and overcoming metformin gastrointestinal intolerance","volume":"19","author":"Bonnet","year":"2017","journal-title":"Diabetes Obes. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Nabrdalik, K., Hendel, M., Irlik, K., Kwiendacz, H., \u0141oniewski, I., Bucci, T., Alam, U., Lip, G.Y.H., Gumprecht, J., and Skonieczna-\u017bydecka, K. (2024). Gastrointestinal adverse events of metformin treatment in patients with type 2 diabetes mellitus: A systematic review and meta-analysis with meta-regression of observational studies. BMC Endocr. Disord., 24.","DOI":"10.1186\/s12902-024-01727-w"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1038\/s41366-025-01859-6","article-title":"Gastrointestinal adverse events associated with GLP-1 RA in non-diabetic patients with overweight or obesity: A systematic review and network meta-analysis","volume":"49","author":"Ismaiel","year":"2025","journal-title":"Int. J. Obes."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"104486","DOI":"10.1016\/j.cdnut.2024.104486","article-title":"Sculpting Success: The Importance of Diet and Physical Activity to Support Skeletal Muscle Health during Weight Loss with New Generation Anti-Obesity Medications","volume":"8","author":"Grosicki","year":"2024","journal-title":"Curr. Dev. Nutr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e285","DOI":"10.1016\/j.jacc.2018.11.003","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"73","author":"Grundy","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1016\/S0140-6736(19)32519-X","article-title":"Application of non-HDL cholesterol for population-based cardiovascular risk stratification: Results from the Multinational Cardiovascular Risk Consortium","volume":"394","author":"Brunner","year":"2019","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"916","DOI":"10.4239\/wjd.v12.i7.916","article-title":"Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind","volume":"12","author":"Infante","year":"2021","journal-title":"World J. Diabetes"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1210\/jc.2015-3754","article-title":"Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study","volume":"101","author":"Aroda","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_52","unstructured":"Son, P., and Lewis, L. (2026, February 21). Hyperhomocysteinemia, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554408\/."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.dld.2006.03.021","article-title":"The role of bright liver echo pattern on ultrasound B-mode examination in the diagnosis of liver steatosis","volume":"38","author":"Palmentieri","year":"2006","journal-title":"Dig. Liver Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3348\/kjr.2025.0966","article-title":"Imaging Evaluation for Steatotic Liver Disease","volume":"27","author":"Chan","year":"2026","journal-title":"Korean J. Radiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/S0899-9007(01)00555-X","article-title":"Fat-free and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years","volume":"17","author":"Kyle","year":"2001","journal-title":"Nutrition"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/1755-8166-6-62","article-title":"Molecular cytogenetic analysis of Xq critical regions in premature ovarian failure","volume":"6","author":"Beke","year":"2013","journal-title":"Mol. Cytogenet."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1007\/s004390000364","article-title":"Molecular definition of Xq common-deleted region in patients affected by premature ovarian failure","volume":"107","author":"Marozzi","year":"2000","journal-title":"Hum. Genet."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2329","DOI":"10.1093\/humrep\/del174","article-title":"Molecular cytogenetic studies of Xq critical regions in premature ovarian failure patients","volume":"21","author":"Aboura","year":"2006","journal-title":"Hum. Reprod."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"240","DOI":"10.3390\/endocrines3020022","article-title":"Turner Syndrome","volume":"3","author":"Clemente","year":"2022","journal-title":"Endocrines"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"335","DOI":"10.4103\/ijem.ijem_22_23","article-title":"Prevalence and Predictors of Prediabetes in Adolescents and Young Adults with Turner Syndrome: A Cross-Sectional Study from Eastern India","volume":"27","author":"Mondal","year":"2023","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1002\/ca.22727","article-title":"Anatomy of turner syndrome","volume":"29","author":"Granger","year":"2016","journal-title":"Clin. Anat."},{"key":"ref_62","unstructured":"Sharma, L., and Shankar Kikkeri, N. (2026, February 21). Turner Syndrome, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554621\/."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1055\/s-0043-1770982","article-title":"Chromosomal Abnormalities of Interest in Turner Syndrome: An Update","volume":"12","year":"2023","journal-title":"J. Pediatr. Genet."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejmg.2012.08.012","article-title":"Detailed clinical and molecular study of 20 females with Xq deletions with special reference to menstruation and fertility","volume":"56","author":"Mercer","year":"2013","journal-title":"Eur. J. Med. Genet."},{"key":"ref_65","first-page":"222","article-title":"Turner syndrome with partial deletion of the X chromosome long arm","volume":"126","author":"Lippe","year":"1973","journal-title":"Am. J. Dis. Child."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/BF00273288","article-title":"Partial long arm deletion of one X chromosome in a patient with secondary amenorrhea","volume":"48","author":"Ruthner","year":"1979","journal-title":"Hum. Genet."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Huang, A.C., Olson, S.B., and Maslen, C.L. (2021). A Review of Recent Developments in Turner Syndrome Research. J. Cardiovasc. Dev. Dis., 8.","DOI":"10.3390\/jcdd8110138"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41574-019-0224-4","article-title":"Turner syndrome: Mechanisms and management","volume":"15","author":"Gravholt","year":"2019","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s004670000315","article-title":"Frequency of renal malformations in Turner syndrome: Analysis of 82 Turkish children","volume":"14","author":"Bilge","year":"2000","journal-title":"Pediatr. Nephrol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1034\/j.1399-0004.1999.560606.x","article-title":"Molecular genetics of Turner syndrome: Correlation with clinical phenotype and response to growth hormone therapy","volume":"56","author":"Tsezou","year":"1999","journal-title":"Clin. Genet."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1046\/j.1365-2265.1998.00552.x","article-title":"The impact of obesity on cardiovascular risk factors in Turner\u2019s syndrome","volume":"49","author":"Elsheikh","year":"1998","journal-title":"Clin. Endocrinol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1210\/jc.2004-1939","article-title":"Excess visceral and hepatic adipose tissue in Turner syndrome determined by magnetic resonance imaging: Estrogen deficiency associated with hepatic adipose content","volume":"90","author":"Ostberg","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1111\/liv.12007","article-title":"Liver involvement in Turner syndrome","volume":"33","author":"Roulot","year":"2013","journal-title":"Liver Int."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1507\/endocrj.EJ15-0288","article-title":"Women with Turner syndrome are at high risk of lifestyle-related disease\u2014From questionnaire surveys by the Foundation for Growth Science in Japan","volume":"63","author":"Hanew","year":"2016","journal-title":"Endocr. J."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.eprac.2023.11.013","article-title":"Abnormal Body Composition Increases the Cardiometabolic Risk in Adolescents and Young Adults with Turner Syndrome","volume":"30","author":"Mondal","year":"2024","journal-title":"Endocr. Pract."},{"key":"ref_76","doi-asserted-by":"crossref","unstructured":"Pinnaro, C.T., Zimmerman, B.I., Ryckman, K.K., Darbro, B.W., and Norris, A.W. (2024). The Influence of X Chromosome Parent-of-Origin on Glycemia in Individuals with Turner Syndrome. Horm. Res. Paediatr., 1\u20139.","DOI":"10.1159\/000542677"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1210\/clinem\/dgae357","article-title":"Characterization of Turner Syndrome-associated Diabetes Mellitus","volume":"110","author":"Davies","year":"2025","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1210\/jcem-72-4-832","article-title":"Insulin resistance: An early metabolic defect of Turner\u2019s syndrome","volume":"72","author":"Caprio","year":"1991","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000520233","article-title":"Increased Prevalence of Beta-Cell Dysfunction despite Normal HbA1c in Youth and Young Adults with Turner Syndrome","volume":"94","author":"Sheanon","year":"2021","journal-title":"Horm. Res. Paediatr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"e901","DOI":"10.1210\/clinem\/dgae435","article-title":"Turner\u2019s Syndrome, Glucagon-like Peptide 1, and Glucose-dependent Insulinotropic Polypeptide Agents: Silver Bullets?","volume":"110","author":"Glueck","year":"2025","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e000048","DOI":"10.1161\/HCG.0000000000000048","article-title":"Cardiovascular Health in Turner Syndrome: A Scientific Statement from the American Heart Association","volume":"11","author":"Silberbach","year":"2018","journal-title":"Circ. Genom. Precis. Med."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Bugajska, J., Berska, J., W\u00f3jcik, M., Starzyk, J.B., and Sztefko, K. (2020). Metabolic Fingerprint of Turner Syndrome. J. Clin. Med., 9.","DOI":"10.3390\/jcm9030664"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/s41574-019-0310-7","article-title":"Waist circumference as a vital sign in clinical practice: A Consensus Statement from the IAS and ICCR Working Group on Visceral Obesity","volume":"16","author":"Ross","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1172\/JCI111040","article-title":"Impact of obesity on metabolism in men and women. Importance of regional adipose tissue distribution","volume":"72","author":"Krotkiewski","year":"1983","journal-title":"J. Clin. Investig."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Swainson, M.G., Batterham, A.M., Tsakirides, C., Rutherford, Z.H., and Hind, K. (2017). Prediction of whole-body fat percentage and visceral adipose tissue mass from five anthropometric variables. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0177175"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-Weekly Semaglutide in Adults with Overweight or Obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1001\/jama.2021.23619","article-title":"Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults with Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial","volume":"327","author":"Rubino","year":"2022","journal-title":"JAMA"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.2337\/dci23-0100","article-title":"Incretin-Based Weight Loss Pharmacotherapy: Can Resistance Exercise Optimize Changes in Body Composition?","volume":"47","author":"Locatelli","year":"2024","journal-title":"Diabetes Care"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1080\/14656566.2024.2343092","article-title":"A systematic review of the effect of semaglutide on lean mass: Insights from clinical trials","volume":"25","author":"Bikou","year":"2024","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/dom.70141","article-title":"Impact of Semaglutide on fat mass, lean mass and muscle function in patients with obesity: The SEMALEAN study","volume":"28","author":"Alissou","year":"2026","journal-title":"Diabetes Obes. Metab."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1111\/dom.15728","article-title":"Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies","volume":"26","author":"Neeland","year":"2024","journal-title":"Diabetes Obes. Metab."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"147","DOI":"10.2337\/dc25-1031","article-title":"Sodium-Glucose Cotransporter 2 Inhibitors, Glucagon-Like Peptide 1 Receptor Agonists, and Frailty Progression in Older Adults with Type 2 Diabetes","volume":"49","author":"Park","year":"2026","journal-title":"Diabetes Care"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"A16","DOI":"10.1210\/jendso\/bvab048.030","article-title":"Impact of Semaglutide on Body Composition in Adults with Overweight or Obesity: Exploratory Analysis of the STEP 1 Study","volume":"5","author":"Wilding","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1007\/s00592-025-02468-5","article-title":"Effect of GLP-1 receptor agonists on bone mineral density, bone metabolism markers, and fracture risk in type 2 diabetes: A systematic review and meta-analysis","volume":"62","author":"Tan","year":"2025","journal-title":"Acta Diabetol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"20420188231222367","DOI":"10.1177\/20420188231222367","article-title":"Anti-inflammatory role of glucagon-like peptide 1 receptor agonists and its clinical implications","volume":"15","author":"Alharbi","year":"2024","journal-title":"Ther. Adv. Endocrinol. Metab."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1111\/dom.14399","article-title":"Glucagon-like peptide-1 receptor agonists improve biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomised controlled trials","volume":"23","author":"Bray","year":"2021","journal-title":"Diabetes Obes. Metab."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Caballero-Mateos, I., Morales-Portillo, C., and Gonz\u00e1lez Aguilera, B. (2025). Once-Weekly Semaglutide Improves Body Composition in Spanish Obese Adults with Type 2 Diabetes: A 48-Week Prospective Real-Life Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14155434"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1093\/ajcn\/82.1.49","article-title":"Bioelectrical impedance analysis: Population reference values for phase angle by age and sex","volume":"82","author":"Barros","year":"2005","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"2536693","DOI":"10.1080\/15502783.2025.2536693","article-title":"Elevated extracellular water to total body water ratio and low phase angle in relation to muscle function in middle-aged and older adults","volume":"22","author":"Lai","year":"2025","journal-title":"J. Int. Soc. Sports Nutr."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"e15462","DOI":"10.1111\/dme.15462","article-title":"Clinical utility of liver function tests for resolution of metabolic dysfunction-associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial","volume":"42","author":"Zhyzhneuskaya","year":"2025","journal-title":"Diabet. Med."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"3545","DOI":"10.62347\/RYLN5360","article-title":"Efficacy and safety of semaglutide combined with metformin in treating T2DM with overweight or obesity: A systematic review and meta-analysis","volume":"16","author":"Li","year":"2024","journal-title":"Am. J. Transl. Res."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1530\/EJE-19-0156","article-title":"Effects of 6-month vitamin D supplementation on insulin sensitivity and secretion: A randomised, placebo-controlled trial","volume":"181","author":"Lemieux","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1210\/clinem\/dgae290","article-title":"Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline","volume":"109","author":"Demay","year":"2024","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Codella, R., Senesi, P., and Luzi, L. (2025). GLP-1 agonists and exercise: The future of lifestyle prioritization. Front. Clin. Diabetes Healthc., 6.","DOI":"10.3389\/fcdhc.2025.1720794"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1002\/oby.24336","article-title":"Nutritional priorities to support GLP-1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society","volume":"33","author":"Mozaffarian","year":"2025","journal-title":"Obesity"},{"key":"ref_106","first-page":"e94126","article-title":"Allodynia and Dysesthesia Associated with Semaglutide and Tirzepatide","volume":"17","author":"Ahern","year":"2025","journal-title":"Cureus"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.jaad.2024.03.021","article-title":"Dermatologic findings associated with semaglutide use: A scoping review","volume":"91","author":"Tran","year":"2024","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/S2213-8587(25)00226-8","article-title":"STEP UP Trial Group. Once-weekly semaglutide 7\u00b72 mg in adults with obesity (STEP UP): A randomised, controlled, phase 3b trial","volume":"13","author":"Wharton","year":"2025","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/S2213-8587(25)00225-6","article-title":"STEP UP T2D Trial Group. Once-weekly semaglutide 7\u00b72 mg in adults with obesity and type 2 diabetes (STEP UP T2D): A randomised, controlled, phase 3b trial","volume":"13","author":"Lingvay","year":"2025","journal-title":"Lancet Diabetes Endocrinol."}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/75\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T05:11:09Z","timestamp":1772601069000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/75"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,28]]},"references-count":109,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["reports9010075"],"URL":"https:\/\/doi.org\/10.3390\/reports9010075","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,28]]}}}